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孟加拉国女性全国样本中的亲密伴侣暴力与意外怀孕、流产、人工流产和死产情况。

Intimate partner violence and unwanted pregnancy, miscarriage, induced abortion, and stillbirth among a national sample of Bangladeshi women.

作者信息

Silverman J G, Gupta J, Decker M R, Kapur N, Raj A

机构信息

Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115, USA.

出版信息

BJOG. 2007 Oct;114(10):1246-52. doi: 10.1111/j.1471-0528.2007.01481.x.

Abstract

OBJECTIVE

To estimate (1) lifetime prevalence of physical and sexual victimisation from husbands among a national sample of Bangladeshi women, (2) associations of unwanted pregnancy and experiences of husband violence, and (3) associations of miscarriage, induced abortion, and fetal death/stillbirth and such victimisation.

DESIGN

Cross-sectional, nationally representative study utilizing matched husband-wife data from the 2004 MEASURE Bangladesh Demographic Health Survey.

SETTING

Bangladesh.

POPULATION

Married Bangladeshi women ages 13-40 years old (n = 2677).

METHODS

Bivariate and multivariate logistic regression analysis.

MAIN OUTCOME MEASURES

Relations of intimate partner violence to unwanted pregnancy, miscarriage, induced abortion and stillbirth.

RESULTS

Three out of four (75.6%) Bangladeshi women experienced violence from husbands. Less educated, poorer, and Muslim women were at greatest risk. Women experiencing violence from husbands were more likely to report both unwanted pregnancy (ORs(adj) 1.46-1.54) and a pregnancy loss in the form of miscarriage, induced abortion, or stillbirth (ORs(adj) 1.43-1.69). Assessed individually, miscarriage was more likely among victimised women (OR(adj) 1.81). A nonsignificant trend was detected for increased risk of induced abortion (OR(adj) 1.64); stillbirth was unrelated to violence from husbands.

CONCLUSION

Intimate partner violence is extremely prevalent and relates to unwanted pregnancy and higher rates of pregnancy loss or termination, particularly miscarriages, among Bangladeshi women. Investigation of mechanisms responsible for these associations will be critical to developing interventions to improve maternal, fetal, and neonatal health. Such programmes may be vital to reducing the significant health and social costs associated with both husband violence and unwanted and adverse pregnancy outcomes.

摘要

目的

估算(1)孟加拉国全国妇女样本中遭受丈夫身体和性侵害的终生患病率;(2)意外怀孕与丈夫暴力经历之间的关联;(3)流产、人工流产、胎儿死亡/死产与此类侵害之间的关联。

设计

采用2004年孟加拉国人口与健康调查中匹配的夫妻数据进行的全国代表性横断面研究。

地点

孟加拉国。

研究对象

年龄在13 - 40岁的已婚孟加拉国妇女(n = 2677)。

方法

双变量和多变量逻辑回归分析。

主要观察指标

亲密伴侣暴力与意外怀孕、流产、人工流产和死产之间的关系。

结果

四分之三(75.6%)的孟加拉国妇女遭受过丈夫的暴力。受教育程度较低、较贫困的穆斯林妇女风险最大。遭受丈夫暴力的妇女更有可能报告意外怀孕(校正比值比为1.46 - 1.54)以及以流产、人工流产或死产形式出现的妊娠丢失(校正比值比为1.43 - 1.69)。单独评估时,受侵害妇女流产的可能性更大(校正比值比为1.81)。人工流产风险增加呈非显著趋势(校正比值比为1.64);死产与丈夫的暴力无关。

结论

亲密伴侣暴力极为普遍,与意外怀孕以及孟加拉国妇女中较高的妊娠丢失或终止率(尤其是流产)有关。调查这些关联背后的机制对于制定改善孕产妇、胎儿和新生儿健康的干预措施至关重要。此类项目对于降低与丈夫暴力以及意外和不良妊娠结局相关的巨大健康和社会成本可能至关重要。

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