Halim Nafisa, Patel Archana, Turan Janet M, Shrikhande Anuradha V, Kavanagh Patricia L, Drainoni Mari-Lynn, Henderson David, Anand Shweta Murali, Agarwal Nandini, Hibberd Patricia L
Department of Global Health, Boston University School of Public Health, Boston, MA, United States.
Lata Medical Research Foundation, Nagpur, India.
Front Glob Womens Health. 2025 May 22;6:1525168. doi: 10.3389/fgwh.2025.1525168. eCollection 2025.
Intimate partner violence (IPV) negatively impacts pregnant women and their unborn children. Globally, an estimated 19%, 9%, and 6% of women experience psychological, physical, and sexual IPV, respectively, during pregnancy. These rates are higher among pregnant women living with a stigmatizing disease. In this study, we examined the effect of antenatal screening for sickle cell disease (SCD) using the sickle cell solubility test on the risk of IPV among pregnant women in the city of Nagpur in Maharashtra state of India. We hypothesized that a positive solubility test increases the risk of IPV via partner disclosure.
We conducted a cohort study comparing IPV in 182 pregnant women, before (baseline) and after (endline) having a solubility test. Of the 182 participants, 91 were pregnant women with a positive solubility test and 91 with a negative solubility test. We used the 49-item Indian Family Violence and Control Scale ( = 0.88) to measure IPV and estimated associations using binomial logistic regressions with robust standard errors.
Pregnant women with a positive solubility test were at least twice as likely to experience physical, sexual, or psychological IPV as pregnant women with a negative solubility test, even after adjusting for baseline differences between these two groups on common IPV risk factors including the lower level of education and scheduled-caste membership.
Pregnant women who have a positive solubility test are at risk of IPV after following routine instructions to disclose their test results to their male partners, so that they can undergo further testing to determine the baby's risk of SCD, sickle cell trait, or no risk.
In resource-poor settings with high SCD prevalence, antenatal clinics are increasingly screening pregnant women to prevent mother-to-child transmission of SCD. There is a need to integrate strategies for women to disclose sickle cell screening test results and prevention of IPV caused by male partners.
亲密伴侣暴力（IPV）对孕妇及其未出生的孩子有负面影响。全球范围内，估计分别有19%、9%和6%的女性在孕期遭受心理、身体和性方面的亲密伴侣暴力。在患有污名化疾病的孕妇中，这些比例更高。在本研究中，我们调查了在印度马哈拉施特拉邦那格浦尔市使用镰状细胞溶解度试验进行镰状细胞病（SCD）产前筛查对孕妇遭受亲密伴侣暴力风险的影响。我们假设溶解度试验呈阳性会通过伴侣知晓而增加亲密伴侣暴力的风险。
我们进行了一项队列研究，比较了182名孕妇在进行溶解度试验之前（基线）和之后（终线）的亲密伴侣暴力情况。在这182名参与者中，91名孕妇的溶解度试验呈阳性，91名呈阴性。我们使用49项的印度家庭暴力与控制量表（=0.88）来测量亲密伴侣暴力，并使用具有稳健标准误的二项逻辑回归估计关联。
即使在对两组在包括较低教育水平和在册种姓成员身份等常见亲密伴侣暴力风险因素方面的基线差异进行调整之后，溶解度试验呈阳性的孕妇遭受身体、性或心理亲密伴侣暴力的可能性至少是溶解度试验呈阴性孕妇的两倍。
溶解度试验呈阳性的孕妇在按照常规指示向其男性伴侣披露检测结果后有遭受亲密伴侣暴力的风险，这样他们可以接受进一步检测以确定婴儿患镰状细胞病、镰状细胞性状或无患病风险的情况。
在镰状细胞病患病率高的资源匮乏地区，产前诊所越来越多地对孕妇进行筛查以预防镰状细胞病的母婴传播。有必要整合相关策略，以便女性能够披露镰状细胞筛查检测结果，并预防男性伴侣导致的亲密伴侣暴力。
