ABSTRACT OBJECTIVE To estimate differential associations between the exposure to violence in the family of origin and victimization and perpetration of intimate partner violence in pregnancy. METHODS A nested case-control study was carried out within a cohort study with 1,120 pregnant women aged 18–49 years old, who were registered in the Family Health Strategy of the city of Recife, State of Pernambuco, Brazil, between 2005 and 2006. The cases were the 233 women who reported intimate partner violence in pregnancy and the controls were the 499 women who did not report it. Partner violence in pregnancy and previous experiences of violence committed by parents or other family members were assessed with a standardized questionnaire. Multivariate logistic regression analyses were modeled to identify differential associations between the exposure to violence in the family of origin and victimization and perpetration of intimate partner violence in pregnancy. RESULTS Having seen the mother suffer intimate partner violence was associated with physical violence in childhood (OR = 2.62; 95%CI 1.89–3.63) and in adolescence (OR = 1.47; 95%CI 1.01–2.13), sexual violence in childhood (OR = 3.28; 95%CI 1.68–6.38) and intimate partner violence during pregnancy (OR = 1.47; 95% CI 1.01 – 2.12). The intimate partner violence during pregnancy was frequent in women who reported more episodes of physical violence in childhood (OR = 2.08; 95%CI 1.43–3.02) and adolescence (OR = 1.63; 95%CI 1.07–2.47), who suffered sexual violence in childhood (OR = 3.92; 95%CI 1.86–8.27), and who perpetrated violence against the partner (OR = 8.67; 95%CI 4.57–16.45). CONCLUSIONS Experiences of violence committed by parents or other family members emerge as strong risk factors for intimate partner violence in pregnancy. Identifying and understanding protective and risk factors for the emergence of intimate partner violence in pregnancy and its maintenance may help policymakers and health service managers to develop intervention strategies.

ABSTRACT OBJECTIVE To estimate differential associations between the exposure to violence in the family of origin and victimization and perpetration of intimate partner violence in pregnancy. METHODS A nested case-control study was carried out within a cohort study with 1,120 pregnant women aged 18–49 years old, who were registered in the Family Health Strategy of the city of Recife, State of Pernambuco, Brazil, between 2005 and 2006. The cases were the 233 women who reported intimate partner violence in pregnancy and the controls were the 499 women who did not report it. Partner violence in pregnancy and previous experiences of violence committed by parents or other family members were assessed with a standardized questionnaire. Multivariate logistic regression analyses were modeled to identify differential associations between the exposure to violence in the family of origin and victimization and perpetration of intimate partner violence in pregnancy. RESULTS Having seen the mother suffer intimate partner violence was associated with physical violence in childhood (OR = 2.62; 95%CI 1.89–3.63) and in adolescence (OR = 1.47; 95%CI 1.01–2.13), sexual violence in childhood (OR = 3.28; 95%CI 1.68–6.38) and intimate partner violence during pregnancy (OR = 1.47; 95% CI 1.01 – 2.12). The intimate partner violence during pregnancy was frequent in women who reported more episodes of physical violence in childhood (OR = 2.08; 95%CI 1.43–3.02) and adolescence (OR = 1.63; 95%CI 1.07–2.47), who suffered sexual violence in childhood (OR = 3.92; 95%CI 1.86–8.27), and who perpetrated violence against the partner (OR = 8.67; 95%CI 4.57–16.45). CONCLUSIONS Experiences of violence committed by parents or other family members emerge as strong risk factors for intimate partner violence in pregnancy. Identifying and understanding protective and risk factors for the emergence of intimate partner violence in pregnancy and its maintenance may help policymakers and health service managers to develop intervention strategies.

OBJETIVO: Estimar a prevalência e analisar o padrão da violência por parceiro íntimo antes e durante a gestação e no pós-parto. MÉTODOS: Estudo de coorte realizado com 960 mulheres de 18 a 49 anos, cadastradas no Programa Saúde da Família da cidade do Recife, PE, entre 2005 e 2006. As mulheres foram entrevistadas durante a gestação e no puerpério, utilizando-se um questionário adaptado do Estudo Multipaíses sobre a Saúde da Mulher e Violência Doméstica da Organização Mundial da Saúde. Para avaliar o padrão de ocorrência da violência por parceiro íntimo, entre um determinado período e o subseqüente, o odds ratio foi calculado com intervalos de 95% de confiança (IC95%). RESULTADOS: A prevalência de violência por parceiro íntimo antes, durante e/ou depois da gestação foi estimada em 47,4% e, para cada período isolado, em 32,4%, 31,0% e 22,6%, respectivamente. As mulheres que relataram violência antes da gravidez tiveram chance 11,6 vezes maior (IC95%: 8,3;16,2) de relatar violência durante a gravidez. Quando as mulheres relataram violência durante a gravidez, a chance de relatos no pós-parto foi 8,2 vezes maior (IC95%: 5,1;11,7). A violência psicológica foi a de maior prevalência, principalmente durante a gestação (28,8%; IC95%: 26,0%;31,7%); a sexual, a menos prevalente, especialmente no pós-parto (3,7%; IC95%: 2,6%;5,0%); e a física diminuiu quase 50% durante a gestação em comparação com o período anterior. CONCLUSÕES: Parcela significativa das mulheres em idade reprodutiva vivencia situações de violência por parceiro íntimo. Os períodos de consultas de pré-natal e de puericultura são oportunidades para que o profissional de saúde possa identificar situações de violência.

