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Background <p>Pregnancy termination poses a major public health burden in developing countries including Pakistan. Intimate partner violence (IPV) and marital control (MC) behaviors are predictors of pregnancy termination. This study aims to investigate mechanism through which IPV and MC influence pregnancy termination by employing mediation analysis.</p> Methods <p>We utilized data from Pakistan Demographic and Health Survey (PDHS). Pregnancy termination, IPV, and MC were treated as dependent, independent, and mediator variables respectively. Logistic regression analyses were performed separately to examine associations of IPV and MC with the outcome. Mediation was formally assessed by employing Structural Equation Modeling (SEM) to estimate direct, indirect, and total effects of IPV on pregnancy termination, with MC behaviors specified as the mediator.</p> Results <p>A sample of 4,082 women was analyzed. Results showed that physical IPV (aOR = 1.27; 95% CI: 1.08–1.48), sexual IPV (aOR = 1.38; 95% CI: 1.01–1.87), and MC (aOR = 1.26; 95% CI: 1.08–1.45) were independently associated with pregnancy termination, after adjusting for socio-demographic variables. Results from SEM and Sobel test showed significant indirect effects of both physical violence (β = 0.016, SE = 0.007, z-value = 2.202, 95% CI = 0.002–0.030, <i>p</i> = 0.028), and sexual violence (β = 0.020, SE = 0.007, z-value = 2.830, 95% CI = 0.006–0.034, <i>p</i> = 0.005) on pregnancy termination through MC behaviors.</p> Conclusion <p>MC behaviors are associated with the relationship between IPV and pregnancy termination, suggesting a potential pathway that links abuse to pregnancy outcomes. Interventions should address both IPV and MC within reproductive health services, while policies should prioritize women’s empowerment, education, and routine screening in maternal care.</p>

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Exploring the mediating role of marital control in the association between intimate partner violence and pregnancy termination among women of reproductive age in Pakistan

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月15日

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  • Zoofa Talha,
  • Mahbubur Rahman

摘要

Background

Pregnancy termination poses a major public health burden in developing countries including Pakistan. Intimate partner violence (IPV) and marital control (MC) behaviors are predictors of pregnancy termination. This study aims to investigate mechanism through which IPV and MC influence pregnancy termination by employing mediation analysis.

Methods

We utilized data from Pakistan Demographic and Health Survey (PDHS). Pregnancy termination, IPV, and MC were treated as dependent, independent, and mediator variables respectively. Logistic regression analyses were performed separately to examine associations of IPV and MC with the outcome. Mediation was formally assessed by employing Structural Equation Modeling (SEM) to estimate direct, indirect, and total effects of IPV on pregnancy termination, with MC behaviors specified as the mediator.

Results

A sample of 4,082 women was analyzed. Results showed that physical IPV (aOR = 1.27; 95% CI: 1.08–1.48), sexual IPV (aOR = 1.38; 95% CI: 1.01–1.87), and MC (aOR = 1.26; 95% CI: 1.08–1.45) were independently associated with pregnancy termination, after adjusting for socio-demographic variables. Results from SEM and Sobel test showed significant indirect effects of both physical violence (β = 0.016, SE = 0.007, z-value = 2.202, 95% CI = 0.002–0.030, p = 0.028), and sexual violence (β = 0.020, SE = 0.007, z-value = 2.830, 95% CI = 0.006–0.034, p = 0.005) on pregnancy termination through MC behaviors.

Conclusion

MC behaviors are associated with the relationship between IPV and pregnancy termination, suggesting a potential pathway that links abuse to pregnancy outcomes. Interventions should address both IPV and MC within reproductive health services, while policies should prioritize women’s empowerment, education, and routine screening in maternal care.