Gender-based violence (GBV), defined as violence perpetrated on the basis of socially ascribed gender differences, is a major global public health, human rights, and development issue [1][2]. Intimate partner violence (IPV) is a subset of GBV and includes physical, sexual, and psychological abuse perpetrated by a current or former intimate partner [3][4]. Violence against women has been recognized internationally as a violation of human rights. The United Nations Declaration on the Elimination of Violence Against Women defines it as any act of gender-based violence that results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women [5].

Globally, IPV remains highly prevalent. Recent estimates indicate that physical and/or sexual intimate partner violence affects a substantial proportion of ever-partnered women worldwide [6]. During pregnancy, IPV remains a significant concern. A systematic review and meta-analysis reported that the global prevalence of IPV in pregnancy was approximately 25%, with prevalence estimates of 9.2% for physical violence, 18.7% for psychological violence, and 5.5% for sexual violence [7]. These findings highlight that pregnancy does not confer protection against violence and may, in some contexts, increase vulnerability.

Evidence from high-income countries further underscores the burden of IPV. In the United States, IPV contributes significantly to long-term health and economic burden, reinforcing its importance as both a clinical and public health issue [8]. In Europe, studies have also documented IPV among pregnant women. For example, research conducted in Spain demonstrated the occurrence of IPV during pregnancy using validated screening tools and highlighted associated risk factors [9]. Additionally, the Abuse Assessment Screen and its subsequent refinements have been developed and validated in Western settings to enhance the detection of abuse in healthcare environments [10][11].

In African settings, the burden appears even higher. In Kenya, Morris et al. reported a lifetime IPV prevalence of 60.3% among women [12]. In Ethiopia, Berhanie et al. documented high levels of IPV both during pregnancy and across the life course [13]. In South Africa, Groves et al. found that more than one-fifth of women experienced IPV during pregnancy or the postpartum period [14]. Yohannes et al. also reported a high prevalence of IPV among pregnant women in Ethiopia and identified spousal occupation and alcohol use as significant predictors [15].

In Nigeria, IPV during pregnancy remains a major concern, with prevalence estimates ranging from 15.4% to 37.2% [16]-[20]. These variations reflect differences in study settings, methodologies, and sociocultural contexts but consistently highlight IPV as a persistent public health challenge.

Several factors have been associated with IPV, including low educational attainment, unemployment, financial dependency, substance abuse, childhood exposure to violence, and sociocultural norms that support male dominance [12][18][21]. Broader structural factors such as gender inequality and economic stress also contribute significantly [22][23].

Despite this, studies on this important issue remain limited in Nigeria. This study, therefore, sought to determine the prevalence, correlates, and predictors of intimate partner violence among pregnant women accessing care in this facility.

Although 381 participants were recruited, 379 respondents with complete data were included in the final analysis. All analyses were conducted using the same complete-case sample (N = 379), ensuring consistency across Tables 1-3.

A total of 379 respondents were included in the final analysis. The majority were aged between 20 and 30 years. Most participants were married (99.2%) and predominantly Muslim (74.9%). A large proportion of respondents were unemployed (84.7%), and many reported low monthly income. Most participants had two or fewer children.

Table 1. Baseline sociodemographic, obstetric, and household characteristics of respondents (N = 379).

Table 2. Abuse assessment screen analysis.

Categories are not mutually exclusive; respondents may report more than one form of violence.

Table 3.Correlates of abuse types.

N = 379; **p < 0.01 (two-tailed).

Pearson correlation analysis demonstrated strong, positive, and statistically significant associations between all forms of IPV. Physical IPV was strongly correlated with emotional IPV (r = 0.856, p < 0.001), physical IPV was also strongly correlated with sexual IPV (r = 0.751, p < 0.001), and emotional IPV was strongly correlated with sexual IPV (r = 0.766, p < 0.001). These findings suggest that IPV often occurs as overlapping forms of abuse rather than as isolated events (Table 4).

