Blumrich Lukas, Sousa Braian Lucas Aguiar, Barbieri Marco Antônio, Simões Vanda Maria Ferreira, da Silva Antonio Augusto Moura, Bettiol Heloisa, Ferraro Alexandre Archanjo
Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Front Glob Womens Health. 2024 Jul 12;5:1397194. doi: 10.3389/fgwh.2024.1397194. eCollection 2024.
Psychosocial stress during pregnancy has long-lasting and important consequences in the following generations, as it can affect intrauterine development. The impact on the developing immune system is notoriously important due to the associated morbidity and mortality in the first years of life. Little attention has been given to the role of violence during pregnancy (VDP), especially its impact on infant infectious morbidity.
We analyzed data from two Brazilian birth cohorts ( = 2,847) in two distinct cities (Ribeirão Preto and São Luís), collected during pregnancy and at the beginning of the second year of life. The association between VDP and infection in infancy was analyzed with structural equation modeling, using the WHO-VAW questionnaire as exposure and a latent variable for infection as the outcome.
VDP was reported by 2.48% (sexual), 11.56% (physical), and 45.90% (psychological) of the mothers. The models presented an adequate fit. In the city of São Luís, VDP was significantly associated with the latent construct for infection (standardized beta = 0.182; = 0.022), while that was not the case for the Ribeirão Preto sample (standardized beta = 0.113; = 0.113). Further analyses showed a gradient effect for the different dimensions of the exposure, from psychological to physical and sexual violence.
Our results suggest an association of VDP with infant morbidity in a poorer socioeconomic setting, and highlight the importance of considering the different dimensions of intimate partner violence. These findings may have important implications for the comprehension of global health inequalities and of the effects of gender-based violence.
孕期的心理社会压力会对后代产生长期且重要的影响，因为它会影响子宫内发育。由于生命最初几年相关的发病率和死亡率，对发育中的免疫系统的影响尤为重要。孕期暴力（VDP）的作用很少受到关注，尤其是其对婴儿感染性发病率的影响。
我们分析了来自巴西两个不同城市（里贝朗普雷图和圣路易斯）的两个出生队列（n = 2847）的数据，这些数据在孕期和生命第二年年初收集。使用结构方程模型分析VDP与婴儿期感染之间的关联，将世界卫生组织暴力侵害妇女问题调查问卷作为暴露因素，将感染的潜在变量作为结果。
2.48%（性暴力）、11.56%（身体暴力）和45.90%（心理暴力）的母亲报告遭受过VDP。模型拟合良好。在圣路易斯市，VDP与感染的潜在结构显著相关（标准化β = 0.182；p = 0.022），而里贝朗普雷图样本则不然（标准化β = 0.113；p = 0.113）。进一步分析显示，从心理暴力到身体暴力和性暴力，暴露的不同维度存在梯度效应。
我们的结果表明，在社会经济状况较差的环境中，VDP与婴儿发病率有关，并强调了考虑亲密伴侣暴力不同维度的重要性。这些发现可能对理解全球健康不平等以及性别暴力的影响具有重要意义。
