Islam Md Jahirul, Broidy Lisa, Baird Kathleen, Mazerolle Paul
School of Criminology and Criminal Justice, Griffith University, Brisbane, Queensland 4122, Australia; Ministry of Planning, Bangladesh Planning Commission, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh.
School of Criminology and Criminal Justice, Griffith University, Brisbane, Queensland 4122, Australia; Department of Sociology, 1 University of New Mexico, Albuquerque, NM 87131, United States.
Midwifery. 2017 Apr;47:43-52. doi: 10.1016/j.midw.2017.02.002. Epub 2017 Feb 7.
Intimate partner violence (IPV) during pregnancy can have serious health consequences for mothers and newborns. The aim of the study is to explore: 1) the influence of experiencing IPV during pregnancy on delayed entry into prenatal care; and 2) whether women's decision-making autonomy and the support for traditional gender roles act to mediate or moderate the relationship between IPV and delayed entry into prenatal care.
cross-sectional survey. Multivariate logistic regression models were estimated that control for various socio-demographic and pregnancy related factors to assess whether women who experienced IPV during pregnancy were more likely to delay entry into prenatal care compared with women who had not experienced IPV. The influence of traditional gender roles acceptance and decision-making autonomy were examined both as independent variables and in interaction with IPV, to assess their role as potential mediators or moderators.
Chandpur district, Bangladesh.
the sample comprised of 426 Bangladeshi women, aged 15-49 years. Postpartum mothers who visited vaccinations centres to receive their children's vaccinations constitute the sampling frame.
almost 70% of the women surveyed reported patterns consistent with delayed entry into prenatal care. Accounting for the influence of other covariates, women who experienced physical IPV during pregnancy were 2.61 times more likely (95% CI [1.33, 5.09]) to have delayed entry into prenatal care than their counterparts who did not report physical IPV. Neither sexual nor psychological IPV victimization during pregnancy was linked with late entry into prenatal care. Both gender role attitudes and levels of autonomy mediate the effect of IPV on prenatal care.
the results suggest that the high rates of IPV in Bangladesh have effects that can compromise women's health seeking behaviour during pregnancy, putting them and their developing fetus at risk. Specifically, Bangladeshi women who experience physical IPV during pregnancy are more likely to delay or forgo prenatal care, an effect that is further magnified by cultural ideals that emphasize women's traditional roles and limit their autonomy.
this study reinforces the need to detect and assist women suffering IPV, not only to offer them help and support but also to increase entry into prenatal care. Healthcare professionals involved in obstetrics and midwifery need to be aware of the risk factors of IPV during pregnancy and be able to identify women who are at risk for delayed entry into prenatal care.
孕期亲密伴侣暴力（IPV）会对母亲和新生儿的健康产生严重影响。本研究的目的是探讨：1）孕期经历IPV对延迟进行产前检查的影响；2）女性的决策自主权以及对传统性别角色的支持是否起到中介或调节IPV与延迟进行产前检查之间关系的作用。
横断面调查。估计多变量逻辑回归模型，控制各种社会人口统计学和与妊娠相关的因素，以评估孕期经历IPV的女性与未经历IPV的女性相比，是否更有可能延迟进行产前检查。将对传统性别角色的接受程度和决策自主权作为自变量，并与IPV进行交互作用分析，以评估它们作为潜在中介或调节因素的作用。
孟加拉国钱德布尔县。
样本包括426名年龄在15 - 49岁的孟加拉国女性。在疫苗接种中心为孩子接种疫苗的产后母亲构成抽样框架。
近70%的受访女性报告有与延迟进行产前检查相符的模式。在考虑其他协变量的影响后，孕期经历身体暴力的女性延迟进行产前检查的可能性是未报告遭受身体暴力的女性的2.61倍（95%置信区间[1.33, 5.09]）。孕期遭受性暴力或心理暴力与延迟进行产前检查无关。性别角色态度和自主水平均介导了IPV对产前检查的影响。
结果表明，孟加拉国高比例的IPV会产生影响，可能损害女性孕期寻求医疗保健的行为，使她们及其发育中的胎儿面临风险。具体而言，孕期经历身体暴力的孟加拉国女性更有可能延迟或放弃产前检查，强调女性传统角色并限制其自主权的文化观念进一步放大了这种影响。
本研究强化了检测和帮助遭受IPV的女性的必要性，不仅要为她们提供帮助和支持，还要增加她们进行产前检查的比例。参与妇产科和助产工作的医疗保健专业人员需要了解孕期IPV的风险因素，并能够识别有延迟进行产前检查风险的女性。
