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Abstract
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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. 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. 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, 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.
In the meta-analysis, the authors found that studies conducted after 2010 and in west Asia produced higher lifetime prevalence estimates, and studies with small sample sizes and high risk of bias produced higher past-year prevalence estimates. Notably, there was significant variation among studies that used three common...
Language: en |