Prevalence, Patterns, and Nomogram Model of Intimate Partner Violence Against Mothers During the Child-Rearing Stage: A Family System Analysis in China for Targeted Prevention Strategies.

Abstract

Intimate partner violence (IPV) is a significant public health issue affecting many women worldwide. While extensive research exists on IPV during pregnancy and postpartum, there is limited information on IPV against mothers during the critical child-rearing stage, specifically the first three years following childbirth. This study examines the prevalence and patterns of IPV among mothers in China during this stage, identifying associated factors across four family subsystems: individual, husband-and-wife, mother-child, and family context, to guide the development of tailored prevention strategies. This study involved 1,099 Chinese mothers, surveyed within the first three years postpartum, through purposive sampling. The revised Conflict Tactics Scale (CTS2) was utilized to evaluate IPV, while a comprehensive questionnaire gathered data on potential risk and protective factors within the four family subsystems. Chi-square tests and lasso regression analyses were used to identify significant independent risk factors, which were used to construct nomograms of IPV among mothers during the critical child-rearing stage. The nomogram's discrimination, calibration, clinical applicability, and generalizability were evaluated using receiver operating characteristic curves (ROC), calibration curves, decision curve analysis (DCA), and internal validation. Approximately 30% of mothers had experienced IPV within three years postpartum, with psychological violence being the most common. Three main patterns of IPV were identified, with multiple forms of violence often co-occurring. Significant risk factors for IPV included age at childbirth, attachment styles, marital issues, marital stability, feeding choices, maternal sense of parenting competence, support from friends, and family stress events. A nomogram model was developed to identify associated factors of IPV, demonstrating good performance. This model integrates factors from individual, spousal, mother-child, and family context subsystems, providing a comprehensive approach to understanding and preventing IPV during the critical child-rearing stage. The high prevalence of IPV underscores the urgent need for targeted prevention strategies to support mothers during this vulnerable period.