Violence against pregnant women and associated factors in the city of Governador Valadares

Defilipo, Érica Cesário; Chagas, Paula Silva de Carvalho; Ribeiro, Luiz Cláudio

doi:10.11606/s1518-8787.2020054002491

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Sumário

Original Article • Rev. Saúde Pública 54 • 2020 • https://doi.org/10.11606/s1518-8787.2020054002491 copy

Violence against pregnant women and associated factors in the city of Governador Valadares

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To characterize violence against women during pregnancy and to verify its association with socioeconomic, demographic, obstetric, behavioral factors, health care and diseases during pregnancy.

METHODS

Cross-sectional study carried out with puerperal women whose birth took place at the Municipal Hospital of Governador Valadares, in Minas Gerais, from May 2017 to July 2018. Data collection was performed through interviews, and complementary information was obtained by analyzing the prenatal file and medical records. For data analysis, logistic regression was used.

RESULTS

The total of 771 puerperal women participated in the study. Of these, 62 (8.0%) reported having suffered physical, psychological or sexual violence during pregnancy. The pregnant women most likely to have suffered violence were alcohol dependent (OR = 4.97; 95%CI 2.30–10.75; p < 0.001), those who did not perform prenatal care (OR = 3.88; 95%CI 1.00–15.09; p = 0.050), those who used health services in an emergency during pregnancy (OR = 2.47; 95%CI 1.42–4.30; p = 0.001) and who had gestational diabetes (OR = 2.59; 95%CI 1.06–6.32; p = 0.037) and sexually transmitted diseases (OR = 3.85; 95%CI 1.41–10.50; p = 0.009).

CONCLUSION

Violence against pregnant women is associated with behavioral factors and related to health care and diseases during pregnancy. It is essential to recognize factors associated by health professionals through actions to track situations of violence against women since the beginning of prenatal care, in order to enable early intervention.

Pregnant Women; Violence Against Women; Risk Factors; Socioeconomic Factors; Cross-Sectional Studies

Variables	Frequency (n = 771)		Exposed to violence		Not exposed to violence		OR	95%CI	p
Variables	n	%	n	%	n	%	OR	95%CI	p
BLOCK 1

Education
Incomplete HS or under grade	393	51.0	39	62.9	354	49.9	Ref
Complete HS or superior grade	378	49.0	23	37.1	355	50.1	0.59	0.34–1.01	0.063^b
Age
≤ 18 years old	99	12.8	12	19.4	87	12.3	Ref
>18 years old	672	87.2	50	80.6	622	87.7	0.58	0.30–1.14	0.110^b
Ethnicity
White	111	14.4	7	11.3	104	14.7	Ref
Black or brown	660	85.6	55	88.7	605	85.3	1.35	0.60–3.05	0.573
Marital Status
With partner	613	79.5	43	69.4	570	80.4	Ref
Without partner	158	20.5	19	30.6	139	19.6	1.81	1.02–3.21	0.039^b
Employment
Without paid occupation	503	65.2	44	71.0	459	64.7	Ref
With paid occupation	268	34.8	18	29.0	250	35.3	0.75	0.43–1.33	0.404
Partner’s education^a
Incomplete HS or under grade	403	58.2	26	51.0	377	58.8	Ref
Complete HS or superior grade	289	41.8	25	49.0	264	41.2	1.37	0.78–2.43	0.275
Partner’s age^a
≤ 18 years old	29	3.9	1	1.8	28	4.0	Ref
>18 years old	720	96.1	56	98.2	664	96.0	2.36	0.32–17.68	0.718
Family income^a
≤ 2 minimum wages	547	74.1	45	76.3	502	73.9	Ref
> 2 minimum wages	191	25.9	14	23.7	177	26.1	0.88	0.47–1.65	0.759
Place of residence
Urban environment	637	82.6	55	88.7	582	82.1	Ref
Rural environment	134	17.4	7	11.3	127	17.9	0.58	0.26–1.31	0.223

BLOCK 2

Number of children
First child	378	49.0	33	53.2	345	48.7	Ref
Second child or more	393	51.0	29	46.8	364	51.3	0.83	0.50–1.40	0.510
Planned pregnancy
No	429	55.6	33	53.2	396	55.9	Ref
Yes	342	44.4	29	46.8	313	44.1	1.11	0.66–1.87	0.690
Previous abortion
No	640	83.0	47	75.8	593	83.6	Ref
Yes	131	17.0	15	24.2	116	16.4	1.63	0.88–3.02	0.115^b

