VIOLENCE AND SPONTANEOUS ABORTION IN INNER CITY WOMEN

描述：(改编自《调查者摘要》)自然流产 (SAB)是怀孕最常见的不良后果，暴力可能是 在城市低收入妇女中最普遍的生殖风险因素。 本申请的具体目的是：1)描述 怀孕早期妇女遭受暴力的流行率和类型；2) 评估怀孕期间的暴力是否是一个重要的独立风险 SAB的因素；3)评估是否出现的频率、性质或时机 暴力影响SAB的风险；以及4)产生以下假设 针对城市低收入孕妇的预防和干预方案。 来自明确的市中心社区的14-40岁参加 宾夕法尼亚大学急诊科(ED)医院将 接受怀孕筛查。病例将包括患有SAB或 随访期内发生SAB者(N=465)。控制将 包括所有继续宫内单胎妊娠的妇女 直到20周的孕周。标准化基线数据收集 将包括一次结构化的面谈，对头发的实验室分析 尿液中有可替宁、酒精和滥用药物。染色体分析 将对大约120例受孕产品进行 在HUP中止任务。后续电话采访将于16日和20日进行。 怀孕几周。妊娠结局状况也将通过以下方式确定 持续审查医疗记录、病理记录和出生证明。 初步分析将是探索性和描述性的、具有特征性的案例 以及现在或过去的暴力、年龄、药物滥用、社会 与世隔绝。主要的分析将是Logistic回归，有赔率 比率和95%的可信区间。调查人员将调查是否 暴力对自然流产的影响因染色体而异 胎儿的状态以及根据时间、频率和性质 暴力事件。最后，他们将描述使用模式的特征 保健和社会服务机构在怀孕早期受到虐待。 调查人员表示，这项研究的意义在于它 提供有关自然和环境卫生的基本流行病学数据的能力 对市中心怀孕妇女的暴力情况进行评估 暴力是自然流产的独立预测因素，最终 为设计有效的治疗和治疗方案提供重要信息 城市环境中的预防干预措施。

DESCRIPTION: (Adapted from Investigator's Abstract) Spontaneous abortion (SAB) is the most common adverse outcome of pregnancy, and violence may be the most prevalent reproductive risk factor among urban, low-income women. The specific aims of this application are to : 1) characterize the prevalence and type of violence experienced by women early in pregnancy; 2) evaluate whether violence during pregnancy is an important independent risk factor for SAB; 3) evaluate whether the frequency, nature, or timing of violence affects the risk of SAB; and 4) generate hypotheses regarding prevention and intervention programs for urban, low-income pregnant women. Women 14-40 years of age from a defined inner-city community who attend the Hospital of the University of Pennsylvania's Emergency Department (ED) will be screened for pregnancy. Cases will include women who present with SAB or who experience a SAB during the follow-up period (N=465). Controls will include all women with intrauterine singleton pregnancies that continue through 20 weeks gestational age. Standardized baseline data collection will include a structured in-person interview, laboratory analyses of hair and urine for cotinine, alcohol, and drugs of abuse. Chromosomal analyses will be conducted on products of conception for approximately 120 cases who abort at HUP. Follow-up telephone interviews will take place at 16 and 20 weeks gestation. Pregnancy outcome status will also be ascertained through ongoing review of medical records, pathology logs, and birth certificates. Initial analyses will be exploratory and descriptive, characterizing cases and controls by current or past violence, age, substance abuse, social isolation. The primary analysis will be logistic regression, with odds ratios and 95% confidence intervals. The investigators will explore whether the effect of violence on spontaneous abortion varies with chromosomal status of the fetus as well as according to the timing, frequency and nature of violent incidents. Finally, they will characterize the patterns of use of health and social service agencies by abused women early in pregnancy. The investigators state that the significance of this study lies in its capacity to provide basic epidemiological data regarding the nature and circumstances of violence among pregnancy inner-city women, evaluate whether violence is an independent predictor of spontaneous abortion, and ultimately contribute information important to designing effective treatment and prevention interventions in urban settings.