ABSTRACT
BACKGROUND: Violence against pregnant women is an increasing public health concern. The purpose of this study is to estimate the prevalence of violence during pregnancy, to identify characteristics associated and to assess the impact of violence on newborn outcomes. METHODS: Prospective cohort study of 652 pregnant women attending primary care clinics in Southern Brazil, from June 2006 to September 2007. Women with gestational age ranging from 16th and 36th were enrolled and their exposure to violence and mental disorder was assessed. After the birth they were contacted by telephone when information on obstetric and neonatal outcomes was obtained. RESULTS: Any violence during current pregnancy was reported by 18.3% [95% confidence interval (CI) 15.3-21.4%] participants, 15.0% (95% CI 12.3-17.8%) psychological violence, 6% (95% CI 4.2-7.8%) physical violence and 3% (0-0.5%) sexual violence. These women were more often of low income, did not work or study and had inadequate prenatal care and pregnancy weight gain. There was a statistically significant crude association between exposure to physical and psychological violence [relative risk (RR) 3.21 (1.51-6.80)]. After adjustment for family income, number of prenatal visits, length of gestation and gestational weight gain, the effect size decreased, but remained statistically significant (RR 2.18; 95% CI 1.16-4.08%). CONCLUSION: In disadvantaged settings in Brazil, violence in pregnancy is frequent; it is associated with inadequate maternal weight gain during pregnancy and prenatal care, and increases risk of low birth-weight. Thus, violence in pregnancy imposes a challenge to effective prenatal care delivery with potential benefits to the mother and her baby.
Subject(s)
Pregnancy Outcome/epidemiology , Violence , Adolescent , Adult , Brazil/epidemiology , Female , Health Behavior , Humans , Infant, Low Birth Weight , Infant, Newborn , Mental Health , Pregnancy , Prospective Studies , Socioeconomic Factors , Young AdultABSTRACT
AIM: To estimate the prevalence of violence, depressive symptoms, and associated factors during pregnancy in women attending antenatal care in Brazil. METHODS: Violence was assessed using a modified version of the abuse assessment screen (ASS), and depressive symptoms were evaluated using the primary care evaluation of mental disorders (PRIME-MD). Participants were pregnant women attending 18 primary care units in Rio Grande do Sul, Brazil, between June 2006 and April 2007. A total of 712 pregnant women participated, but only 627 of them responded the ASS. RESULTS: Experience of any lifetime violence was reported by 273 (43.4%) women and 114 (18.2%) reported violence during the current pregnancy. One-third of them (n = 211) reported lifetime domestic violence and 100 (15.9%) women reported this type of violence during the current pregnancy. Experience of domestic violence during pregnancy was more common in unemployed women, among those with two or more children, with a higher consumption of alcohol, and who had not planned their current pregnancy. Of the total of sample (n = 712), 198 (27.8%) women reported six or more depressive symptoms. The presence of depressive symptoms during pregnancy was associated with low educational levels, living in a household with five or more people, and with higher consumption of alcohol during pregnancy. CONCLUSION: Pregnant women attending primary care are exposed to high rates of domestic violence, and many have clinically relevant depressive symptoms. Appropriate interventions to avoid or minimize the effects of violence and mental disorders to the well-being of the mothers and their babies are urgently required. Primary care services play an important role in identifying and supporting women at risk.
Subject(s)
Depression/epidemiology , Domestic Violence/statistics & numerical data , Pregnancy Complications/epidemiology , Primary Health Care/statistics & numerical data , Adult , Age Factors , Brazil/epidemiology , Depression/diagnosis , Depression/psychology , Domestic Violence/psychology , Educational Status , Family Characteristics , Female , Humans , Income/statistics & numerical data , Male , Pregnancy , Pregnancy Trimesters/psychology , Pregnancy, Unplanned/psychology , Prenatal Care/methods , Prenatal Care/psychology , Prenatal Care/statistics & numerical data , Prevalence , Primary Health Care/methods , Risk Factors , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To examine the prevalence of inappropriate eating behaviors and associated factors among pregnant women in primary care. METHOD: The Eating Disorder Examination Questionnaire was used to assess eating disorders and the Primary Care Evaluation of Mental Disorders was used to examine anxiety and depressive symptoms. Body mass index (BMI) and pregestational weight were also assessed. RESULTS: Prevalence of binge eating during pregnancy was 17.3% [95% confidence interval (CI) 14.5-20.0], followed by excessive shape (5.6%; 95% CI 4-8) and weight concerns (5.5%; 95% CI 4-8). Binge eating during pregnancy was significantly associated with binge eating before pregnancy [prevalence ratio (PR) = 3.1; 95% CI 2.2-4.3], current anxiety symptoms (PR = 1.8; 95% CI 1.3-2.4), and prepregnancy BMI < 19.8 kg/m(2) (PR = 1.6; 95% CI 1.1-2.5). The prevalence of eating disorders was 0.6% (95% CI 0.01-1.11). DISCUSSION: Eating disorder symptoms should be routinely assessed and treated during prenatal care, along with other comorbid psychiatric symptoms such as anxiety.
