Physical violence by an intimate partner and the inappropriate use of prenatal care services among women in Northeastern Brazil

ABSTRACT:

Objective:

To analyze the association between physical violence by an intimate partner (PVIP) and the inappropriate use of prenatal care services.

Methods:

A nested cross-sectional study was conducted with 1,026 women, based on data from a prospective cohort study designed to investigate intimate partner violence among pregnant women enrolled in the Family Health Program (PSF) in Recife, Northeastern Brazil. The use of prenatal care services was assessed with basis on the guidelines from the Program for Humanization of Prenatal Care and Childbirth (Brazilian Ministry of Health) and considered the time of the first prenatal care visit and the total number of visits during the pregnancy. Data were collected through two face-to-face interviews (one in the last pregnancy trimester and the other in the postpartum period), using standardized questionnaires and data on Pregnancy Card records. An unconditional logistic regression was performed to estimate the odds ratio (OR) and the 95% confidence intervals to measure the association between an PVIP and the inappropriate use of prenatal care services, using the stepwise method.

Results:

The prevalence of the inappropriate use of prenatal care services was 44.1% and of an PVIP, 25.6%. In the logistic regression analysis, an intimatePVIP was associated with inappropriate prenatal care (OR = 1.37; 95%CI 1.01 - 1.85; p = 0.04) after adjustment by variables confirmed as confounders (parity, alcohol use in pregnancy, and education level).

Conclusion:

Women who are victims of an PVIP have more chance of receiving inappropriate prenatal care due to late onset of prenatal care, fewer prenatal care visits, or both.

Keywords:
Violence against women; Spousal abuse; Prenatal care; Pregnancy; Risk factors; Cross-sectional studies