Intimate partner violence during pregnancy: prevalence and associated factors

Silva, Ranielle de Paula; Leite, Franciéle Marabotti Costa

doi:10.11606/s1518-8787.2020054002103

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Sumário

Original Article • Rev. Saúde Pública 54 • 2020 • https://doi.org/10.11606/s1518-8787.2020054002103 copy

Intimate partner violence during pregnancy: prevalence and associated factors

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To identify the prevalence of violence during pregnancy and the association with the socioeconomic, behavioral and clinical characteristics of pregnant women.

METHODS

Cross-sectional study in a low-risk maternity hospital in the municipality of Cariacica, Espírito Santo. A total of 330 puerperal women were interviewed from August to October 2017. Information on socioeconomic, behavioral, reproductive and clinical characteristics, as well as life experiences, was collected through a questionnaire. To identify the types of violence, the proper World Health Organization instrument was used. Gross bivariate and multivariate analysis was performed and adjusted for Poisson regression with robust variance.

RESULTS

Prevalence was 16.1% (95%CI 2.5–20.4) for psychological violence, 7.6% (95%CI 5.1–11.0) for physical violence and 2.7% (95%CI 1.4–5.2) for sexual violence. Psychological violence remained associated with age, family income, beginning of sexual life, disease in pregnancy, desire to interrupt pregnancy and number of partners. Physical violence was associated with schooling, beginning of sexual life and disease in pregnancy. Sexual violence remained associated with marital status and desire to interrupt pregnancy (p < 0.05).

CONCLUSIONS

Psychological violence by an intimate partner was the most prevalent among pregnant women. Women that were younger, had lower income and less schooling, who started their sexual life before the age of 14 and who wished to interrupt pregnancy, experienced violence more frequently during pregnancy.

Pregnant women; Violence against women; Intimate partner violence; Domestic violence; Socioeconomic Factors

Characteristics of the woman			Psychological violence		Physical violence		Sexual violence
Variables	N	%	% (95%CI)	p	% (95%CI)	p	% (95%CI)	p ^a
Age (years)				0.002		0.068		0.031ª
14 to 19	82	24.8	26.8 (18.3–37.5)		12.2 (6.6–21.3)		6.1 (2.5–13.9)
20 or more	248	75.2	12.5 (8.9–17.3)		6.1 (3.7–9.8)		1.6 (0.6–4.2)
Race ^b				0.937		0.109		0.473ª
Non-black	228	73.5	15.9 (9.4–25.5)		12.2 (6.6–21.3)		2.2 (0.9–5.2)
Black	82	26.5	16.2 (12.0–21.6)		6.6 (4.0–10.7)		3.7 (1.2–10.8)
Schooling level (years)				0.001		0.000		0.231ª
Up to 4 years	89	27.0	27.0 (18.7–37.2)		18.0 (11.3–27.5)		4.5 (1.7–11.5)
5 or more	241	73.0	12.0 (8.5–16.8)		3.3 (1.9–7.0)		2.1 (0.9–4.9)
Marital status				0.019		0.146		0.027ª
Without partner	47	14.2	27.7 (16.7–42.2)		12.8 (5.9–25.9)		8.5 (3.2–20.8)
With a partner	283	85.8	14.1 (10.5–18.7)		6.7 (4.3–10.3)		1.8 (0.7–4.2)
Employment situation				0.122		0.163		0.648ª
No	77	23.3	10.4 (5.2–19.5)		3.9 (1.2–11.5)		2.6 (0.6–9.9)
Yes	253	76.7	17.8 (13.5–23.0)		8.7 (5.8–12.9)		2.8 (1.3–5.7)
Monthly family income(reais)				0.001		0.557		0.216ª
< 1,000	153	46.4	23.5 (17.4–30.9)		8.5 (5.0–14.3)		3.9 (1.8–8.5)
≥ 1,000	177	53.6	9.6 (6.0–14.9)		6.8 (3.9–11.6)		1.7 (0.5–5.2)
Alcohol consumption during pregnancy				0.081		0.488ª		0.235ª
No	296	89.7	14.9 (11.2–19.4)		7.4 (4.9–11.1)		2.4 (1.1–4.9)
Yes	34	10.3	26.5 (14.2–43.9)		8.8 (2.8–24.5)		5.9 (1.4–21.1)
Smoking habit during pregnancy				0.003		0.070		0.395ª
No	298	90.3	14.1 (10.6–18.6)		6.7 (4.4–10.2)		3.0 (1.6–5.7)
Yes	32	9.7	34.4 (19.9–52.4)		15.6 (6.5–32.9)		-
History of illicit drug use				0.003		0.011		0.308ª
No	290	87.9	13.8 (10.3–18.3)		6.2 (3.9–9.7)		3.1 (1.6–5.9)
Yes	40	12.1	32.5 (19.7–48.5)		17.5 (8.5–32.7)		-

