DOMESTIC ABUSE IN PREGNANCY AND ADVERSE BIRTH OUTCOMES

怀孕期间的家庭虐待和不良出生结果

• 批准号: 6228942
• 负责人: AUDREY FRIEDA SAFTLAS
• 金额: $ 32.62万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-06-01 至 2005-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6228942
• 关键词: behavioral /social science research tag; clinical research; computer assisted diagnosis; disease /disorder onset; disease /disorder proneness /risk; dyadic interaction; family planning; family structure /dynamics; female; human birth weight; human population study; human subject; interview; medical complication; postpartum; pregnancy; premature labor; prenatal stress; psychological stressor; sex abuse; social behavior disorders; telecommunications; trauma; violence; women's health

Recent studies suggest that 2.4 % to 5.6 % of pregnant women are physically abused each year in the United States. Domestic violence is hypothesized to cause adverse pregnancy outcomes through two mechanisms: physical trauma and prenatal stress. To date, research into the association of domestic violence in pregnancy and adverse birth outcomes provides inconsistent evidence. Most studies, however, have been small in size, used an endpoint of low birthweight, and focused primarily on low-income women, who are at highest risk of both domestic violence and adverse pregnancy outcomes. We propose to conduct a population-based case-control study to investigate the independent and joint effects of domestic violence and prenatal stress on the risk of preterm delivery (N=950) and intrauterine growth retardation (N=1210). In addition, patterns of abuse will be examined over three points in time (prepregnancy, pregnancy, postpartum) among control subjects (N=950) to determine if the pregnancy or postpartum periods are high-risk times for domestic abuse. The influence of contextual factors, such as pregnancy intendedness, will also be examined. The study population, identified from the Iowa live birth certificate file, will be comprised of residents of three Iowa counties who deliver between August 1, 2001 and July 31, 2003. Domestic violence and prenatal stress will be assessed using well-tested, established instruments, including the revised Conflict Tactics Scale (CTS2) and the Prenatal Life Events Scale. Data will be collected using computer-assisted telephone interviews, covering the primary study exposures and risk factors for domestic violence and the two study outcomes. Subjects will be interviewed 3 to 6 months postpartum and compensated for their participation. Medical chart abstractions will be conducted to validate case definitions and document prenatal care variables, medical history, and pregnancy complications. With at least 80 % power, the study will be able to detect increased risks of 2.0 for the least prevalent exposure, domestic violence. This study will be the first to examine the effect of prenatal stress in conjunction with domestic violence on adverse pregnancy outcomes, and offers a unique combination of methodological and conceptual strengths to address these issues.

最近的研究表明，在美国，每年有2.4％至5.6％的孕妇受到身体虐待。假设家庭暴力通过两种机制引起不良怀孕的结果：身体创伤和产前压力。迄今为止，对怀孕和不良出生结果的家庭暴力关联的研究提供了不一致的证据。但是，大多数研究的规模很小，使用了低出生体重的终点，主要集中于低收入妇女，这些妇女面临家庭暴力和不良怀孕后果的最高风险。我们建议进行一项基于人群的病例对照研究，以研究家庭暴力和产前压力对早产风险（n = 950）和宫内内生长迟缓（n = 1210）的独立和关节影响。此外，将在对照组受试者（n = 950）之间检查三个时间点（孕妇，怀孕，产后）的虐待模式，以确定怀孕或产后时期是否是家庭虐待的高风险时间。还将研究情境因素（例如妊娠预期性）的影响。从爱荷华州实时出生证明文件中确定的研究人群将由三个爱荷华州县的居民组成，这些县的居民在2001年8月1日至2003年7月31日之间交付。将使用经过良好测试的，经过良好的既定工具来评估家庭暴力和产前压力，包括经过经过修订的冲突战术量表（CTS2）和产前生命的事件量表。数据将使用计算机辅助的电话访谈收集，涵盖家庭暴力的主要研究暴露和风险因素以及两个研究结果。受试者将在产后3到6个月接受采访，并为其参与而进行补偿。将进行医学图表摘要，以验证病例定义并记录产前护理变量，病史和妊娠并发症。有了至少80％的功率，该研究将能够检测到最不流行的暴露，家庭暴力的2.0风险。这项研究将是第一个研究产前压力与家庭暴力对不良怀孕结果的影响的作用，并提供了解决这些问题的方法和概念优势的独特组合。