孕期亲密伴侣暴力与产妇抑郁：埃塞俄比亚一项基于社区的横断面研究。
Intimate partner violence and maternal depression during pregnancy: A community-based cross-sectional study in Ethiopia.
机构信息
School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Department of Social Medicine and Global Health, Lund University, Lund, Sweden.
出版信息
PLoS One. 2019 Jul 31;14(7):e0220003. doi: 10.1371/journal.pone.0220003. eCollection 2019.
INTRODUCTION
Intimate partner violence (IPV) is regarded an important public health and human rights issue, characterized by physical, sexual or emotional abuse. Globally more than one in three women report physical or sexual violence by their intimate partners. Though the association between IPV and depression is known, we found no study investigating depression as a risk factor for IPV and very few studies using standard tools in assessing both IPV and depression among pregnant women.
AIM
To measure the prevalence of IPV and depression during pregnancy and assess the association between IPV and depression and other determinants.
METHODS
A community-based cross-sectional study was conducted among 589 pregnant women living in Wondo-Genet district, southern Ethiopia. IPV experience was assessed using a structured questionnaire of the World Health Organization (WHO), and maternal depression was measured by the Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics were computed and multivariable logistic regression was carried out to estimate risk and adjust for confounders.
RESULTS
The overall prevalence of IPV was 21% (95% confidence interval [CI] = 18.1-24.7). After adjusting for potential confounders, increased risk of IPV remained among rural women (adjusted odds ratio[AOR] = 2.09; 95%CI = 1.06-4.09), women who had parental exposure to IPV (AOR = 14.00; 95%CI = 6.43-30.48), women whose pregnancy was not desired (AOR = 9.64; 95%CI = 3.44-27.03), women whose husbands used alcohol (AOR = 17.08; 95%CI = 3.83-76.19), women with depression (AOR = 4.71; 95%CI = 1.37-16.18) and women with low social support (AOR = 13.93; 95%CI = 6.98-27.77). The prevalence of antenatal depressive symptom (with EPDS score above 13) was 6.8% (95% CI 6.2-11.3). Increased risk of depression was found among women who had been exposed to IPV (AOR = 17.60; 95%CI = 6.18-50.10) and whose husbands use alcohol (AOR = 3.31; 95%CI = 1.33-8.24).
CONCLUSION
One in five pregnant women experienced IPV and it was strongly associated with depression. Screening for IPV and depression at antenatal visits with referral to relevant care and service is recommended.
简介
亲密伴侣暴力（IPV）被认为是一个重要的公共卫生和人权问题，其特征是身体、性或情感虐待。全球超过三分之一的女性报告称受到过亲密伴侣的身体或性暴力。虽然已经知道 IPV 与抑郁之间存在关联，但我们没有发现研究调查抑郁作为 IPV 的风险因素，也很少有研究使用标准工具评估孕妇中的 IPV 和抑郁。
目的
测量怀孕期间 IPV 和抑郁的发生率，并评估 IPV 和抑郁与其他决定因素之间的关联。
方法
在埃塞俄比亚南部 Wondo-Genet 区进行了一项基于社区的横断面研究，共纳入 589 名孕妇。使用世界卫生组织（WHO）的结构化问卷评估 IPV 经历，使用爱丁堡产后抑郁量表（EPDS）评估产妇抑郁。计算描述性统计数据，并进行多变量逻辑回归以估计风险并调整混杂因素。
结果
IPV 的总体患病率为 21%（95%置信区间[CI] = 18.1-24.7）。在调整了潜在混杂因素后，农村妇女（调整后的优势比[AOR] = 2.09；95%CI = 1.06-4.09）、父母遭受 IPV 暴露的妇女（AOR = 14.00；95%CI = 6.43-30.48）、不希望怀孕的妇女（AOR = 9.64；95%CI = 3.44-27.03）、丈夫饮酒的妇女（AOR = 17.08；95%CI = 3.83-76.19）、患有抑郁的妇女（AOR = 4.71；95%CI = 1.37-16.18）和社会支持度低的妇女（AOR = 13.93；95%CI = 6.98-27.77），发生 IPV 的风险增加。产前抑郁症状（EPDS 评分高于 13）的患病率为 6.8%（95%CI 6.2-11.3）。遭受 IPV 暴露（AOR = 17.60；95%CI = 6.18-50.10）和丈夫饮酒（AOR = 3.31；95%CI = 1.33-8.24）的妇女发生抑郁的风险增加。
结论
五分之一的孕妇经历过 IPV，且与抑郁密切相关。建议在产前检查时筛查 IPV 和抑郁，并转介至相关护理和服务。
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