OBJECTIVE: To estimate the prevalence and analyze the pattern of intimate partner violence, before and during pregnancy and in the postpartum period. METHODS: This was a cohort study undertaken on 960 women aged 18 to 49 years, who were registered in the Family Health Program of the city of Recife, Northeastern Brazil, between 2005 and 2006. The women were interviewed during pregnancy and in the postpartum period, using a questionnaire adapted from the World Health Organization's Multi-country Study on Women's Health and Domestic Violence. To assess the pattern of intimate partner violence occurrences between a given time period and the subsequent period, the odds ratio (OR) was calculated with 95% confidence intervals (95%CI). RESULTS: The prevalence of intimate partner violence before, during and/or after pregnancy was estimated to be 47.4%. For the three periods separately, it was 32.4%, 31.0% and 22.6% respectively. The women who reported violence before pregnancy were 11.6 times more likely to report violence during pregnancy (95%CI: 8.3;16.2). When the women reported violence during pregnancy, the chance of reports in the postpartum period was 8.2 times higher (95%CI: 5.1;11.7). Psychological violence was more prevalent, especially during pregnancy (28.8%; 95%CI: 26.0%;31.7%). Sexual violence was less prevalent, especially after delivery (3.7%; 95%CI: 2.6%;5.0%). Physical violence diminished by almost 50% during pregnancy, in comparison with the preceding period. CONCLUSIONS: A significant proportion of women of reproductive age experience situations of intimate partner violence. The periods of prenatal and childcare consultations are opportunities for healthcare professionals to identify situations of violence.

OBJETIVO: Estimar la prevalencia y analizar el patrón de violencia por pareja íntima, antes y durante la gestación y en el postparto. MÉTODOS: Estudio de cohorte realizado con 960 mujeres de 18 a 49 años, catastradas en el Programa Salud de la Familia de la ciudad de Recife, Noreste de Brasil, entre 2005 y 2006. Las mujeres fueron entrevistadas durante la gestación y en el puerperio, utilizándose un cuestionario adaptado del Estudio Multipaíses sobre la Salud de la Mujer y Violencia Domestica de la Organización Mundial de la Salud. Para evaluar el patrón de ocurrencia de la violencia por pareja íntima, entre un determinado periodo y el subsecuente, el odds ratio (OR) fue calculado con intervalos de 95% de confianza (IC95%). RESULTADOS: La prevalencia de violencia por pareja íntima antes, durante y/o después de la gestación fue estimada en 47,4% y para cada período aislado, en 32,4%, 31,0% y 22,6%, respectivamente. Las mujeres que relataron violencia antes del embarazo tuvieron chance 11,6 veces mayor (IC95%:8,3;6,2) de relatar violencia durante el embarazo. Cuando las mujeres relataron violencia durante el embarazo, el chance de relatos en el postparto fue 8,2 veces mayor (IC95%:5,1;11,7). La violencia psicológica fue la de mayor prevalencia, principalmente durante la gestación (28,8%; IC95%:26,0%;31,7%); la sexual, la menos prevalente, especialmente en el postparto (3,7%; IC95%: 2,6%;5,0%); y la física disminuyó casi 50% durante la gestación en comparación con el período anterior. CONCLUSIONES: Parcela significativa de as mujeres en edad reproductiva experimenta situaciones de violencia por pareja íntima. Los períodos de consultas de prenatal y de puericultura son oportunidades para que el profesional de salud pueda identificar situaciones de violencia.

