Sexual violence during pregnancy: cross-sectional study with women in puerperium
DOI:
https://doi.org/10.36311/jhgd.v32.13786Palabras clave:
Sex Offenses, Violence against woman, Pregnant Women, Crime Victims, Intimate Partner ViolenceResumen
Introduction: Sexual violence during pregnancy is a serious violation of human rights and reproductive rights. Its prevalence is variable and multifactorial, depending on the analyzed territory and sociocultural and economic factors, requiring permanent monitoring.
Methods: A cross-sectional study conducted at the Mandaqui Hospital, São Paulo, Brazil. The Abuse Assessment Screen (AAS) was applied to 350 puerperium women, with the outcome of suffering or not sexual violence during pregnancy, with data collected between September and December 2021. Sociodemographic and reproductive data were considered. We used an urn technique, with pre-coded data analyzed in EpiInfo® by Pearson's Chi-square and Mann Whitney test, adopting p<0.05 and 95% CI. Research approved by the Research Ethics Committee, CAAE No. 50580421.5.0000.5551.
Results: We found eight cases of sexual violence (2.3%) and sample loss of 18.9%. Women who suffered sexual violence reported more physical violence in the last 12 months (25.0% x 6.1% - p=0.033, OR/CI 0.19: 0.03-1.03) and fear of the most frequent intimate partner (25.0% x 3.5% - p=0.002, OR/CI 0.10: 0.01-0.59), but we did not find a difference in the history of suffering violence before the age of 15 and by the partner throughout life. There was no difference in age, schooling, race/color, union, income and work. The same occurred for reproductive aspects, with no difference regarding the occurrence of prematurity, high-risk pregnancy, reproductive planning and tobacco/alcohol use during pregnancy.
Conclusion: The prevalence of sexual violence during pregnancy was lower than in other Brazilian studies and populations from other countries. Women with sexual violence during pregnancy face a daily life of fear and more frequent physical violence. The high history of suffering violence before the age of 15 and experiencing physical or emotional violence by the intimate partner can aggravate the situation. The high history of violence and fear of the partner may have contributed to eventual understatement.
Descargas
Referencias
World Health Organization. WHO multi-country study on women's health and domestic violence against women: summary report of initial results on prevalence, health outcomes and women's responses. Geneva: World Health Organization; 2005. 206p.
Bessa MMB, Drezett J, Rolim M, Abreu LC. Violence against women during pregnancy: sistematized revision. Reprod Clim. 2014;29(2):71-9. DOI: 10.1016/j.recli.2014.09.001.
Durand JG, Schraiber LB. Violência na gestação entre usuárias de serviços públicos de saúde da Grande São Paulo: prevalência e fatores associados. Rev Bras Epidemiol. 2007;10(3):310.22. DOI: 10.1590/S1415-790X2007000300003.
Khosla AH, Dua D, Devi L, Sud SS. Domestic violence in pregnancy in North Indian women. Indian J Med Sci. 2005;59(5):195-9. DOI: 10.4103/0019-5359.16255.
Campbell J, García-Moreno C, Sharps P. Abuse during pregnancy in industrialized and developing countries. Violence Against Women. 2004;7:770-89.
DOI: 10.1177/1077801204265551.
Iliyasu Z, Abubakar IS, Galadanci HS, Hayatu Z, Aliyu MH. Prevalence and risk factors for domestic violence among pregnant women in northern Nigeria. J Interpers Violence. 2013;28(4):868-83. DOI: 10.1177/0886260512455872.
Taft AJ, Watson LF. Depression and termination of pregnancy (induced abortion) in a national cohort of young Australian women: the confounding effect of women’s experience of violence. BMC Public Health. 2008;26(75):1-8. DOI: 10.1186/1471-2458-8-75.
Hoang TN, Van TN, Gammeltoft T, Meyrowitsch DW, Thuy HNT, Rasch V. Association between intimate partner violence during pregnancy and adverse pregnancy outcomes in Vietnam: a prospective cohort study. PLoS One. 2016;11(9):e0162844. DOI:10.1371/journal.pone.0162844.
