Violência doméstica: um estudo realizado no período puerperal de adolescentes e adultas
Data
2013-04-24
Tipo
Tese de doutorado
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Resumo
A dinâmica da violência é particularmente complexa durante a gravidez. Não há consenso se existe maior número de ocorrências violentas contra a mulher durante a gestação ou se a gravidez funciona como evento protetor. Foi nosso objetivo determinar a prevalência da violência doméstica em Vitória, em puérperas adolescentes e adultas, e compará-la entre os dois grupos, avaliar a prevalência da violência física antes e durante a gravidez, identificar fatores associados à violência e avaliar a associação de resultados obstétricos e perinatais desfavoráveis entre as que sofreram violência na gestação. Realizamos estudo descritivo, transversal, com grupos de comparação em duas Maternidades de Vitória, Espírito Santo no período de maio de 2009 a abril de 2010. Foram avaliadas 359 puérperas, 179 adolescentes e 180 adultas através de entrevista padronizada, aplicada verbalmente, do “Abuse Assessment Screen” e coletados dados do prontuário médico das puérperas e recém-nascidos. A prevalência entre todas as participantes que foram alguma vez maltratadas emocionalmente ou fisicamente foi de 40,1%, (adolescentes 38,5%, adultas 41,7%). A violência emocional foi a mais freqüente, 82,6% (adolescentes 87,0%, adultas 76,0%) seguida da física de 17,4%, (adolescentes 10,1%, adultas 24,0%) e da sexual no último ano anterior a gravidez (adolescentes 1,1%, adultas 1,1%). No último ano anterior a gravidez, 3,9% foram agredidas fisicamente e durante a gravidez atual, 3,3%, (adolescentes, 4,5% no último ano e 5,0% na gravidez atual, adultas, 3,3% no último ano e 1,7% na gravidez atual). Os fatores associados à violência doméstica foram, entre as adolescentes, sofrer violência na família e maior número de parceiros sexuais e entre as adultas, sofrer violência na família, fumar e maior número de parceiros sexuais. Quanto aos resultados obstétricos e perinatais desfavoráveis não encontramos associação estatisticamente significante entre as que sofreram violência doméstica. Concluímos que os índices de violência doméstica são elevados na cidade de Vitória, semelhantes para a população de adolescentes e adultas e que em nossas pacientes a gravidez não influenciou a ocorrência de violência. A violência doméstica não influenciou os resultados perinatais.
The dynamics of violence is particularly complex during pregnancy. There is no consensus on whether there are more violent incidents against women during pregnancy or if pregnancy serves as a protective event. Our objective was to determine the prevalence of domestic violence in Vitoria, occurring on adolescents and adult mothers who have recently given birth, and compare it between the two groups, to evaluate the prevalence of physical violence before and during pregnancy, to identify factors associated with violence and the association of adverse obstetric and perinatal outcomes among those who experienced violence during pregnancy. We conducted a descriptive, crosssectional study with comparison groups from two maternity clinics in Vitoria, Espirito Santo, between May 2009 and April 2010. We evaluated 359 mothers, 179 adolescents and 180 adults through standardized verbal interviews, the "Abuse Assessment Screen" and data from medical records of mothers who have recently given birth and newborns. The percentage among all participants who have been emotionally or physically abused amounted to 40.1% (38.5% adolescents, adults 41.7%). Emotional abuse was the most frequent, 82.6% (87.0% adolescents, 76.0% adults) followed by physical abuse, 17.4% (10.1% adolescents, 24.0% adults) and sexual abuse occurring on the last year before pregnancy (1.1% adolescents, adults 1.1%). Physical assault on the last year before pregnancy occurred on 3.9% of the participants. During the current pregnancy, 3.3% were physically assaulted (adolescents, 4.5% in the last year and 5.0% during current pregnancy; adults, 3.3% in the last year and 1.7% during current pregnancy). Factors associated with domestic violence among adolescents were i) violence in the family and ii) a greater number of sexual partners; among adults, i) violence in the family, ii) smoking and iii) a greater number of sexual partners. As for adverse obstetric and perinatal outcome, no statistically significant association between those who suffered domestic violence was found. We conclude that rates of domestic violence are high in the city of Vitória. The rates are similar among the population of adolescents and adults, and pregnancy did not influence the occurrence of violence in our patients. The domestic violence did not influence perinatal outcomes.
The dynamics of violence is particularly complex during pregnancy. There is no consensus on whether there are more violent incidents against women during pregnancy or if pregnancy serves as a protective event. Our objective was to determine the prevalence of domestic violence in Vitoria, occurring on adolescents and adult mothers who have recently given birth, and compare it between the two groups, to evaluate the prevalence of physical violence before and during pregnancy, to identify factors associated with violence and the association of adverse obstetric and perinatal outcomes among those who experienced violence during pregnancy. We conducted a descriptive, crosssectional study with comparison groups from two maternity clinics in Vitoria, Espirito Santo, between May 2009 and April 2010. We evaluated 359 mothers, 179 adolescents and 180 adults through standardized verbal interviews, the "Abuse Assessment Screen" and data from medical records of mothers who have recently given birth and newborns. The percentage among all participants who have been emotionally or physically abused amounted to 40.1% (38.5% adolescents, adults 41.7%). Emotional abuse was the most frequent, 82.6% (87.0% adolescents, 76.0% adults) followed by physical abuse, 17.4% (10.1% adolescents, 24.0% adults) and sexual abuse occurring on the last year before pregnancy (1.1% adolescents, adults 1.1%). Physical assault on the last year before pregnancy occurred on 3.9% of the participants. During the current pregnancy, 3.3% were physically assaulted (adolescents, 4.5% in the last year and 5.0% during current pregnancy; adults, 3.3% in the last year and 1.7% during current pregnancy). Factors associated with domestic violence among adolescents were i) violence in the family and ii) a greater number of sexual partners; among adults, i) violence in the family, ii) smoking and iii) a greater number of sexual partners. As for adverse obstetric and perinatal outcome, no statistically significant association between those who suffered domestic violence was found. We conclude that rates of domestic violence are high in the city of Vitória. The rates are similar among the population of adolescents and adults, and pregnancy did not influence the occurrence of violence in our patients. The domestic violence did not influence perinatal outcomes.
Descrição
Citação
LIMA, Lucia Helena Mello de. Violência doméstica: um estudo realizado no período puerperal de adolescentes e adultas. 2013. 111 f. Tese (Doutorado em Obstetrícia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2013.