Intimate partner violence (IPV) during the perinatal period can negatively affect both a woman’s health and the bonding with her infant. Research on IPV among pregnant women experiencing psychological distress in South Asia is limited. We examined associations between perinatal exposure to IPV and postnatal maternal-infant bonding in Pakistani women with symptoms of anxiety and assessed if breastfeeding practices moderated these associations. Postnatal data were collected from 720 Pakistani women who reported at least mild levels of anxiety symptoms in pregnancy. We performed Poisson regression with robust variance analyses to examine the associations between IPV during pregnancy or within 6 weeks after delivery (i.e., the perinatal period) and maternal-infant bonding. Interaction terms between IPV and breastfeeding practices were included in the analytic models to examine the moderating effects. About 27% of women were exposed to at least one type of perinatal IPV. Women who were exposed to IPV were more likely to have moderate to severe postpartum anxiety ( n = 57, 28.9% of IPV-exposed women), compared to those without IPV ( n = 65, 12.4% of unexposed women; p value < .001). Compared to women not reporting IPV, women exposed to any IPV showed a 38% increase in Postpartum Bonding Questionnaire scores, suggesting higher likelihood of impaired bonding (risk ratio [RR] = 1.38, 95% confidence interval [CI] [1.21, 1.56]). Among women who initiated breastfeeding later than 1 hr post-delivery, IPV was associated with impaired bonding (RR = 1.09, 95% CI [1.06, 1.20]), whereas no association was present for women who initiated breastfeeding within 1 hr (RR = 1.03, 95% CI [0.98, 1.08]). In addition to the efforts to reduce IPV, encouraging IPV-exposed women to adhere to the breastfeeding guidelines (e.g., early breastfeeding) may enhance maternal-infant bonding.

中文翻译：

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巴基斯坦有焦虑症状的妇女围产期亲密伴侣暴力和母婴关系：母乳喂养的调节作用


围产期的亲密伴侣暴力 (IPV) 会对女性的健康以及与婴儿的关系产生负面影响。关于南亚经历心理困扰的孕妇 IPV 的研究有限。我们研究了有焦虑症状的巴基斯坦妇女围产期 IPV 暴露与产后母婴关系之间的关联，并评估了母乳喂养做法是否会调节这些关联。产后数据收集自 720 名巴基斯坦妇女，她们报告在怀孕期间至少有轻度焦虑症状。我们进行了泊松回归和稳健方差分析，以检查怀孕期间或分娩后 6 周内（即围产期）的 IPV 与母婴关系之间的关联。 IPV 和母乳喂养实践之间的相互作用项被纳入分析模型中，以检验调节作用。大约 27% 的女性至少接触过一种围产期 IPV。与未接触过 IPV 的女性相比（n = 65，未接触过 IPV 的女性为 12.4%；p 值 <），接触过 IPV 的女性更有可能出现中度至重度产后焦虑（n = 57，接触过 IPV 的女性为 28.9%） .001）。与未报告 IPV 的女性相比，接触任何 IPV 的女性产后亲密关系问卷得分增加了 38%，表明亲密关系受损的可能性更高（风险比 [RR] = 1.38，95% 置信区间 [CI] [1.21, 1.56] ）。在产后 1 小时后开始母乳喂养的女性中，IPV 与亲密关系受损相关（RR = 1.09，95% CI [1.06，1.20]），而对于 1 小时内开始母乳喂养的女性则不存在关联（RR = 1.09，95% CI [1.06，1.20]）。 1.03，95% CI [0.98，1.08]）。 除了努力减少 IPV 之外，鼓励接触 IPV 的妇女遵守母乳喂养指南（例如早期母乳喂养）可能会增强母婴关系。