Intimate Partner Violence and Gestational Weight Gain in a Population-Based Sample of Perinatal Women.
Intimate Partner Violence and Gestational Weight Gain in a Population-Based Sample of Perinatal Women.
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DOI：
10.1016/j.jogn.2016.12.003
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发表时间：
2017-05
期刊：
影响因子：
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通讯作者：
Siega-Riz AM
中科院分区：
文献类型：
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作者：
Alhusen JL;Geller R;Dreisbach C;Constantoulakis L;Siega-Riz AM
目的探讨围产期不同时间点亲密伴侣暴力（IPV）对妊娠期体重增加不足和过度的影响。采用基于人群的次要数据的回顾性队列研究。怀孕风险评估监测系统和出生证明数据，包括纽约市和35个州。该研究获得了2004-2011年间生育的251,342名美国母亲的数据，这些母亲在出生后2-9个月完成了妊娠风险评估监测系统调查。暴露是围产期IPV，定义为在怀孕前一年或怀孕期间遭受现任或前任伴侣的身体虐待。妊娠期体重增加充足性（GWG）分类使用2009年医学研究所指南。采用加权描述性统计和多元逻辑回归模型。大约6%的参与者报告围产期IPV， 2.7%的参与者在怀孕前一年报告IPV， 1.1%的参与者仅在怀孕期间报告IPV，其余2.5%的参与者在怀孕前和怀孕期间报告IPV。GWG不足在怀孕期间经历IPV的参与者以及怀孕前和怀孕期间经历IPV的参与者中（分别为23.3%和23.5%）比没有IPV的参与者（20.2%,P < 0.001）更为普遍。仅在怀孕前经历IPV的参与者更有可能出现GWG过高（P < 0.001）。结果在多元模型中被减弱；只有在怀孕前经历过IPV的参与者有微弱的显著的GWG过量的几率（aOR 1.14, 95% CI 1.02-1.26）。围产期IPV与GWG不足之间的关系可以通过混淆变量来解释；然而，报告围产期IPV的妇女在最佳范围外的GWG率较高。未来的研究需要确定相关的混杂变量如何影响女性妊娠期体重增加。通过更好地了解亲密伴侣暴力与妊娠期体重增加之间的关系，可以制定干预措施，促进孕产妇和儿童健康。
To examine the effects of intimate partner violence (IPV) at varied time points in the perinatal period on inadequate and excessive gestational weight gain. Retrospective cohort using population-based secondary data. Pregnancy Risk Assessment Monitoring System and birth certificate data, including New York City and 35 states. Data were obtained for 251,342 U.S. mothers who gave birth from 2004–2011 and completed the Pregnancy Risk Assessment Monitoring System survey 2–9 months after birth. The exposure was perinatal IPV, defined as experiencing physical abuse by a current or ex-partner in the year before or during pregnancy. Adequacy of gestational weight gain (GWG) was categorized using 2009 Institute of Medicine guidelines. Weighted descriptive statistics and multivariate logistic regression models were used. Approximately 6% of participants reported perinatal IPV, 2.7% of participants reported IPV in the year before pregnancy, 1.1% reported IPV during pregnancy only, and the remaining 2.5% reported IPV before and during pregnancy. Inadequate GWG was more prevalent among participants who experienced IPV during pregnancy and those who experienced IPV before and during pregnancy (23.3% and 23.5%, respectively) than in participants who reported no IPV (20.2%; P < 0.001). Participants who experienced IPV before pregnancy only were significantly more likely to have excessive GWG (P < 0.001). Results were attenuated in the multivariate modeling; only participants who experienced IPV before pregnancy had weakly significant odds of excessive GWG (aOR 1.14, 95% CI 1.02–1.26). The association between perinatal IPV with inadequate GWG was explained by confounding variables; however, women who reported perinatal IPV had higher rates of GWG outside of the optimal range. Future studies are needed to determine how relevant confounding variables may affect a woman’s gestational weight gain. Through a greater understanding of the relationship between intimate partner violence and gestational weight gain, interventions can be developed to promote maternal and child health.