Santos SA, Lovisi GM, Valente CCB, Legay L, Abelha L. Violência doméstica durante a gestação: um estudo descritivo em uma unidade básica de saúde no Rio de Janeiro, Brasil. Cad Saude Colet. 2010;18(4):483-93.
Coker AL, Sanderson M, Dong B. Partner violence during pregnancy and risk of adverse pregnancy outcomes. Paediatr Perinat Epidemiol. 2004;18(4):260-9. DOI: 10.1111/j.1365-3016.2004.00569.x.
Okada MM, Hoga LAK, Borges ALV, Albuquerque RS, Belli MA. Domestic violence against pregnant women. Acta Paul Enferm. 2015;28(3):270-4. DOI: 10.1590/1982-0194201500045.
Menezes TC, Amorim MMR, Santos LC, Faúndes A. Violência física doméstica e gestação: resultados de um inquérito no puerpério. Rev Bras Ginecol Obstet. 2003;25(5): 309-16. DOI: 10.1590/S0100-72032003000500002.
Karaoglu L, Celbis O, Ercan C, Ilgar M, Pehlivan E, Gunes G, et al. Physical, emotional and sexual violence during pregnancy in Malatya, Turkey. Eur J Public Health. 2006;16(2):149-56. DOI: 10.1093/eurpub/cki161.
Audi CAF, Segall-Corrêa AM, Santiago SM, Andrade MGG, Pèrez-Escamila R. Violence against pregnant women: prevalence and associated factors. Rev Saude Publica. 2008;42(5):877-85. DOI: 10.1590/S0034-89102008005000041.
Moraes CL, Arana FDN, Reichenheim ME. Physical intimate partner violence during gestation as a risk factor for low quality of prenatal care. Rev Saude Publica. 2010;44(4):667-76. DOI: 10.1590/S0034-89102010000400010.
Viellas EF, Gama SGN, Carvalho ML, Pinto LW. Factors associated with physical aggression in pregnant women and adverse outcomes for the newborn. J Pediatr. 2013;89(1):83-90. DOI: 10.1016/j.jpedp.2012.08.009.
Ahmed S, Koenig MA, Stephenson R. Effects of domestic violence on perinatal and early-childhood mortality: evidence from north India. Am J Public Health. 2006;96(8):1423-8. DOI: 10.2105/AJPH.2005.066316.
Martin-de-Las-Heras S, Velasco C, Luna-Del-Castillo JD, Khan KS. Maternal outcomes associated to psychological and physical intimate partner violence during pregnancy: a cohort study and multivariate analysis. PloS One. 2019;14(6):e0218255. DOI:10.1371/journal.pone.0218255.
Monteiro CFS, Costa NSS, Nascimento PSV. A violência intra-familiar contra adolescentes grávidas. Rev Bras Enferm. 2007;60(4):373-6. DOI: 10.1590/S0034-71672007000400002.
Bo M, Canavese A, Magnano L, Rondana A, Castagna P, Gino S. Violence against pregnant women in the experience of the rape centre of Turin: Clinical and forensic evaluation. J Forensic Leg Med. 2020;76:102071. DOI: 10.1016/j.jflm.2020.102071.
Gazmararian JA, Lazorick S, Spitz AM, Ballard TJ, Saltzman LE, Marks JS. Prevalence of violence against pregnant women. JAMA. 1996;275(24):1915-20. doi:10.1001/jama.1996.03530480057041
Valladares E, Peña R, Persson LA, Högberg U. Violence against pregnant women: prevalence and characteristics. A population-based study in Nicaragua. BJOG. 2005:112(9):1243-8. DOI: 10.1111/j.1471-0528.2005.00621.x.
Johnson JK, Haider F, Ellis K, Hay DM, Lindow SW. The prevalence of domestic violence in pregnant women. BJOG. 2003;110(3):272-5. DOI: 10.1046/j.1471-0528.2003.02216.x.
Leung WC, Leung TW, Lam YYI, HO PC. The prevalence of domestic violence against pregnant women in a Chinese community: social issues in reproductive health. Int J Gynecol Obstet. 1999;66(1):23-30. DOI: 10.1016/S0020-7292(99)00053-3.
