Violence during pregnancy and the mental health of women victims of their partners

Author(s)

Mariana de Oliveira Fonseca Machado

• Document type: Doctoral Thesis
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC)
• Defense date: 2014-05-15

Examining board members

Flávia Azevedo Gomes sponholz; Ana Cristina Freitas de Vilhena Abrão; Vanderlei José Haas; Juliana Cristina dos Santos Monteiro

• Advisor: Flávia Azevedo Gomes sponholz

Abstract

The objective of this study was to verify the repercussions of violence by the intimate partner during the present pregnancy on the mental health of women users of a prenatal care service. This is an observational study, performed with a cross-sectional design, at the Reference Center for Women\'s Health of Ribeirão Preto, São Paulo, Brazil, with 358 pregnant women following prenatal care at the referred service between May 2012 and May 2013. Data collection was performed on the day of the women\'s first prenatal appointment at the service, using seven instruments: i. instrument for sociodemographic, economic and behavioral characteristics; ii. instrument for obstetrical characteristics; iii. Edinburgh Postnatal Depression Scale; iv. Post-Traumatic Stress Disorder Checklist - Civilian Version; v. Beck Scale for Suicidal Ideation; vi. State-Trait Anxiety Inventory; vii. instrument for violence identification and characterization. The data were analyzed using Statistical Package for Social Sciences, version 21.0. Furthermore, univariate, bivariate and multivariate analyses of the data were performed, by absolute and relative frequency distribution, central and variability tendency measures, the Chi-square and T-Test statistical tests, prevalence ratio, prevalence odds ratio, multiple logistic regression and multiple linear regression. At the moment of data collection, the participants\' mean age was 25 years, and they had a mean of 9.5 years of formal education. Most women reported having the following characteristics: skin color different from white; single; living with the intimate partner; having some kind of religion; unemployed; mean monthly family income of 2.6 Brazilian minimum wages; partner was the breadwinner. Most reported not having smoked, consumed alcohol or any illicit drugs during the present pregnancy. Moreover, the sample was characterized by multiparous and nulliparous women, most of whom had living children and without a history of miscarriages. The prevalence rate for intimate partner violence during the present pregnancy was 17.6%. The prevalence rates of probable antenatal depression, probable antenatal post-traumatic stress disorder and probable antenatal suicidal ideation were 28.2%, 17.0% and 7.8%, respectively. The women\'s mean scores on the trait-anxiety and state-anxiety scales were 39.1 and 42.5, respectively. After adjustment using multiple logistic regression models, associations were found between intimate partner violence during the pregnancy and probable antenatal depression, probable antenatal post-traumatic stress disorder and probable antenatal suicidal ideation. The adjusted multiple linear regression models showed that women victims of intimate partner violence in the present pregnancy had higher scores for trait-anxiety and state-anxiety symptoms compared to those who did not endure this type of violence. Therefore, recognizing violence as a clinically relevant and identifiable risk factor for the occurrence of mental disorders during pregnancy may be a first step to prevent these problems. Ideally, the answers should include the health, social work and justice domains so as to meet the duty of the Brazilian State of eliminating the violence against women (AU)

• FAPESP's process: 12/06037-0 - Violence during pregnancy and the mental health of women victim of intimate partner
• Grantee: Mariana de Oliveira Fonseca-Machado
• Support Opportunities: Scholarships in Brazil - Doctorate