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首页> 外文期刊>Journal of women’s health >Intimate Partner Violence During Pregnancy: Maternal and Neonatal Outcomes
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Intimate Partner Violence During Pregnancy: Maternal and Neonatal Outcomes

机译：怀孕期间的亲密伴侣暴力：孕妇和新生儿的结果

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摘要

The effects of intimate partner violence (IPV) on maternal and neonatal outcomes are multifaceted and largely preventable. During pregnancy, there are many opportunities within the current health care system for screening and early intervention during routine prenatal care or during episodic care in a hospital setting. This article describes the effects of IPV on maternal health (e.g., insufficient or inconsistent prenatal care, poor nutrition, inadequate weight gain, substance use, increased prevalence of depression), as well as adverse neonatal outcomes (e.g., low birth weight [LBW]), preterm birth [PTB], and small for gestational age [SGA]) and maternal and neonatal death. Discussion of the mechanisms of action are explored and include: maternal engagement in health behaviors that are considered "risky," including smoking and alcohol and substance use, and new evidence regarding the alteration of the hypothalamic-pituitary-adrenal axis and resulting changes in hormones that may affect LBW and SGA infants and PTB. Clinical recommendations include a commitment for routine screening of IPV in all pregnant women who present for care using validated screening instruments. In addition, the provision of readily accessible prenatal care and the development of a trusting patient-provider relationship are first steps in addressing the problem of IPV in pregnancy. Early trials of targeted interventions such as a nurse-led home visitation program and the Domestic Violence Enhanced Home Visitation Program show promising results. Brief psychobehavioral interventions are also being explored. The approach of universal screening, patient engagement in prenatal care, and targeted individualized interventions has the ability to reduce the adverse effects of IPV and highlight the importance of this complex social disorder as a top priority in maternal and neonatal health.
机译：亲密伴侣暴力（IPV）对孕产妇和新生儿结局的影响是多方面的，在很大程度上是可以预防的。在怀孕期间，当前的医疗保健系统中有很多机会可以在常规产前检查或医院环境中的情节护理中进行筛查和早期干预。本文介绍了IPV对孕产妇健康的影响（例如，产前护理不足或不一致，营养不良，体重增加不足，使用药物，抑郁症患病率增加）以及不利的新生儿结局（例如，低出生体重[LBW]） ），早产[PTB]，胎龄小[SGA]和孕产妇和新生儿死亡。探讨了作用机理的讨论，包括：孕产妇参与被认为是“危险”的健康行为，包括抽烟，酗酒和滥用毒品，以及有关下丘脑-垂体-肾上腺轴改变以及激素变化的新证据。可能会影响LBW和SGA婴儿以及PTB。临床建议包括承诺对所有使用经过验证的筛查工具就诊的孕妇进行常规IPV筛查。此外，提供容易获得的产前护理以及建立信任的患者与提供者的关系是解决孕妇IPV问题的第一步。诸如护士主导的家庭探望计划和家庭暴力强化家庭探望计划等针对性干预措施的早期试验显示出令人鼓舞的结果。还正在探索简短的心理行为干预措施。普遍筛查，患者参与产前保健以及针对性的个体化干预措施具有减少IPV不良反应的能力，并强调了这种复杂的社会障碍作为孕产妇和新生儿健康的重中之重的重要性。

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