Variables	Frequency (n = 771)		Exposed to violence		Not exposed to violence		OR	95%CI	Valor de p
Variables	n	%	n	%	n	%	OR	95%CI	Valor de p
BLOCK 3

Alcohol dependence
No	726	94.2	50	80.6	676	95.3	Ref
Yes	45	5.8	12	19.4	33	4.7	4.92	2.39–10.11	< 0.001*
Cigarette use
No	710	92.1	52	83.9	658	92.8	Ref
Yes	61	7.9	10	16.1	51	7.2	2.48	1.19–5.17	0.012*
Drug use
No	763	99.0	60	96.8	703	99.2	Ref
Yes	8	1.0	2	3.2	6	0.8	3.91	0.78–19.77	0.076*

BLOCK 4

Prenatal care
No	12	1.6	4	6.5	8	1.1	Ref
Yes	759	98.4	58	93.5	701	98.9	0.17	0.05–0.57	0.001*
Prenatal care institution
Public	658	86.7	52	89.7	606	86.4	Ref
Private	101	13.3	6	10.3	95	13.6	0.74	0.31–1.76	0.687
Number of prenatal appointments
< 6 appointments	190	24.9	23	37.1	167	23.9	Ref
≥ 6 appointments	572	75.1	39	62.9	533	76.1	0.53	0.31–0.92	0.021*
First prenatal appointments
≤ 16 weeks	636	84.8	51	87.9	585	84.5	Ref
> 16 weeks	114	15.2	7	12.1	107	15.5	0.75	0.33–1.70	0.572
Emergency use of health services
No	490	63.6	28	45.2	462	65.2	Ref
Yes	281	36.4	34	54.8	247	34.8	2.27	1.35–3.83	0.002*

Variables	Frequency (n = 771)		Exposed to violence		Not exposed to violence		OR	95%CI	p
Variables	n	%	n	%	n	%	OR	95%CI	p
Gestational diabetes
No	732	94.9	55	88.7	677	95.5	Ref
Yes	39	5.1	7	11.3	32	4.5	2.69	1.14–6.38	0.020*
Gestational hypertension
No	671	87.0	53	85.5	618	87.2	Ref
Yes	100	13.0	9	14.5	91	12.8	1.15	0.55–2.42	0.706
Chronic hypertension
No	752	97.5	61	98.4	691	97.5	Ref
Yes	19	2.5	1	1.6	18	2.5	0.63	0.08–4.80	1.000
Pre-eclampsia or eclampsia
No	734	95.2	61	98.4	673	94.9	Ref
Yes	37	4.8	1	1.6	36	5.1	0.31	0.04 - 2.27	0.352
Urinary tract infection
No	474	61.5	31	50.0	443	62.5	Ref
Yes	297	38.5	31	50.0	266	37.5	1.67	0.99–2.80	0.053*
Vaginal bleeding in the first trimester
No	650	84.3	44	71.0	606	85.5	Ref
Yes	121	15.7	18	29.0	103	14.5	2.41	1.34–4.33	0.003*
Oligohydramnios
No	731	94.8	57	91.9	674	95.1	Ref
Yes	40	5.2	5	8.1	35	4.9	1.69	0.64 - 4.48	0.287
Premature rupture of the membrane
No	741	96.1	61	98.4	680	95.9	Ref
Yes	30	3.9	1	1.6	29	4.1	0.38	0.05–2.87	0.503
Anemia
No	555	72.0	40	64.5	515	72.6	Ref
Yes	216	28.0	22	35.5	194	27.4	1.46	0.85–2.52	0.172*
STD (HIV or syphilis)
No	747	96.9	56	90.3	691	97.5	Ref
Yes	24	3.1	6	9.7	18	2.5	4.11	1.57–10.78	0.002*

Blocks	Variables	OR	95%CI	p
Block 3	Alcohol dependence
	No	Ref
	Yes	4,97	2,30–10,75	< 0,001*
Block 4	Prenatal care
	Yes	Ref
	No	3,88	1,00–15,09	0,050
	Use of emergency health services
	No	Ref
	Yes	2,47	1,42–4,30	0,001*
Block 5	Gestational diabetes
	No	Ref
	Yes	2,59	1,06–6,32	0,037*
	Sexually Transmitted Diseases
	No	Ref
	Yes	3,85	1,41–10,50	0,009*

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E-mail: revsp@usp.br

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[1] Correspondence: Érica Cesário Defilipo Clínica Escola de Fisioterapia Rua Leonardo Cristino, 3.400 35012-000 Governador Valadares, MG, Brasil E-mail: erica.defilipo@ufjf.br