Characteristics of the woman			Psychological violence		Physical violence		Sexual violence
Variables	N	%	% (95%CI)	p	% (95%CI)	p	% (95%CI)	p*
Menarche (years)				0,603		0,138*		0.245
Up to 13	240	72.7	15.4 (11.4–20.6)		8.8 (5.8–13.1)		3.3 (1.7–6.7)
14 or more	90	27.3	17.8 (11.1–27.2)		4.4 (1.7–11.3)		1.1 (0.1–7.6)
Beginning of sex life (years)				< 0.001		< 0.001		0.007
Up to 14	89	27.0	30.3 (21.6–40.7)		19.1 (12.2–28.7)		6.7 (3.0–14.3)
15 or more	241	73.0	10.8 (7.4–15.4)		3.3 (1.7–6.5)		1.2 (0.4–3.8)
Number of pregnancies				0.922		0.291		0.694
1	126	38.2	15.1 (9.8 - 22.5)		4.8 (2.1–10.3)		4.0 (1.7–9.2)
2	94	28.5	17.0 (10.7–26.1)		8.5 (4.3–16.2)		2.1 (0.5–8.2)
3 or more	110	33.3	16.4 (10.5–24.6)		10.0 (5.6–17.2)		1.8 (0.4–7.1)
History of STI				< 0.001		0.126		0.183
No	274	83.0	12.0 (8.7–16.5)		6.6 (4.2–10.2)		2.2 (0.9–4.8)
Yes	56	17.0	35.7 (24.2–49.1)		12.5 (6.0–24.2)		5.4 (1.7–15.5)
Disease during pregnancy				0.001		0.028		0.327
No	256	77.6	12.5 (9.0–17.2)		5.9 (3.6–9.5)		2.3 (1.1–5.1)
Yes	74	22.4	28.4 (19.2–39.8)		13.5 (7.4–23.5)		4.1 (1.3–12.0)
Desire to interrupt the pregnancy				< 0.001		0.024		< 0.001
No	277	83.9	11.6 (8.3–15.9)		6.1 (3.8–9.7)		0.7 (0.1–2.9)
Yes	53	16.1	39.6 (27.3–53.4)		15.1 (7.7–27.6)		13.2 (6.4–25.4)
Number of sexual partners in the latest years				< 0.001		0.108		0.002
1	265	80.3	11.7 (8.3–16.2)		6.4 (4.0–10.1)		1.1 (0.4–3.5)
2 or more	65	19.7	33.9 (23.3–46.2)		12.3 (6.2–22.9)		9.2 (4.2–19.2)
Sexual violence before the age of 15				0.015		0.150*		0.172
No	302	91.5	14.6 (11.0–19.0)		7.0 (4.6–10.5)		2.3 (1.1–4.8)
Yes	28	8.5	32.1 (17.4–51. 6)		14.3 (5.3–33.0)		7.1 (1.7–25.1)

Psychological violence
Variables	Gross analysis		Adjusted analysis
Variables	Gross PR (95%CI)	p	Adjusted PR (95%CI)	p
Age (years)		0.002		0.007
14 to 19	2.14 (1.32–3.49)		2.09 (1.29–3.38)
20 or more	1.0		1.0
Schooling level (years)		0.001		0.066
Up to 4 years	2.24 (1.38–3.64)		1.63 (0.97–2.74)
5 or more	1.0		1.0
Marital status		0.016		0.084
Without partner	1.95 (1.13–3.38)		1.63 (0.94–2.84)
With a partner	1.0		1.0
Employment situation		0.137		0.882
No	1.71 (0.84–3.48)		0.97 (0.54–2.04)
Yes	1.0		1.0
Monthly family income(reais)		0.001		0.001
< 1,000	2.45 (1.43–4.18)		2.40 (1.41–4.08)
≥ 1,000	1.0		1.0
Alcohol consumption during pregnancy		0.070		0.816
No	1.0		1.0
Yes	1.78 (0.95–3.32)		0.92 (0.47–1.81)
Smoking habit during pregnancy		0.002		0.584
No	1.0		1.0
Yes	2.44 (1.40–4.25)		1.19 (0.63–2.25)
History of illicit drug use		0.002		0.187
No	1.0		1.0
Yes	2.35 (1.38–4.01)		1.43 (0.84–2.45)
Beginning of sex life (years)		< 0.001		0.011
Up to 14	2.81 (1.74–4.55)		1.87 (1.15–3.03)
15 or more	1.0		1.0
History of STI		< 0.001		0.413
No	1.0		1.0
Yes	2.97 (1.84–4.77)		1.31 (0.69–2.50)
Disease during pregnancy		0.001		0.049
No	1.0		1.0
Yes	2.27 (1.40–3.69)		1.66 (1.01–2.75)
Desire to interrupt the pregnancy		< 0.001		0.006
No	1.0		1.0
Yes	3.43 (2.15–5.47)		2.0 (1.22–3.29)
Number of sexual partners in the latest years		< 0.001		0.020
1	1.0		1.0
2 or more	2.89 (1.80–4.65)		1.82 (1.10–3.00)
Sexual violence before the age of 15		0.010		0.092
No	1.0		1.0
Yes	2.21 (1.21–4.04)		1.66 (0.92–3.00)

