Association of the COVID-19 Pandemic With Unstable and/or Unsafe Living Situations and Intimate Partner Violence Among Pregnant Individuals.
Association of the COVID-19 Pandemic With Unstable and/or Unsafe Living Situations and Intimate Partner Violence Among Pregnant Individuals.
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DOI：
10.1001/jamanetworkopen.2023.0172
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发表时间：
2023-02-01
影响因子：
13.8
通讯作者：
Young-Wolff, Kelly C.
中科院分区：
文献类型：
--
作者：
Avalos, Lyndsay A.;Ray, G. Thomas;Alexeeff, Stacey E.;Adams, Sara R.;Does, Monique B.;Watson, Carey;Young-Wolff, Kelly C.
2019冠状病毒病大流行是否与孕妇不稳定和/或不安全的生活环境以及亲密伴侣暴力（IPV）的趋势有关？在这项对2019年1月1日至2020年12月31日期间发生的77310例妊娠（74663人）的横断面分析中，在大流行的第一个月，不稳定和/或不安全的生活状况增加了38%，在大流行的前两个月，IPV增加了101%。然而，在研究期间，不稳定和/或不安全的生活状况和IPV的总体增加趋势没有受到大流行的影响。这项研究的结果表明，IPV的保障措施，需要在流行病应急反应计划。COVID-19大流行的社会、行为和经济后果可能与怀孕个体中不稳定和/或不安全的生活环境以及亲密伴侣暴力（IPV）有关。调查COVID-19大流行之前和期间怀孕个体的不稳定和/或不安全生活状况和IPV趋势。在Kaiser Permanente北方加州成员中进行了一项基于横断面人群的中断时间序列分析，这些成员在2019年1月1日至2020年12月31日期间怀孕并接受了不稳定和/或不安全的生活状况和IPV筛查，作为标准产前护理的一部分。2019冠状病毒病疫情（疫情前：2019年1月1日至2020年3月31日;疫情期间：2020年4月1日至12月31日）。2个结局是不稳定和/或不安全的生活状况和IPV。数据来自电子健康记录。中断的时间序列模型进行拟合，并根据年龄、种族和民族进行调整。研究样本包括77 310例妊娠（74 663例个体）; 27.4%的个体为亚洲人或太平洋岛民，6.5%为黑人，29.0%为西班牙裔，32.3%为非西班牙裔白色，4.8%为其他/未知/多种族，平均（SD）年龄为30.9（5.3）岁。在24个月的研究期间，不安全和/或不稳定生活状况的标准化发生率（2.2%;率比[RR]，1.022; 95% CI，1.016-1.029/月）和IPV（4.9%; RR，1.049; 95% CI，1.021-1.078/月）呈上升趋势。ITS模型显示，在大流行的第一个月，不安全和/或不稳定的生活状况增加了38%（RR，1.38; 95%CI，1.13-1.69），之后恢复到研究期间的总体趋势。对于IPV，中断时间序列模型显示在大流行的前2个月增加了101%（RR，2.01; 95%CI，1.20-3.37）。这项横断面研究指出，在24个月期间，不稳定及╱或不安全的居住环境及IPV整体上升，暂时上升与COVID-19大流行有关。在应急计划中纳入IPV保障措施，以应对未来的流行病，这可能是有用的。这些研究结果表明，需要产前筛查不安全和/或不稳定的生活条件和IPV加上转介到适当的支持服务和预防干预措施。这项横断面研究比较了在COVID-19大流行之前与期间怀孕的个人中不稳定和/或不安全的生活环境以及亲密伴侣暴力的发生率。
Is there an association of the COVID-19 pandemic with trends in unstable and/or unsafe living situations and intimate partner violence (IPV) among pregnant individuals? In this cross-sectional analysis of 77 310 pregnancies (74 663 individuals) occurring between January 1, 2019, and December 31, 2020, there was a 38% increase in unstable and/or unsafe living situations in the first month of the pandemic and a 101% increase in IPV in the first 2 months of the pandemic. However, overall increasing trends in unstable and/or unsafe living situations and IPV over the study period were not affected by the pandemic. The findings of this study suggest that IPV safeguards are needed in pandemic emergency response plans. The social, behavioral, and economic consequences of the COVID-19 pandemic may be associated with unstable and/or unsafe living situations and intimate partner violence (IPV) among pregnant individuals. To investigate trends in unstable and/or unsafe living situations and IPV among pregnant individuals prior to and during the COVID-19 pandemic. A cross-sectional population-based interrupted time-series analysis was conducted among Kaiser Permanente Northern California members who were pregnant and screened for unstable and/or unsafe living situation and IPV as part of standard prenatal care between January 1, 2019, and December 31, 2020. COVID-19 pandemic (prepandemic period: January 1, 2019, to March 31, 2020; during pandemic period: April 1 to December 31, 2020). The 2 outcomes were unstable and/or unsafe living situations and IPV. Data were extracted from electronic health records. Interrupted time-series models were fit and adjusted for age and race and ethnicity. The study sample included 77 310 pregnancies (74 663 individuals); 27.4% of the individuals were Asian or Pacific Islander, 6.5% were Black, 29.0% were Hispanic, 32.3% were non-Hispanic White, and 4.8% were other/unknown/multiracial, with a mean (SD) age of 30.9 (5.3) years. Across the 24-month study period there was an increasing trend in the standardized rate of unsafe and/or unstable living situations (2.2%; rate ratio [RR], 1.022; 95% CI, 1.016-1.029 per month) and IPV (4.9%; RR, 1.049; 95% CI, 1.021-1.078 per month). The ITS model indicated a 38% increase (RR, 1.38; 95% CI, 1.13-1.69) in the first month of the pandemic for unsafe and/or unstable living situation, with a return to the overall trend afterward for the study period. For IPV, the interrupted time-series model suggested an increase of 101% (RR, 2.01; 95% CI, 1.20-3.37) in the first 2 months of the pandemic. This cross-sectional study noted an overall increase in unstable and/or unsafe living situations and IPV over the 24-month period, with a temporary increase associated with the COVID-19 pandemic. It may be useful for emergency response plans to include IPV safeguards for future pandemics. These findings suggest the need for prenatal screening for unsafe and/or unstable living situations and IPV coupled with referral to appropriate support services and preventive interventions. This cross-sectional study compares the rates of unstable and/or unsafe living situations and intimate partner violence in individuals who were pregnant before vs during the COVID-19 pandemic.
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