Efeitos a longo prazo da violência contra a mulher na gestação sobre a criança: Contribuição da coorte BRISA

Abstract

Violence against women in pregnancy has short and long term effects. Some complications are visible immediately; others may affect the course of pregnancy, the breastfeeding period and / or development of the child. This study aimed to analyze the effects of violence against women during pregnancy on exclusive breastfeeding duration and the risk for changes in child development in a prospective cohort study conducted in the city of Sao Luis, MA. In the first article, structural modeling equation was used to appreciate the effects of violence against women, on the exclusive breast-feeding duration in a sample of 1,133 women. The tested model was estimated by the method of least squares, with good fit (RMSA <0:08; CFI / TLI> 0.95). Violence against women during pregnancy and mental disorders showed no effects on exclusive breast-feeding duration. Pregnant women with higher perceived social support (p=0.007) and greater stability of marital status (p=0.028), showed higher exclusive breast-feeding time. In the second article, we used Poisson regression, to evaluate the effect of violence against women during pregnancy on the risk for changes in child development, using as a tool the Bayley III Screening Test, and the sample of 981 mother / child dyads. Maternal education represented risk to receptive communication (OR=7.3, CI=2.3 to 22.3), cognitive domain (OR=4.0; CI=1.5 to 10.5), and expressive communication (OR=1.3, CI=1.0 to 1.7); family income lower than one minimum wage represented risk for gross motor (OR=2.3, CI=1.0 to 5.2); preterm birth increased the risk for problems in expressive communication (OR=1.3, CI=1.0-1.6), fine motor skills (OR=1.60, CI=1.16 to 2.20), and gross motor skills (OR=1.9, CI=1.19 to 3.0). Violence had no effect on exclusive breastfeeding duration, or on the Bayley dimensions evaluated, but the tracking of family conflict situations since the beginning of prenatal care to protect the woman is necessary, your children and your family.