孕期亲密伴侣暴力和孕晚期就寝-晨起规律与小于胎龄儿的关系

Relation of intimate partner violence during pregnancy and sleep-wake rules in late pregnancy to small for gestational age infant

目的:探讨孕期亲密伴侣暴力(IPV)与小于胎龄儿(SGA)的关联,并分析孕晚期就寝-晨起规律在其关联中的作用。方法:从2015年3月-2019年6月在合肥市三家医院的产科门诊招募孕妇4908名,使用WHO多国妇女健康和家庭暴力研究小组总结而来的清单式问卷进行调查,并采用多元logistic回归模型进行分析。结果:孕期精神暴力、躯体暴力、性暴力和总IPV发生率分别为9.1%、1.4%、0.9%和9.7%,SGA发生率为7.1%。回归分析结果显示,孕期IPV与SGA正向关联(OR=1.59);分别按就寝时间和晨起时间分层,7∶00后起床、22∶00-23∶00和23∶00后就寝组的IPV与SGA正向关联(OR=2.85、2.18、1.98);按就寝-晨起规律分层,非早睡早起组的IPV和IPV组的非早睡早起与SGA正向关联(OR=2.15、3.32)。结论:孕期遭受IPV(尤其是精神暴力)会增加SGA的风险,而就寝-晨起规律会使IPV与SGA的关联在不同的规律下增强或减弱。

Objective:To investigate the association between intimate partner violence(IPV)during pregnancy and small for gestationalage(SGA),and to analyze the role of sleep-wake rules play in this association.Methods:From March 2015 to June 2019,a total of 4908 pregnant women were recruited as the subjects from the obstetrics clinics of three hospitals in Hefei.The list questionnaire summarized by the WHO Multi-country Study on Women’s Health and Domestic Violence against Women Study Team was used for investigation,and the multiple logistic regression model was used for analysis.Results:The rates of mental violence,physical violence,sexual violence and total IPV during pregnancy were 9.1%,1.4%,0.9%and 9.7%respectively,and the rate of SGA was 7.1%.Regression analysis showed that IPV during pregnancy was positively associated with SGA(OR=1.59).Stratified analysis by the bedtime and the wake-up time,the IPV in the groups of getting up after 7∶00,going to bed at 22∶00-23∶00,going to bed after 23∶00 were positively associated with SGA(OR=2.85,2.18,1.98).Stratified analysis by the sleep-wake rules,IPV in non-early to bed and early to rise group,and non-early to bed and early to rise in IPV group were positively associated with SGA(OR=2.15,3.32).Conclusion:It suggests that exposure to IPV during pregnancy(especially mental violence)may increase the risk of SGA,and the sleep-wake rules may be an important related factor,making the association between IPV and SGA strengthen or weaken under different patterns.