Could children exposed to intimate partner violence against their mother have more functional gastrointestinal disorders?

OBJECTIVE: To analyze the association between child exposure to intimate partner violence (CEIPV) committed against their mother and functional gastrointestinal disorders (FGIDs) in school-age children. METHODS: A prospective cohort study was carried out that evaluated 626 mother-child pairs living in a poor urban area in the Northeast of Brazil. The mothers were asked about their children's exposure to intimate partner violence. Holden's classification was used, which investigates ten types of CEIPV from prenatal care. The number of exposures, age of onset, and the perpetrator of the exposure were also verified. The FGIDs in children were identified from the mother's responses to the questionnaire about pediatric gastrointestinal symptoms, Roma III version parent-report, translated and cross-culturally adapted into Brazilian Portuguese. RESULTS: FGIDs were more frequent among children exposed to violence than those not exposed (OR: 1.64; 95% CI: 1.04-2.58; p = 0.03). Likewise, in children who suffered four or more types of exposure (OR: 1.81; 95% CI: 1.10-2.96; p  = 0.01), in which the exposure started in the first two years of life (OR: 1.93; 95% CI: 1.08-3.47; p = 0.02) and in those whose biological father was the perpetrator of the violence (OR; 1.62; 95% CI: 1, 05-2.48; p = 0.02). CONCLUSION: Corroborating the proposal of the biopsychosocial model, CEIPV increases the chance of occurrence of FGIDs in school-age children. Therefore, early identification and proposals for appropriate interventions are suggested both for the prevention of CEIPV and for the prevention and follow-up of FGIDs.

Could children exposed to intimate partner violence against their mother have more functional gastrointestinal disorders?

Abstract Objective: To analyze the association between child exposure to intimate partner violence (CEIPV) committed against their mother and functional gastrointestinal disorders (FGIDs) in school-age children. Methods: A prospective cohort study was carried out that evaluated 626 mother-child pairs living in a poor urban area in the Northeast of Brazil. The mothers were asked about their children's exposure to intimate partner violence. Holden's classification was used, which investigates ten types of CEIPV from prenatal care. The number of exposures, age of onset, and the perpetrator of the exposure were also verified. The FGIDs in children were identified from the mother's responses to the questionnaire about pediatric gastrointestinal symptoms, Roma III version parent-report, translated and cross-culturally adapted into Brazilian Portuguese. Results: FGIDs were more frequent among children exposed to violence than those not exposed (OR: 1.64; 95% CI: 1.04-2.58; p = 0.03). Likewise, in children who suffered four or more types of exposure (OR: 1.81; 95% CI: 1.10-2.96; p = 0.01), in which the exposure started in the first two years of life (OR: 1.93; 95% CI: 1.08-3.47; p = 0.02) and in those whose biological father was the perpetrator of the violence (OR; 1.62; 95% CI: 1, 05-2.48; p = 0.02). Conclusion: Corroborating the proposal of the biopsychosocial model, CEIPV increases the chance of occurrence of FGIDs in school-age children. Therefore, early identification and proposals for appropriate interventions are suggested both for the prevention of CEIPV and for the prevention and follow-up of FGIDs.

Physical violence by an intimate partner and the inappropriate use of prenatal care services among women in Northeastern Brazil. / Violência física pelo parceiro íntimo e uso inadequado do pré-natal entre mulheres do Nordeste do Brasil.

OBJECTIVE: To analyze the association between physical violence by an intimate partner (PVIP) and the inappropriate use of prenatal care services. METHODS: A nested cross-sectional study was conducted with 1,026 women, based on data from a prospective cohort study designed to investigate intimate partner violence among pregnant women enrolled in the Family Health Program (PSF) in Recife, Northeastern Brazil. The use of prenatal care services was assessed with basis on the guidelines from the Program for Humanization of Prenatal Care and Childbirth (Brazilian Ministry of Health) and considered the time of the first prenatal care visit and the total number of visits during the pregnancy. Data were collected through two face-to-face interviews (one in the last pregnancy trimester and the other in the postpartum period), using standardized questionnaires and data on Pregnancy Card records. An unconditional logistic regression was performed to estimate the odds ratio (OR) and the 95% confidence intervals to measure the association between an PVIP and the inappropriate use of prenatal care services, using the stepwise method. RESULTS: The prevalence of the inappropriate use of prenatal care services was 44.1% and of an PVIP, 25.6%. In the logistic regression analysis, an intimatePVIP was associated with inappropriate prenatal care (OR = 1.37; 95%CI 1.01 - 1.85; p = 0.04) after adjustment by variables confirmed as confounders (parity, alcohol use in pregnancy, and education level). CONCLUSION: Women who are victims of an PVIP have more chance of receiving inappropriate prenatal care due to late onset of prenatal care, fewer prenatal care visits, or both.

