Singh Jitendra Kumar, Evans-Lacko Sara, Acharya Dilaram, Kadel Rajendra, Gautam Salila
Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, India; Department of Community Medicine and Public Health, Janaki Medical College, Tribhuvan University, Janakpur, Nepal.
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK; King's College London, Institute of Psychiatry, Psychology & Neuroscience, UK.
Women Birth. 2018 Apr;31(2):96-102. doi: 10.1016/j.wombi.2017.07.009.
Underutilisation of antenatal care services due to intimate partner violence during pregnancy has been well documented elsewhere, but it is understudied in Nepal. Our study aimed at exploring the impact of intimate partner violence on antenatal care service utilisation in southern Terai of Nepal.
A community-based cross-sectional study was performed in 6 village development committees in Dhanusha district, Nepal. A total of 426 pregnant women in their second trimester were selected using a multistage cluster sampling method. Multivariable regression analyses were used to examine the association between exposure to intimate partner violence and selected antenatal care services, adjusting for covariates.
Among 426 pregnant women, almost three out of ten women (28.9%) were exposed to intimate partner violence at some point during their pregnancy. Pregnant women who were exposed to intimate partner violence were less likely to: register for antenatal care (OR 0.31; 95% CI (0.08-0.50)), take iron and folic acid (OR 0.55; 95% CI (0.12-0.90)), report dietary diversity (middle vs low: OR 0.34; 95% CI (0.11-0.58) and high vs low: OR 0.18; 95% CI (0.08-0.37)), have rest and sleep during day time (OR 0.47; 95% CI (0.61-0.58)), and attend mother's group meetings (OR 0.29; 95% CI (0.10-0.83)).
Intimate partner violence during pregnancy is associated with low utilisation of antenatal care services. Therefore, effective strategies to prevent or reduce intimate partner violence during pregnancy is needed, which may lead to improved antenatal care service utilization in Nepal with healthier mothers and children's outcome.
孕期因亲密伴侣暴力导致产前护理服务利用不足的情况在其他地方已有充分记录，但在尼泊尔却研究较少。我们的研究旨在探讨亲密伴侣暴力对尼泊尔南部特莱地区产前护理服务利用的影响。
在尼泊尔达努沙区的6个乡村发展委员会开展了一项基于社区的横断面研究。采用多阶段整群抽样方法，共选取了426名孕中期孕妇。使用多变量回归分析来检验亲密伴侣暴力暴露与选定的产前护理服务之间的关联，并对协变量进行调整。
在426名孕妇中，近十分之三（28.9%）的女性在孕期的某个阶段遭受过亲密伴侣暴力。遭受亲密伴侣暴力的孕妇不太可能：进行产前护理登记（比值比0.31；95%置信区间(0.08 - 0.50)）、服用铁剂和叶酸（比值比0.55；95%置信区间(0.12 - 0.90)）、报告饮食多样性（中等水平与低水平相比：比值比0.34；95%置信区间(0.11 - 0.58)，高水平与低水平相比：比值比0.18；95%置信区间(0.08 - 0.37)）、白天休息和睡眠（比值比0.47；95%置信区间(0.61 - 0.58)）以及参加母亲小组会议（比值比0.29；95%置信区间(0.10 - 0.83)）。
孕期亲密伴侣暴力与产前护理服务利用率低有关。因此，需要采取有效的策略来预防或减少孕期亲密伴侣暴力，这可能会提高尼泊尔产前护理服务的利用率，并改善母婴健康结局。