Table 4. Association between sociodemographic characteristics and Intimate Partner Violence (IPV).

Age was recategorized for inferential analysis.

At the bivariate level, age, educational level, and monthly income were significantly associated with IPV, while religion, employment status, number of children, and spouse occupation were not (Table 5).

Multivariable logistic regression analysis identified employment status and educational level as significant predictors of intimate partner violence. Women who were employed had significantly higher odds of experiencing IPV compared to unemployed women (AOR = 6.34, 95% CI: 2.78 - 14.43, p < 0.001). Similarly, women with higher educational attainment had increased odds of IPV compared to those with lower education levels (AOR = 7.64, 95% CI: 3.29 - 17.74, p < 0.001).

Age, religion, and gestational age were not significantly associated with IPV after adjustment.

Table 5. Multivariable logistic regression of factors associated with IPV.

This study provides important insight into the determinants of intimate partner violence (IPV) among pregnant women attending antenatal care in North-Central Nigeria. The findings show that educational attainment and employment status emerged as independent predictors of IPV, as shown inTable 5, while age group, religion, gestational age, spouse’s occupation, monthly income, and number of children were not significant after adjustment. These results reinforce the complex and context-dependent nature of IPV in pregnancy and suggest that the relationship between women’s socioeconomic position and IPV is not always straightforward.

The prevalence of IPV observed in this study confirms that violence during pregnancy remains a major public health concern. Table 2shows that emotional violence was the most commonly reported form (22.2%), followed by physical (17.1%) and sexual violence (8.2%). These findings are consistent with global evidence indicating that IPV affects a substantial proportion of women worldwide and that pregnancy does not necessarily protect women from abuse [1][2]. Similar patterns have been reported across sub-Saharan Africa, where IPV during pregnancy remains common and often under-recognized within routine maternity services [3][4]. In Nigeria, previous studies have also documented substantial levels of IPV during pregnancy, with prevalence estimates broadly comparable to those found in the present study [16]-[19].

A key finding of this study is the strong positive correlation among emotional, physical, and sexual IPV, indicating that these forms of violence frequently co-occur rather than occur in isolation. As demonstrated in Table 3, correlation coefficients ranged from 0.751 to 0.856 (p < 0.001), reflecting a high degree of overlap between IPV subtypes. This supports the conceptualization of IPV as a multidimensional construct and justifies the use of a composite outcome measure in the regression analysis. Similar patterns of co-occurrence have been reported in previous studies, where emotional abuse often precedes or accompanies physical and sexual violence [4][5].

At the bivariate level, age, educational level, and monthly income were significantly associated with IPV, as presented in Table 4, while religion, employment status, number of children, and spouse occupation were not. However, in the multivariable model, only educational attainment and employment status remained significant predictors, as shown in Table 5, highlighting the influence of confounding factors and the importance of adjusted analyses.

A notable finding of this study is that higher educational attainment was associated with increased odds of IPV. Table 5further demonstrates that women with higher educational levels had significantly greater odds of experiencing IPV. This appears counterintuitive, as education is often considered protective against violence [11]. However, this finding has been reported in settings where women’s education may disrupt traditional gender roles without corresponding changes in male attitudes or societal norms [11][12]. Increased autonomy and assertiveness among educated women may generate tension in relationships where patriarchal structures remain dominant, thereby increasing the risk of IPV.

Similarly, employment status emerged as an independent predictor of IPV. Findings inTable 5indicate that employed women had higher odds of experiencing IPV compared to unemployed women. Although employment is typically viewed as empowering, it may, in certain sociocultural contexts, challenge established power dynamics within households and provoke conflict [11]-[13]. This highlights the complex interplay between economic empowerment and IPV risk, suggesting that employment alone may not be sufficient to protect women without broader shifts in gender norms and partner dynamics.