Violência física pelo parceiro íntimo e uso inadequado do pré-natal entre mulheres do Nordeste do Brasil / Physical violence by an intimate partner and the inappropriate use of prenatal care services among women in Northeastern Brazil

RESUMO: Objetivo: Analisar a associação entre violência física pelo parceiro íntimo e uso inadequado da atenção pré-natal. Métodos: Estudo transversal realizado com 1.026 mulheres participantes de estudo de coorte prospectivo delineado para investigar violência na gravidez entre mulheres cadastradas no Programa Saúde da Família (PSF) do Recife. O uso do pré-natal foi avaliado utilizando a norma do Programa de Humanização do Pré-natal e Nascimento (PHPN), do Ministério da Saúde (MS), considerando a época de início do pré-natal e o total de consultas durante a gravidez. Os dados foram coletados por meio de duas entrevistas presenciais (uma no último trimestre da gravidez, outra no pós-parto) para aplicação de questionário estruturado e a partir dos registros do cartão da gestante. Regressão logística não condicional foi realizada para estimar odds ratio (OR) e valores de intervalo de confiança de 95% (IC95%), a fim de medir a associação entre violência física pelo parceiro íntimo e uso inadequado de cuidados pré-natais, utilizando-se o método stepwise. Resultados: A prevalência de uso inadequado do pré-natal foi de 44,1%, e da violência física pelo parceiro íntimo, de 25,6%. Na análise de regressão logística, a violência física pelo parceiro íntimo apresentou-se associada à realização de pré-natal inadequado (OR = 1,37; IC95% 1,01 - 1,85; p = 0,04), após ajuste pelas variáveis confirmadas como confundidoras (paridade, uso de álcool na gravidez e nível de escolaridade). Conclusão: Mulheres vítimas de violência física pelo parceiro íntimo têm maior chance de realizar um pré-natal inadequado, seja pelo início tardio, pela realização de menor número de consultas ou mesmo pelas duas condições juntas.

ABSTRACT: Objective: To analyze the association between physical violence by an intimate partner (PVIP) and the inappropriate use of prenatal care services. Methods: A nested cross-sectional study was conducted with 1,026 women, based on data from a prospective cohort study designed to investigate intimate partner violence among pregnant women enrolled in the Family Health Program (PSF) in Recife, Northeastern Brazil. The use of prenatal care services was assessed with basis on the guidelines from the Program for Humanization of Prenatal Care and Childbirth (Brazilian Ministry of Health) and considered the time of the first prenatal care visit and the total number of visits during the pregnancy. Data were collected through two face-to-face interviews (one in the last pregnancy trimester and the other in the postpartum period), using standardized questionnaires and data on Pregnancy Card records. An unconditional logistic regression was performed to estimate the odds ratio (OR) and the 95% confidence intervals to measure the association between an PVIP and the inappropriate use of prenatal care services, using the stepwise method. Results: The prevalence of the inappropriate use of prenatal care services was 44.1% and of an PVIP, 25.6%. In the logistic regression analysis, an intimatePVIP was associated with inappropriate prenatal care (OR = 1.37; 95%CI 1.01 - 1.85; p = 0.04) after adjustment by variables confirmed as confounders (parity, alcohol use in pregnancy, and education level). Conclusion: Women who are victims of an PVIP have more chance of receiving inappropriate prenatal care due to late onset of prenatal care, fewer prenatal care visits, or both.