不良童年经历与意外怀孕之间的关系：系统回顾和荟萃分析

IF 3.4 2区心理学 Q1 FAMILY STUDIES

Child Abuse & Neglect Pub Date : 2025-08-28 DOI:10.1016/j.chiabu.2025.107642

Xiaoxue Li , Boran Yang , Lirong Nie , Ziyang Ren , Yuchun Sun , Jufen Liu

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引用次数: 0

摘要

目前，关于不良童年经历（adverse childhood experiences, ace）与意外怀孕（unplanned pregnancy， UP）之间关系的研究结果并不一致，这可能与样本特征和测量方法的差异有关。目的综合评价不同类型ace与UP的关联强度，以及这些经历对UP的累积效应，进行meta分析。本荟萃分析包括16项研究，151,089名参与者。方法检索5个英文数据库和3个中文数据库，对ace与UP之间的关系进行实证研究。本研究采用美国卫生保健研究与质量局（AHRQ）和纽卡斯尔-渥太华量表（NOS）工具进行质量评估。对异质性结果使用随机/固定效应模型汇总效应大小。敏感性/亚组分析解决了异质性，而剂量-反应曲线评估了ace的累积效应。通过漏斗图和Egger检验检验发表偏倚。结果ACE组显著增加了UP的几率（OR = 1.57, 95% CI:1.35 ~ 1.83），且呈剂量-反应模式：每增加一个ACE组，UP的几率分别增加31.8%，分别达到73.9% （2.5 ACE）和144.3% （4 ACE）。性虐待与身体和心理虐待的相关性最强（OR = 1.45, 95% CI: 1.23-1.70）。从地理上看，非洲的几率最高，其次是亚洲、欧洲和北美。与HI国家（OR = 1.36, 95% CI: 1.29-1.44）相比，LI国家的赔率明显升高（OR = 2.92, 95% CI: 1.87-4.55）。结论saces与UP几率呈显著的剂量-反应关系，且在不同的地理区域和经济群体中存在差异。这些发现突出表明，需要采取早期综合干预措施，将儿童保护、心理健康和生殖保健结合起来，以减少对健康的长期影响。

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Association between adverse childhood experiences and unintended pregnancy: A systematic review and meta-analysis

Background

At present, the research results on the relationship between adverse childhood experiences (ACEs) and unplanned pregnancy (UP) are inconsistent, likely due to variations in sample characteristics and measurement methods.

Objective

To comprehensively evaluate the strength of the association between different subtypes of ACEs and UP, as well as the cumulative effects of these experiences on UP, a meta-analysis was conducted.

Participants and setting

This present meta-analysis included 16 studies with 151,089 participants.

Methods

Five English and three Chinese databases were searched on empirical studies that reported the association between ACEs and UP. This study employed Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Scale (NOS) tools for quality assessment. Effect sizes were pooled using random/fixed-effects models per heterogeneity results. Sensitivity/subgroup analyses addressed heterogeneity, while dose-response curves evaluated ACEs cumulative effects. Publication bias was examined via funnel plots and Egger's test.

Results

ACEs significantly increased UP odds (OR = 1.57, 95 %CI:1.35–1.83) with a dose-response pattern: each additional ACE raised odds by 31.8 %, reaching 73.9 % (2.5 ACEs) and 144.3 % (4 ACEs). Sexual abuse showed strongest association (OR = 1.45, 95 %CI:1.23–1.70) versus physical and psychological abuse. Geographically, Africa exhibited the highest odds, with Asia, Europe and North America following in descending order. LI countries demonstrated markedly elevated odds(OR = 2.92, 95 % CI: 1.87–4.55) compared to HI nations (OR = 1.36, 95 %CI:1.29–1.44).

Conclusions

ACEs exhibited a significant dose-response relationship with UP odds, with variations across geographic regions and economic groups. These findings highlight the need for early, integrated interventions combining child protection, mental health, and reproductive care to reduce long-term health impacts.

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来源期刊

Child Abuse & Neglect Multiple-

CiteScore

7.40

自引率

10.40%

发文量

397

期刊介绍： Official Publication of the International Society for Prevention of Child Abuse and Neglect. Child Abuse & Neglect The International Journal, provides an international, multidisciplinary forum on all aspects of child abuse and neglect, with special emphasis on prevention and treatment; the scope extends further to all those aspects of life which either favor or hinder child development. While contributions will primarily be from the fields of psychology, psychiatry, social work, medicine, nursing, law enforcement, legislature, education, and anthropology, the Journal encourages the concerned lay individual and child-oriented advocate organizations to contribute.