Intimate Partner Violence during Pregnancy in Asia: Prevalence, Associated Factors, and Outcomes – A Review of Literature and Meta-Analysis with Special Reference to Sri Lanka

Introduction: Intimate partner violence (IPV) during pregnancy is an important yet under-detected determinant of maternal and foetal morbidity in many Asian settings. This review aims to synthesise evidence on the prevalence, associated factors, and pregnancy outcomes of IPV during pregnancy in Asia, with special reference to Sri Lanka, to inform policy and programme responses.

Methods: A narrative review was conducted using PubMed, Google Scholar, Lens.org, Dimensions, and relevant grey literature. English-language publications (2000-2025) from Asian settings were screened for evidence on IPV during pregnancy. Eligible studies were synthesised thematically across prevalence, associated factors, and outcomes. Where prevalence estimates were sufficiently comparable, pooled prevalence was calculated in RStudio using a random-effects generalised linear mixed model (logit transformation) with 95% confidence intervals, and heterogeneity was assessed using I² and τ².

Results: IPV during pregnancy prevalence ranged from 1.6% to 41.0% across Asia, while Sri Lankan estimates ranged from 4.7% to 15.9%. In the meta-analysis of 23 studies (n=52,072 pregnancies), the overall prevalence in Asia was 14.4% (95% CI 10.3-19.9), with extremely high heterogeneity and a wide prediction interval (2%- 55%). Subgroup pooling yielded 8.8% (95% CI, 3.6-19.9) for Sri Lanka and 15.1% (95% CI, 10.6-21.2) for other Asian countries; the between-subgroup difference was not statistically significant (p=0.2449). Psychological violence was reported more frequently than physical or sexual violence. Commonly identified correlates included low maternal education, younger age, poverty, limited partner support, partner alcohol use, and traditional gender norms. IPV exposure was associated with low birth weight, preterm delivery, miscarriage,
maternal depression, and anaemia. Despite Sri Lanka’s strong maternal health infrastructure, responses to IPV during pregnancy remain fragmented.

Conclusion: IPV during pregnancy is prevalent and preventable. Sri Lanka should strengthen routine identification and referral within maternal health services, expand