| Intimate partner violence and pregnancy spacing: results from a meta-analysis of individual participant time-to-event data from 29 low-and middle-income countries |
| Authors: |
Lauren Maxwell, Arijit Nandi, Andrea Benedetti, Karen Devries, Jennifer Wagman, and Claudia García-Moreno |
| Source: |
BMJ Global Health, 3(1); DOI: http://dx.doi.org/10.1136/bmjgh- 2017- 000304 |
| Topic(s): |
Birth interval
Intimate Partner Violence (IPV)
|
| Country: |
More than one region
Multiple Regions
|
| Published: |
JAN 2018 |
| Abstract: |
Introduction Inadequately spaced pregnancies, defined
as pregnancies fewer than 18 months apart, are linked
to maternal, infant, and child morbidity and mortality, and
adverse social, educational and economic outcomes in
later life for women and children. Quantifying the relation
between intimate partner violence (IPV) and women’s ability
to space and time their pregnancies is an important part of
understanding the burden of disease related to IPV.
Methods We applied Cox proportional hazards models to
monthly data from the Demographic and Health Surveys’
Reproductive Health Calendar to compare interpregnancy
intervals for women who experienced physical, sexual and/
or emotional IPV in 29 countries. We conducted a one-stage
meta-analysis to identify the periods when women who
experienced IPV were at the highest risk of unintended and
incident pregnancy, and a two-stage meta-analysis to explore
cross-country variations in the magnitude of the relation
between women’s experience of IPV and pregnancy spacing.
Results For the one-stage analysis, considering 52 959
incident pregnancies from 90 446 women, which represented
232 394 person-years at risk, women’s experience of IPV
was associated with a 51% increase in the risk of pregnancy
(95% CI 1.38 to 1.66), although this association decreased
over time. When limiting our inference to unintended
pregnancies that resulted in live births, women’s experience
of IPV was associated with a 30% increase in the risk of
unintended pregnancy (95% CI 1.25 to 1.34; n=13 541
pregnancies, 92 848 women, 310 319 person-years at risk).
In the two-stage meta-analyses, women’s experience of IPV
was associated with a 13% increase in the probability of
incident pregnancy (95% CI 1.07 to 1.20) and a 28% increase
in the likelihood of unintended pregnancy (95% CI 1.19 to
1.38).
Conclusions Across countries, women’s experience of IPV
is associated with a reduction in time between pregnancies
and an increase in the risk of unintended pregnancy; the
magnitude of this effect varied by country and over time. |
| Web: |
http://gh.bmj.com/content/3/1/e000304 |
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