OBJETIVO: Estimar a prevalência e analisar o padrão da violência por parceiro íntimo antes e durante a gestação e no pós-parto. MÉTODOS: Estudo de coorte realizado com 960 mulheres de 18 a 49 anos, cadastradas no Programa Saúde da Família da cidade do Recife, PE, entre 2005 e 2006. As mulheres foram entrevistadas durante a gestação e no puerpério, utilizando-se um questionário adaptado do Estudo Multipaíses sobre a Saúde da Mulher e Violência Doméstica da Organização Mundial da Saúde. Para avaliar o padrão de ocorrência da violência por parceiro íntimo, entre um determinado período e o subseqüente, o odds ratio foi calculado com intervalos de 95% de confiança (IC95%). RESULTADOS: A prevalência de violência por parceiro íntimo antes, durante e/ou depois da gestação foi estimada em 47,4% e, para cada período isolado, em 32,4%, 31,0% e 22,6%, respectivamente. As mulheres que relataram violência antes da gravidez tiveram chance 11,6 vezes maior (IC95%: 8,3;16,2) de relatar violência durante a gravidez. Quando as mulheres relataram violência durante a gravidez, a chance de relatos no pós-parto foi 8,2 vezes maior (IC95%: 5,1;11,7). A violência psicológica foi a de maior prevalência, principalmente durante a gestação (28,8%; IC95%: 26,0%;31,7%); a sexual, a menos prevalente, especialmente no pós-parto (3,7%; IC95%: 2,6%;5,0%); e a física diminuiu quase 50% durante a gestação em comparação com o período anterior. CONCLUSÕES: Parcela significativa das mulheres em idade reprodutiva vivencia situações de violência por parceiro íntimo. Os períodos de consultas de pré-natal e de puericultura são oportunidades para que o profissional de saúde possa identificar situações de violência.

OBJECTIVE: To estimate the prevalence and analyze the pattern of intimate partner violence, before and during pregnancy and in the postpartum period. METHODS: This was a cohort study undertaken on 960 women aged 18 to 49 years, who were registered in the Family Health Program of the city of Recife, Northeastern Brazil, between 2005 and 2006. The women were interviewed during pregnancy and in the postpartum period, using a questionnaire adapted from the World Health Organization's Multi-country Study on Women's Health and Domestic Violence. To assess the pattern of intimate partner violence occurrences between a given time period and the subsequent period, the odds ratio (OR) was calculated with 95% confidence intervals (95%CI). RESULTS: The prevalence of intimate partner violence before, during and/or after pregnancy was estimated to be 47.4%. For the three periods separately, it was 32.4%, 31.0% and 22.6% respectively. The women who reported violence before pregnancy were 11.6 times more likely to report violence during pregnancy (95%CI: 8.3;16.2). When the women reported violence during pregnancy, the chance of reports in the postpartum period was 8.2 times higher (95%CI: 5.1;11.7). Psychological violence was more prevalent, especially during pregnancy (28.8%; 95%CI: 26.0%;31.7%). Sexual violence was less prevalent, especially after delivery (3.7%; 95%CI: 2.6%;5.0%). Physical violence diminished by almost 50% during pregnancy, in comparison with the preceding period. CONCLUSIONS: A significant proportion of women of reproductive age experience situations of intimate partner violence. The periods of prenatal and childcare consultations are opportunities for healthcare professionals to identify situations of violence.

OBJETIVO: Estimar la prevalencia y analizar el patrón de violencia por pareja íntima, antes y durante la gestación y en el postparto. MÉTODOS: Estudio de cohorte realizado con 960 mujeres de 18 a 49 años, catastradas en el Programa Salud de la Familia de la ciudad de Recife, Noreste de Brasil, entre 2005 y 2006. Las mujeres fueron entrevistadas durante la gestación y en el puerperio, utilizándose un cuestionario adaptado del Estudio Multipaíses sobre la Salud de la Mujer y Violencia Domestica de la Organización Mundial de la Salud. Para evaluar el patrón de ocurrencia de la violencia por pareja íntima, entre un determinado periodo y el subsecuente, el odds ratio (OR) fue calculado con intervalos de 95% de confianza (IC95%). RESULTADOS: La prevalencia de violencia por pareja íntima antes, durante y/o después de la gestación fue estimada en 47,4% y para cada período aislado, en 32,4%, 31,0% y 22,6%, respectivamente. Las mujeres que relataron violencia antes del embarazo tuvieron chance 11,6 veces mayor (IC95%:8,3;6,2) de relatar violencia durante el embarazo. Cuando las mujeres relataron violencia durante el embarazo, el chance de relatos en el postparto fue 8,2 veces mayor (IC95%:5,1;11,7). La violencia psicológica fue la de mayor prevalencia, principalmente durante la gestación (28,8%; IC95%:26,0%;31,7%); la sexual, la menos prevalente, especialmente en el postparto (3,7%; IC95%: 2,6%;5,0%); y la física disminuyó casi 50% durante la gestación en comparación con el período anterior. CONCLUSIONES: Parcela significativa de as mujeres en edad reproductiva experimenta situaciones de violencia por pareja íntima. Los períodos de consultas de prenatal y de puericultura son oportunidades para que el profesional de salud pueda identificar situaciones de violencia.