Intimate partner violence among women with infertility.
Intimate partner violence among women with infertility.
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DOI：
10.1016/s2214-109x(22)00205-4
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发表时间：
2022-06
影响因子：
34.3
通讯作者：
Murray, Sarah
中科院分区：
文献类型：
--
作者：
Bourey, Christine;Murray, Sarah
亲密伴侣暴力(IPV)是一个严重的公共卫生问题，在整个生命过程中影响到心理、身体和生殖健康。不孕不育不仅是一个生殖健康问题，也是一个可能影响婚姻、家庭和其他人际关系的社会问题，特别是在生育受到高度重视并成为女性观念核心的环境中。在后代最重要的文化中，经历不孕不育的女性可能会因为没有孩子或家庭规模较小而受到社会制裁。1因此，暴力经历可能会影响生育，而不孕症可能会增加传染性支气管炎的风险。认识到这一潜力，王渊源及其同事在《柳叶刀全球健康》杂志上就2000-19年9个低收入和中等收入国家(LMIC)不孕不育妇女感染IPV的流行率进行了全面的系统文献回顾和荟萃分析。2系统综述中包括30项研究，Meta分析中包括25项研究(7164名参与者)。这项工作建立在以前的文献的基础上，这些文献探讨了不孕不育是IPV的一个未被认识到的风险因素，3进行了一项综合，将IPV与其他形式的暴力区分开来，并广泛地着眼于全球区域。作者使用亚组分析和元回归来探索不同研究时期、研究地区、不孕不育类型、偏见风险、样本量和测量工具的IPV患病率的变化。尽管现有研究中的异质性很大，但他们确定了不孕不育妇女过去一年的合并IPV患病率为36.0%(95%可信区间20.4-55.2%)，终生患病率为47.2%(31.7-63.3%)。由于用于评估IPV及其亚型(如心理、身体和性)的工具不同，很难将这些患病率估计与一般人群进行比较；然而，在对按生育状况单独报告IPV患病率的研究进行的一项小规模分析中，不孕妇女比有生育能力的妇女更有可能经历身体暴力和性暴力。心理和总体IPV的终生患病率并不因生育状况而异。
Intimate partner violence (IPV) represents a critical public health problem that impacts mental, physical, and reproductive health throughout the life-course. Infertility is not only an issue of reproductive health, but also a social issue that can influence marital, family, and other interpersonal relationships, particularly in settings where childbearing is highly valued and central to ideas of womanhood. Women experiencing infertility might be socially sanctioned for childlessness or small family sizes in cultures where progeny is among what matters most. 1 Thus, experiences of violence can affect fertility, and infertility can confer risk for IPV. Recognising this potential, Yuanyuan Wang and colleagues present a comprehensive systematic literature review and meta-analysis in The Lancet Global Health of the prevalence of IPV against women with infertility in nine low-income and middle-income countries (LMICs) in 2000–19. 2 30 studies were included in the systematic review, and 25 studies were included in the meta-analysis (7164 participants). This work builds upon previous literature that explores infertility as an under-recognised risk factor for IPV, 3 undertaking a synthesis that distinguishes IPV from other forms of violence and looks broadly across global regions. The authors used subgroup analyses and meta-regressions to explore variations in IPV prevalence by study period, study region, type of infertility, risk of bias, sample size, and measurement tools. Despite substantial heterogeneity in existing studies, they identified a pooled past-year IPV prevalence of 36· 0%(95% CI 20· 4–55· 2) and lifetime prevalence of 47· 2%(31· 7–63· 3) among women with infertility. It is difficult to compare these prevalence estimates to the general population due to differences in tools used to assess IPV and its subtypes (eg, psychological, physical, and sexual); however, in a small analysis of studies that separately reported IPV prevalence by fertility status, infertile women were more likely to experience physical violence and sexual violence than were fertile women. Lifetime prevalence of psychological and overall IPV did not differ by fertility status.