妊娠期丈夫对妻子的家庭暴力与不良妊娠结局

Effect of domestic violence on obstetric outcome during pregnancy

目的 探讨妊娠期家庭暴力的现况以及其与不良妊娠结局的关系。 方法 采用分层整群抽样的方法 ,在天津市和辽宁、河南、陕西省的 6个市、32个区 ,对有 6个月至 1岁半小儿的妇女12 0 4 4名进行了调查及分析。 结果 妊娠期家庭暴力的发生率为 4 .3% ,形式为心理暴力、性暴力和躯体暴力 ,且反复发生 ,性暴力的发生率最高。妊娠期遭受家庭暴力的孕妇 ,妊娠次数多 (P <0 .0 1,OR =2 .0 )、有人工流产史的比例高 (P <0 .0 1,OR =1.89)、产前检查开始晚 (P =0 .0 1,OR =1.32 ) ,而且妊娠期阴道出血、胎儿生长受限、胎盘早剥、妊娠期贫血、胎膜早破以及新生儿疾病的发生率明显高 (P <0 .0 5 ,OR值分别为 1.85、2 .81、5 .39、1.92、1.6 4和 1.92 )。未发现妊娠期家庭暴力与早产的关系。此外 ,孕妇和其丈夫的文化程度、职业、月收入、吸烟、饮酒的状况与孕妇受虐和丈夫施暴有关 (P <0 .0 5 )。 结论 本研究提示家庭暴力应作为影响不良妊娠结局的一个因素 ,妊娠期检查时应该常规询问 ,以及时发现 ,给予适当的救助 。

Objective To understand the situation of abuse during pregnancy and its effect on obstetric outcome. Methods This was a community based face to face survey of a representative group of women whose child aged 6 to 18 months in 32 communities of Tianjing, Liaoning, He’nan and Shannxi provinces between November 1, 2001 and February 28, 2002. There were 12 044 women included. Results The incidence of domestic violence during pregnancy was 4.3% (522/12 044)most of which was sexual abuse. There were different forms of violence including psychological, sexual and physical abuse. Women being abused during pregnancy were more likely to have more times of pregnancy ( P<0.01,OR =2.0), higher abortion rate ( P<0.01,OR =1.89) and late beginning of prenatal care ( P=0.01,OR =1.32). Abuse was a significant risk factor for vaginal bleeding during pregnancy, FGR, anemia, placenta abruption, premature rupture of membranes, and neonatal morbidity ( P<0.05, OR was 1.85, 2.81, 5.39, 1.92, 1.64 and 1.92, respectively). No relationship between abuse during pregnancy and preterm delivery was found. There showed that domestic violence was associated with the education, occupation, monthly income, smoking and drinking of the couples. Conclusions As a risk factor of adverse pregnant outcome, domestic violence should be inquired during prenatal care routinely. Proper help in time can improve the pregnant outcome.