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，美国每年有 2.4% 至 5.6% 的孕妇遭受身体虐待。据推测，家庭暴力会通过两种机制导致不良妊娠结局：身体创伤和产前压力。迄今为止，对妊娠期家庭暴力与不良分娩结果之间关系的研究提供了不一致的证据。然而，大多数研究规模较小，使用低出生体重作为终点，并且主要关注低收入妇女，她们遭受家庭暴力和不良妊娠结局的风险最高。我们建议开展一项基于人群的病例对照研究，探讨家庭暴力和产前应激对早产（N=950）和宫内生长迟缓（N=1210）风险的独立和联合影响。此外，还将在对照受试者（N = 950）中检查三个时间点（怀孕前、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期。还将检查背景因素（例如怀孕意向）的影响。从爱荷华州活产证明文件中确定的研究人群将由爱荷华州三个县在 2001 年 8 月 1 日至 2003 年 7 月 31 日期间分娩的居民组成。家庭暴力和产前压力将使用经过充分测试的既定工具进行评估，包括修订后的冲突策略量表（CTS2）和产前生活事件量表。将通过计算机辅助电话访谈收集数据，涵盖主要研究暴露和家庭暴力的风险因素以及两项研究结果。受试者将在产后 3 至 6 个月接受采访，并为其参与提供报酬。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。凭借至少 80% 的功效，该研究将能够检测到最不普遍的暴露——家庭暴力——的风险增加 2.0。这项研究将首次探讨产前压力与家庭暴力对不良妊娠结局的影响，并提供方法和概念优势的独特组合来解决这些问题。