Ribeiro Marizélia Rodrigues Costa, da Silva Antônio Augusto Moura, E Alves Maria Teresa Seabra Soares de Britto, Batista Rosângela Fernandes Lucena, de Rocha Lourdes Maria Leitão Nunes, Schraiber Lilia Blima, Medeiros Nilzângela Lima, Costa Danielle Cristina Silva, Bettiol Heloisa, Barbieri Marco Antônio
Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
BMC Pregnancy Childbirth. 2014 Feb 12;14:66. doi: 10.1186/1471-2393-14-66.
Violence against pregnant women has been associated with gestational and perinatal disorders. Psychological violence is the type least investigated and its associated factors have been little studied. The present study was conducted in order to estimate prevalence rates and analyze the factors associated with exclusive and recurrent psychological violence in the municipality of São Luís, Brazil.
Data regarding 982 pregnant women, aged from 14 to 45 years, interviewed in 2010 and 2011 in a prenatal cohort were used. A self-applied questionnaire was used to screen for violence. Pregnant women submitted to physical and sexual violence were excluded from the analysis of factors associated with exclusive psychological violence. Prevalence ratios and 95% confidence intervals were estimated by a Poisson regression model with a hierarchical approach at three levels. At level 1 of the theoretical-conceptual model, we analyzed demographic and socioeconomic characteristics and variables that express gender inequalities; at level 2, we analyzed social support received by the women, and at level 3, the life experiences of the pregnant women.
Prevalence rate of exclusive psychological violence was 41.6% and of recurrent violence was 32.6%. Exclusive psychological violence was associated with pregnant women's age of 14 to 18 years (PR: 1.32 95% CI: 1.04 - 1.70), pregnant women's schooling superior to that of her intimate partner (PR: 1.54 95% CI: 1.09 - 2.16), inadequate social affective support/positive social interaction (PR: 1.34 95% CI: 1.11 - 1.62), use of illicit drugs by the pregnant women (PR: 1.80 95% CI: 1.16 - 2.81) and having had six or more intimate partners in life (PR: 1.52 95% CI: 1.18 - 1.96). Recurrent exclusive psychological violence was associated with inadequate social affective support/positive social interaction (PR: 1.47 95% CI: 1.15 - 1.87), use of illicit drugs by the pregnant women (PR: 2,28 95% CI: 1,40 - 3,71) and having had six or more intimate partners in life (PR: 1.47 95% CI: 1.06 - 2.03).
Psychological violence was a common phenomenon in this population of pregnant women that was associated with gender inequalities, inadequate social support and illicit drug use and should be routinely investigated during prenatal visits at health care services.
针对孕妇的暴力行为与妊娠及围产期疾病有关。心理暴力是研究最少的类型，其相关因素也鲜少被研究。本研究旨在估计巴西圣路易斯市单纯性和复发性心理暴力的患病率，并分析与之相关的因素。
使用了2010年和2011年在一个产前队列中对982名年龄在14至45岁之间的孕妇进行访谈的数据。采用自填式问卷筛查暴力行为。遭受身体和性暴力的孕妇被排除在与单纯性心理暴力相关因素的分析之外。通过具有三级分层方法的泊松回归模型估计患病率和95%置信区间。在理论 - 概念模型的第1层，我们分析了人口统计学和社会经济特征以及表达性别不平等的变量；在第2层，我们分析了女性获得的社会支持；在第3层，分析了孕妇的生活经历。
单纯性心理暴力的患病率为41.6%，复发性暴力的患病率为32.6%。单纯性心理暴力与14至18岁的孕妇（患病率比：1.32，95%置信区间：1.04 - 1.70）、孕妇的受教育程度高于其亲密伴侣（患病率比：1.54，95%置信区间：1.09 - 2.16）、社会情感支持不足/积极社会互动不足（患病率比：1.34，95%置信区间：1.11 - 1.62）、孕妇使用非法药物（患病率比：1.80，95%置信区间：1.16 - 2.81）以及一生中拥有六个或更多亲密伴侣（患病率比：1.52，95%置信区间：1.18 - 1.96）有关。复发性单纯性心理暴力与社会情感支持不足/积极社会互动不足（患病率比：1.47，95%置信区间：1.15 - 1.87）、孕妇使用非法药物（患病率比：2.28，95%置信区间：1.40 - 3.71）以及一生中拥有六个或更多亲密伴侣（患病率比：1.47，95%置信区间：1.06 - 2.03）有关。
心理暴力在这群孕妇中是一种常见现象，与性别不平等、社会支持不足和非法药物使用有关，在医疗保健服务的产前检查中应常规进行调查。