Kaye DK, Mirembe FM, Bantebya G, Johansson A, Ekstrom AM. Domestic violence during pregnancy and risk of low birth weight and maternal complications: a prospective cohort study at Mulago Hospital, Uganda. Trop Med Int Health. 2006;11(10):1576-84. DOI: 10.1111/j.1365-3156.2006.01711.x.
Chasweka R, Chimwaza A, Maluwa A. Isn't pregnancy supposed to be a joyful time? A cross-sectional study on the types of domestic violence women experience during pregnancy in Malawi. Malawi Med J. 2018;30(3):191-6. DOI: 10.4314/mmj.v30i3.11.
Drezett J, Bessa MMM, Valenti VE, Adami F, Abreu LC. Sexually transmitted infections among adolescent and adult women victims of sexual violence in the metropolitan region of São Paulo, Brazil, Hum Reprod Arch. 2020;35:e000320. DOI: 10.4322/hra.000320.
Dikmen HA, Çankaya S. The effect of exposure to sexual violence on sexual dysfunction and sexual distress in pregnant women. J Sex Med. 2020;17(12):2394-407. DOI: 10.1016/j.jsxm.2020.09.006.
Gürkan ÖC, Ekşi Z, Deniz D, Çırçır H. The influence of intimate partner violence on pregnancy symptoms. J Interpers Violence. 2020;35(3-4):523-41. DOI: 10.1177/0886260518789902.
Moraes CL, Reichenheim ME. Domestic violence during pregnancy in Rio de Janeiro. Int J Gynaecol Obstet. 2002;79(3):269-77. DOI: 10.1016/s0020-7292(02)00250-3.
Bessa MMM, Drezett J, Souza-Júnior HMF, Adami F, Bezerra IMP, Abreu LC. Physical and sexual violence during pregnancy in the northeastern backlands of Brazil: a cross-sectional study. Hum Reprod Arch. 2022;37:e000321. DOI: 10.4322/hra.000321.
Instituto Brasileiro de Geografia e Estatística. Ministério do Planejamento, Desenvolvimento e Gestão. Síntese de indicadores sociais: uma análise das condições de vida da população brasileira 2016. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística; 2016. 141p.
Reichenheim ME, Moraes CL, Hasselmann MH. Equivalência semântica da versão em português do instrumento Abuse Assessment Screen para rastrear a violência contra a mulher grávida. Rev Saude Publica. 2000;34(6):610-16. DOI: 10.1590/S0034-89102000000600008.
Ferri CP, Mitsuhiro SS, Barros MCM, Chalem E, Guinsburg R, Patel V, et al. The impact of maternal experience of violence and common mental disorders on neonatal outcomes: a survey of adolescent mothers in Sao Paulo, Brazil. BMC Public Health. 2007;7:209. DOI: 10.1186/1471-2458-7-209.
Rurangirwa AA, Mogren I, Ntaganira J, Krantz G. Intimate partner violence among pregnant women in Rwanda, its associated risk factors and relationship to ANC services attendance: a population-based study. BMJ Open. 2017;7(2):e013155. DOI: 10.1136/bmjopen-2016-013155.
Naghizadeh S, Mirghafourvand M, Mohammadirad R. Domestic violence and its relationship with quality of life in pregnant women during the outbreak of COVID-19 disease. BMC Pregnancy Childbirth. 2021;21(1):88. DOI: 10.1186/s12884-021-03579-x.
Cervantes-Sánchez P, Delgado-Quiñones EG, Nuño-Donlucas MO, Sahagún-Cuevas MN, Hernández-Calderón J, Ramírez-Ramos JK. Prevalence of domestic violence in pregnant women from 20 to 35 years in a family medicine unit. Rev Med Inst Mex Seguro Soc. 2016;54(3):286-91.
Koch AR, Rosenberg D, Geller SE. Higher risk of homicide among pregnant and postpartum females aged 10-29 years in Illinois, 2002-2011. Obstet Gynecol. 2016:128(3):440-6. DOI: 10.1097/AOG.0000000000001559.
Halpern-Meekin S, Costanzo M, Ehrenthal D, Rhoades G. Intimate partner violence screening in the prenatal period: variation by state, insurance, and patient characteristics. Matern Child Health J. 2019; 23(6):756-67. DOI: 10.1007/s10995-018-2692-x.
