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围产期妇女的家庭暴力与虐待:印度贫民窟社区中与婴儿发病率的关联

Family Violence and Maltreatment of Women During the Perinatal Period: Associations with Infant Morbidity in Indian Slum Communities.

作者信息

Silverman Jay G, Balaiah Donta, Decker Michele R, Boyce Sabrina C, Ritter Julie, Naik D D, Nair Saritha, Saggurti Niranjan, Raj Anita

机构信息

Division of Global Public Health, Center on Gender Equity and Health, School of Medicine, University of California, San Diego (UCSD), 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.

Division of Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, USA.

出版信息

Matern Child Health J. 2016 Jan;20(1):149-157. doi: 10.1007/s10995-015-1814-y.

Abstract

OBJECTIVES

To determine the prevalence of non-violent, gender-based forms of maltreatment of women by husbands and in-laws [i.e., gender-based household maltreatment (GBHM)] during pregnancy and postpartum; to clarify the role of GBHM in compromising infant health, and whether this role extends beyond that previously observed for intimate partner violence (IPV).

METHODS

Cross-sectional, quantitative data were collected from women (ages 15-35) seeking immunizations for their infants <6 months of age (N = 1061) in urban health centers in Mumbai, India. Logistic regression models were constructed to assess associations between maternal abuse (perinatal IPV, in-law violence and GBHM) and recent infant morbidity (diarrhea, respiratory distress, fever, colic and vomiting).

RESULTS

More than one in four women (28.4%) reported IPV during their recent pregnancy and/or during the postpartum period, 2.6% reported perinatal violence from in-laws, and 49.0% reported one or more forms of perinatal GBHM. In adjusted regression models that included all forms of family violence and maltreatment, perinatal GBHM remained significantly associated with infant morbidity (AORs 1.4-1.9); perinatal IPV and in-law violence ceased to predict infant morbidity in models including GBHM.

CONCLUSIONS

Findings indicate that non-violent expressions of gender inequity (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care during pregnancy) are more strongly associated with poor infant health than physical or sexual violence from husbands or in-laws in urban India. These results strongly suggest the need to expand the conception of gender inequities beyond IPV to include non-violent forms of gendered mistreatment in considering their impact on infant health.

摘要

目的

确定孕期和产后丈夫及姻亲对妇女实施的非暴力、基于性别的虐待形式(即基于性别的家庭虐待,GBHM)的患病率;阐明GBHM对损害婴儿健康的作用,以及这一作用是否超出先前观察到的亲密伴侣暴力(IPV)的影响范围。

方法

从印度孟买城市健康中心为6个月以下婴儿寻求免疫接种的15至35岁女性(N = 1061)中收集横断面定量数据。构建逻辑回归模型,以评估孕产妇虐待(围产期IPV、姻亲暴力和GBHM)与近期婴儿发病率(腹泻、呼吸窘迫、发烧、绞痛和呕吐)之间的关联。

结果

超过四分之一的女性(28.4%)报告在近期怀孕和/或产后遭受IPV,2.6%报告遭受围产期姻亲暴力,49.0%报告一种或多种围产期GBHM形式。在纳入所有形式家庭暴力和虐待的调整回归模型中,围产期GBHM仍与婴儿发病率显著相关(调整后比值比为1.4 - 1.9);在纳入GBHM的模型中,围产期IPV和姻亲暴力不再能预测婴儿发病率。

结论

研究结果表明,在印度城市,与丈夫或姻亲的身体暴力或性暴力相比,性别不平等的非暴力表现形式(如营养剥夺、睡眠剥夺、孕期阻止获得医疗保健)与婴儿健康不良的关联更强。这些结果强烈表明,在考虑性别不平等对婴儿健康的影响时,有必要将性别不平等的概念从IPV扩展到包括非暴力形式的性别虐待。

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