By contrast, age group, religion, and gestational age were not independently associated with IPV after adjustment, as also reflected in Table 5, despite some associations observed at the bivariate level. This indicates that these factors may be mediated by other socioeconomic or relational variables. The absence of an independent association with religion suggests that IPV transcends religious boundaries and is more strongly influenced by structural and interpersonal factors than by religious affiliation.

It is important to note that some variables, including spouse’s occupation, monthly income, and number of children, were associated with unstable estimates due to sparse data in some categories and were therefore not emphasized in the final regression model. This limitation is evident when comparing the bivariate findings in Table 4 with the multivariable results in Table 5 and underscores the challenges of modeling complex social phenomena with highly stratified categorical variables.

The implications of these findings are important for both clinical practice and policy. First, routine IPV screening should be integrated into antenatal care using validated tools such as the Abuse Assessment Screen [14][15]. Second, interventions should move beyond individual-level approaches to address relationship dynamics and structural determinants of violence [11]-[13]. Third, programs aimed at women’s empowerment through education and employment should be complemented by efforts to engage male partners, promote gender equity, and support healthy conflict resolution within households.

This study adds to the growing Nigerian and African evidence base on IPV in pregnancy [12]-[19]. It highlights those socioeconomic transitions, particularly in relation to education and employment, which may shape vulnerability to violence in ways that are context-specific and socially mediated. Addressing IPV in this setting, therefore, requires multilevel interventions that combine antenatal screening, psychosocial support, male partner engagement, and broader community strategies aimed at transforming inequitable gender norms.

Intimate partner violence remains prevalent among pregnant women in this setting, with significant co-occurrence of abuse types. Integrating routine IPV screening into antenatal care and implementing partner-focused, socioeconomically informed interventions are essential for reducing IPV and improving maternal health outcomes in Nigeria.

This study demonstrates that intimate partner violence (IPV) is a common experience among pregnant women attending antenatal care in North-Central Nigeria, with emotional abuse being the most prevalent form and substantial co-occurrence across different IPV types. The findings further reveal that women’s educational attainment and employment status are significant predictors of IPV after adjustment, underscoring the complex and context-dependent relationship between socioeconomic factors and vulnerability to violence.

These results highlight that IPV in pregnancy is not only prevalent but also multifaceted, requiring a comprehensive approach to identification and management. Routine screening for IPV should be integrated into antenatal care services using validated tools, with appropriate referral pathways for affected women. In addition, interventions should extend beyond individual-level responses to address broader relational and societal dynamics, including gender norms, power imbalances, and partner engagement.

Overall, addressing IPV in this setting will require coordinated, multilevel strategies that combine clinical screening, psychosocial support, community sensitization, and policy-driven efforts aimed at promoting gender equity and reducing violence against women.

Based on the findings of this study, the following actions are recommended:

1) Routine IPV Screening: Integrate structured IPV screening into antenatal care using validated tools such as the Abuse Assessment Screen, with emphasis on privacy and confidentiality.

2) Capacity Building for Healthcare Providers: Train antenatal care providers on identification, safe inquiry, and appropriate response to IPV, including trauma-informed care approaches.

3) Strengthening Referral Systems: Establish and formalize referral pathways linking health facilities to counseling services, social welfare units, legal aid, and community-based support organizations.

4) Male Partner Engagement: Develop community-based interventions that involve male partners to address harmful gender norms and promote healthy relationship dynamics.

5) Policy Integration: Incorporate IPV indicators into maternal health monitoring frameworks and national reproductive health policies to improve accountability and resource allocation.

6) Further Research: Conduct longitudinal and multi-centre studies to better understand causal pathways and improve generalizability.

Conception and Study design: PEA; LIC; EFA; LAA.

Study Protocol Design: PEA; LIC; MCM; SOM; DBB; RM; SCO; OA; EFA; LAA.

Manuscript Review: PEA; LIC; MCM; SOM; DBB; RM; SCO; OA; EFA; LAA.

Manuscript Approval: PEA; LIC; MCM; SOM; DBB; RM; SCO; OA; EFA; LAA.