Garcia LP, Silva GDM. Violência por parceiro íntimo: perfil dos atendimentos em serviços de urgência e emergência nas capitais dos estados brasileiros, 2014. Cad Saude Publica. 2018;34(4):e00062317 DOI: 10.1590/0102-311X00062317.
Monteiro MFG, Romio JAF, Drezett J. Is there race/color differential on femicide in Brazil? The inequality of mortality rates for violent causes among white and black women. J Hum Growth Dev. 2021;31(2):358-66. DOI: 10.36311/jhgd.v31.1225.
Fiorotti KF, Amorim MHC, Lima EFA, Primo CC. Prevalência e fatores associados à violência doméstica: estudo em uma maternidade de alto risco. Texto Contexto Enferm. 2018;27(3). DOI: 10.1590/0104-07072018000810017.
Stöckl H, Watts C, Kilonzo Mbwambo JKK. Physical violence by a partner during pregnancy in Tanzania: prevalence and risk factors. Reprod Health Matters. 2010;18(36):171-80. DOI: 10.1016/S0968-8080(10)36525-6.
Finnbogadóttir H, Dykes AK, Wann-Hansson C. Prevalence and incidence of domestic violence during pregnancy and associated risk factors: a longitudinal cohort study in the south of Sweden. BMC Pregnancy and Childbirth. 2016;16:228. DOI: 10.1186/s12884-016-1017-6.
Janssen PA, Holt VL, Sugg NK, Emanuel I, Critchlow CM, Henderson AD. Intimate partner violence and adverse pregnancy outcomes: a population-based study. Am J Obstet Gynecol. 2003;188(5):1341-7. DOI: 10.1067/mob.2003.274.
Fórum Brasileiro de Segurança Pública. Anuário brasileiro de segurança pública 2020. 14ª ed. Brasília: Fórum Brasileiro de Segurança Pública; 2020. 332p.
Waiselfisz JJ. Mapa da violência 2015: homicídio de mulheres no Brasil. Brasília: FLACSO; 2015. 83p.
Talley P, Heitkemper M, Chicz-Demet A, Sandman CA. Male violence, stress, and neuroendocrine parameters in pregnancy: a pilot study. Biol Res Nurs. 2006;7(3):222-33. DOI: 10.1177/1099800405283182.
Belay S, Astatkie A, Emmelin M, Hinderaker SG. Intimate partner violence and maternal depression during pregnancy: a community-based cross-sectional study in Ethiopia. PLoS One. 2019;14(7):e0220003. DOI: 10.1371/journal.pone.0220003.
Brasil. Ministério da Saúde. Pesquisa nacional de demografia e saúde da criança e da mulher - PNDS 2006: dimensões do processo reprodutivo e da saúde da criança. Brasília: Ministério da Saúde, 2009. 302p.
Al-Tawil NG. Association of violence against women with religion and culture in Erbil Iraq: a cross-sectional study. BMC Public Health. 2012; 12(1). DOI: 10.1186/1471-2458-12-800.
Mohammadhosseini E, Sahraean L, Bahrami T. Domestic abuse before, during and after pregnancy in Jahrom, Islamic Republic of Iran. East Mediterr Health J. 2010;16:752-8. DOI:10.26719/2010.16.7.752.
Peedicayil A, Sadowski LS, Jeyaseelan L, Shankar V, Jain D, Suresh S, et al. Spousal physical violence against women mduring pregnancy. BJOG. 2004;111(7):682-7.
DOI: 10.1111/j.1471-0528.2004.00151.x.
Bacchus L, Mezey G, Bewley S. A qualitative exploration of the nature of domestic violence in pregnancy. Violence Against Women. 2006;12(6):588–604.
DOI: 10.1177/1077801206289131.
Ministério Público do Estado de São Paulo. Nota técnica. Alterações trazidas pela Lei n° 13.931/19 na Lei de notificação compulsória n. 10.778/03 e a Portaria n. 2.282, de 27 de agosto de 2020 do Ministério da Saúde. São Paulo: Ministério Público do Estado de São Paulo; 2020. 46p.
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2022 Journal of Human Growth and Development
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
