Division of Global Health & Inequalities, The Angels Trust - Nigeria, Abuja, Nigeria.
BMC Pregnancy Childbirth. 2012 Nov 14;12:128. doi: 10.1186/1471-2393-12-128.
Intimate partner violence (IPV) is a major public health problem with serious consequences for women's physical, mental, sexual and reproductive health. Reproductive health outcomes such as unwanted and terminated pregnancies, fetal loss or child loss during infancy, non-use of family planning methods, and high fertility are increasingly recognized. However, little is known about the role of community influences on women's experience of IPV and its effect on terminated pregnancy, given the increased awareness of IPV being a product of social context. This study sought to examine the role of community-level norms and characteristics in the association between IPV and terminated pregnancy in Nigeria.
Multilevel logistic regression analyses were performed on nationally-representative cross-sectional data including 19,226 women aged 15-49 years in Nigeria. Data were collected by a stratified two-stage sampling technique, with 888 primary sampling units (PSUs) selected in the first sampling stage, and 7,864 households selected through probability sampling in the second sampling stage.
Women who had experienced physical IPV, sexual IPV, and any IPV were more likely to have terminated a pregnancy compared to women who had not experienced these IPV types.IPV types were significantly associated with factors reflecting relationship control, relationship inequalities, and socio-demographic characteristics. Characteristics of the women aggregated at the community level (mean education, justifying wife beating, mean age at first marriage, and contraceptive use) were significantly associated with IPV types and terminated pregnancy.
Findings indicate the role of community influence in the association between IPV-exposure and terminated pregnancy, and stress the need for screening women seeking abortions for a history of abuse.
亲密伴侣暴力（IPV）是一个严重影响妇女身心健康、性健康和生殖健康的重大公共卫生问题。越来越多的人认识到，生殖健康结局如意外怀孕和人工终止妊娠、胎儿或婴儿死亡、不使用计划生育方法以及高生育率等与 IPV 有关。然而，由于认识到 IPV 是社会背景的产物，社区对妇女遭受 IPV 经历及其对人工终止妊娠的影响的作用知之甚少。本研究旨在探讨尼日利亚社区一级规范和特征在 IPV 与人工终止妊娠之间的关联中的作用。
对包括尼日利亚年龄在 15-49 岁的 19226 名妇女在内的全国代表性横断面数据进行多水平逻辑回归分析。数据采用分层两阶段抽样技术收集，在第一阶段抽样中选择了 888 个初级抽样单位（PSU），在第二阶段抽样中通过概率抽样选择了 7864 个家庭。
与未经历过这些 IPV 类型的妇女相比，经历过身体 IPV、性 IPV 和任何 IPV 的妇女更有可能终止妊娠。IPV 类型与反映关系控制、关系不平等和社会人口特征的因素显著相关。社区一级聚集的妇女特征（平均教育程度、为打妻子辩护、初婚年龄和避孕措施使用情况）与 IPV 类型和终止妊娠显著相关。
研究结果表明，社区影响在 IPV 暴露与终止妊娠之间的关联中发挥作用，并强调需要对寻求堕胎的妇女进行虐待史筛查。
