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全球围产期亲密伴侣暴力与女性创伤后应激障碍的风险因素:系统评价和荟萃分析。

Worldwide Perinatal Intimate Partner Violence Prevalence and Risk Factors for Post-traumatic Stress Disorder in Women: A Systematic Review and Meta-analysis.

机构信息

Zunyi Medical University, Guizhou, China.

The Ohio State University College of Medicine, Columbus, USA.

出版信息

Trauma Violence Abuse. 2024 Jul;25(3):2363-2376. doi: 10.1177/15248380231211950. Epub 2023 Nov 24.

Abstract

Post-traumatic stress disorder (PTSD) in women who have experienced perinatal intimate partner violence (P-IPV) has gradually attracted the attention of psychologists, mental health, and health care professionals. However, a comprehensive understanding of its prevalence and associated risk factors is still lacking. The aim of this systematic review and meta-analysis was to determine the prevalence and explore influencing factors for PTSD in women who have suffered P-IPV. Our study inclusion criteria were: women who experienced IPV in the year before conception, throughout pregnancy, during delivery, and up to 1 year after giving birth for which a quantitative assessment of PTSD was done using validated diagnostic or screening tools. This study searched nine English databases and four Chinese databases. The final analysis included 16 studies, involving 9,098 female subjects. Meta-analysis was performed on the extracted data using the Stata 16.0 software (Stata Corp. LP, College Station, TX, USA).Fixed or random effect models were selected to pool odds ratio (OR) and 95% confidence interval (CI) of PTSD after heterogeneity test. Meta-analysis showed that the pooled prevalence of PTSD in women who suffered P-IPV was 30.0% (95% confidence interval [95% CI] = [22.0%, 37.0%]). Only nine studies described influencing factors for PTSD based on multivariate logistic regression analysis. The five identified influencing factors were: non-immigrants (OR = 2.56; 95% CI [1.29, 5.08]), non-cohabitation (OR = 2.45; [1.35, 4.42]), trauma history (OR = 1.80; [1.18, 2.76]), education below senior high school (OR = 1.32; [0.64, 2.75]), and age 18 to 29 years (OR = 1.06; [0.94, 1.19]). These findings provided a reference value of PTSD prevalence, risk factors, and potential association with P-IPV among women worldwide. However, the geographical coverage of the reviewed studies is limited and epidemiological investigations from more diverse areas are required in the future.

摘要

创伤后应激障碍(PTSD)在经历围产期亲密伴侣暴力(P-IPV)的女性中逐渐引起了心理学家、心理健康和医疗保健专业人员的关注。然而,对于其普遍程度和相关风险因素,仍缺乏全面的了解。本系统评价和荟萃分析的目的是确定经历围产期亲密伴侣暴力的女性中 PTSD 的患病率,并探讨其影响因素。我们的研究纳入标准为:在受孕前一年、怀孕期间、分娩期间和分娩后 1 年内经历过 IPV 的女性,并且使用经过验证的诊断或筛查工具对 PTSD 进行了定量评估。本研究在九个英文数据库和四个中文数据库中进行了检索。最终分析纳入了 16 项研究,共涉及 9098 名女性受试者。使用 Stata 16.0 软件(StataCorp LP,College Station,TX,USA)对提取的数据进行荟萃分析。在异质性检验后,选择固定或随机效应模型来汇总 PTSD 的比值比(OR)和 95%置信区间(95%CI)。荟萃分析显示,经历围产期亲密伴侣暴力的女性中 PTSD 的总体患病率为 30.0%(95%CI [22.0%,37.0%])。只有九项研究基于多元逻辑回归分析描述了 PTSD 的影响因素。确定的五个影响因素为:非移民(OR=2.56;95%CI [1.29,5.08])、非同居(OR=2.45;95%CI [1.35,4.42])、创伤史(OR=1.80;95%CI [1.18,2.76])、高中以下教育(OR=1.32;95%CI [0.64,2.75])和 18 至 29 岁年龄(OR=1.06;95%CI [0.94,1.19])。这些发现为全球范围内女性 PTSD 患病率、风险因素以及与围产期亲密伴侣暴力的潜在关联提供了参考值。然而,所审查研究的地理覆盖范围有限,未来需要来自更多不同地区的流行病学调查。

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