Physical Violence
Variables	Gross analysis		Adjusted analysis
Variables	Gross PR (95%CI)	p	Adjusted PR (95%CI)	p
Age (years)		0.071		0.237
14 to 19	2.02 (0.94–4.32)		1.58 (0.74–3.37)
20 or more	1.0		1.0
Race		0.112		0.209
Non-black	1.0		1.0
Black	0.54 (0.25–1.15)		0.62 (0.29–1.31)
Schooling level (years)		< 0.001		< 0.001
Up to 4 years	4.81 (2.20–10.51)		4.50 (2.02–9.97)
5 or more	1.0		1.0
Marital status		0.146		0.269
Without partner	1.90 (0.80–4.52)		1.58 (0.70–3.53)
With a partner	1.0		1.0
Employment situation		0.183		0.619
No	2.23 (0.69–7.27)		1.36 (0.41–4.55)
Yes	1.0		1.0
Smoking habit during pregnancy		0.069		0.416
No	1.0		1.0
Yes	2.32 (0.94–5.79)		0.73 (0.34–1.57)
History of illicit drug use		0.012		0.300
No	1.0		1.0
Yes	2.82 (1.26–6.33)		1.65 (0.64–4.24)
Menarche (years)		0.203		0.984
Up to 13	1.97 (0.69–5.59)		0.99 (0.36–2.74)
14 or more	1.0		1.0
Beginning of sex life (years)		< 0.001		0.002
Up to 14	5.75 (2.57–12.88)		3.90 (1.68–9.14)
15 or more	1.0		1.0
History of STI		0.127		0.281
No	1.0		1.0
Yes	1.90 (0.83–4.34)		0.67 (0.32–1.39)
Disease during pregnancy		0.031		0.037
No	1.0		1.0
Yes	2.31 (1.08–4.92)		2.07 (1.05–4.11)
Desire to interrupt the pregnancy		0.025		0.321
No	1,0		1,0
Yes	2,46 (1,12–5,41)		1,60 (0,63–4,03)
Number of sexual partners in the latest years		0,108		0,688
1	1,0		1,0
2 or more	1,92 (0,86–4,25)		1,21 (0,47–3,12)
Sexual violence before the age of 15		0,157		0,287
No	1,0		1,0
Yes	2,05 (0,76–5,57)		1,48 (0,72–3,04)

Sexual violence
Variables	Gross analysis		Adjusted analysis
Variables	Gross PR (95%CI)	p	Adjusted PR (95%CI)	p
Age (years)
14 to19	3.78 (1.04–13.77)	0.044	1.41 (0.81 – 10.62)	0.100
20 or more	1.0		1.0
Marital status		0.016		0.041
Without partner	4.82 (1.34–17.32)		3.76 (1.06–13.40)
With a partner	1.0		1.0
Beginning of sex life (years)		0.015		0.127
Up to 14	5.42 (1.38–21.23)		3.17 (0.72–14.00)
15 or more	1.0		1.0
History of STI		0.197		0.238
No	1.0		1.0
Yes	2.45 (0.63–9.51)		0.52 (0.18–1.54)
Desire to interrupt the pregnancy		< 0.001		0.006
No	1.0		1.0
Yes	18.29 (3.90–85.85)		14.90 (2.20–100.90)
Number of sexual partners in the latest years		0.003		0.069
1	1.0		1.0
2 or more	8.15 (2.09–31.80)		4.17 (0.90–19.43)
Sexual violence before the age of 15		0.148		0.191
No	1.0		1.0
Yes	3.08 (0.67–14.17)		2.20 (0.68–7.12)

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[1] Correspondence: Franciéle Marabotti Costa Leite Universidade Federal do Espírito Santo Departamento de Enfermagem Av. Marechal Campos, 1468 29040-090 Vitória, ES, Brasil E-mail: francielemarabotti@gmail.com