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） 会对女性的健康和与婴儿的联系产生负面影响。对南亚经历心理困扰的孕妇的 IPV 研究有限。我们检查了有焦虑症状的巴基斯坦妇女围产期暴露于 IPV 与产后母婴关系之间的关联，并评估了母乳喂养做法是否调节了这些关联。从 720 名巴基斯坦妇女那里收集了产后数据，这些妇女报告了怀孕期间至少轻微的焦虑症状。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） IPV 与母婴结合之间的关联。分析模型中包括 IPV 和母乳喂养实践之间的交互作用，以检查调节作用。大约 27% 的女性暴露于至少一种类型的围产期 IPV。与没有 IPV 的妇女 （n = 65， 12.4% 的未暴露妇女;p 值 < .001） 相比，暴露于 IPV 的妇女更容易出现中度至重度产后焦虑 （n = 57,28.9% 的 IPV 暴露妇女）。与未报告 IPV 的妇女相比，暴露于任何 IPV 的妇女产后亲子关系问卷评分增加了 38%，表明亲子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]）。在分娩后 1 小时后开始母乳喂养的妇女中，IPV 与亲子关系受损相关（RR = 1.09， 95% CI [1.06， 1.20]），而在 1 小时内开始母乳喂养的妇女则不存在关联（RR = 1.03， 95% CI [0.98， 1.08]）。 除了努力减少 IPV 外，鼓励暴露于 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。