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Sob o olhar da saúde pública, a desproporcional carga de doença física e psiquiátrica no sistema carcerário apresenta um desafio e uma oportunidade para ações interdisciplinares em todo o mundo. OBJETIVO: verificar a prevalência e os fatores associados à violência na vida pregressa das reeducandas da Penitenciária Feminina de Campinas-SP. MÉTODO: trata-se de estudo transversal realizado com 1.013 reeducandas. Realizou-se análise de regressão logística múltipla. RESULTADOS: sofreram violência psicológica 40,3% e violência física/sexual 31,2% das mulheres. Cor da pele não branca (OR=1,40; IC95%:1,09 - 1,81), uso de tranquilizante (OR=1,40; IC95%:1,04-1,93), violência física referida antes dos 15 anos de idade (OR=1,40; IC95%:1,05-1,87) e transtorno mental comum (OR=1,95; IC95%:1,47-2,60), associaram-se positivamente à violência psicológica. A prevalência de violência física foi maior nas mulheres solteiras/divorciadas/separadas, naquelas que presenciaram agressão física na infância e com rastreamento positivo para TMC. CONCLUSÃO: entre as demandas específicas do gênero, merece especial atenção a violência contra a mulher, já que é um agravo recorrente, que causa danos irreparáveis à saúde física e psicológica das vítimas, configurando-se em um problema de saúde pública. Ações de promoção da saúde e cultura de paz devem ser trabalhadas desde a infância.(AU)

From a public health perspective, the disproportionate burden of physical and psychiatric illness in the prison system presents a challenge and an opportunity for interdisciplinary action around the world. Objective: to verify the prevalence and factors associated with violence in the previous life of female prisoners of the Campinas Penitentiary for Women ­ SP. Method: this is a cross-sectional study conducted with 1,013 inmates. Multiple logistic regression analysis was performed. Results: 40.3% of the women suffered psychological violence and 31.2% suffered physical/sexual violence. Non-white skin color (OR=1.40; 95% CI: 1.09 ­ 1.81), tranquilizer use (OR=1.40; 95% CI: 1.04-1.93), physical violence reported before 15-year-olds (OR=1.40; 95% CI: 1.05-1.87) and common mental disorder (OR=1.95; 95% CI: 1.47-2.60) were positively associated to psychological violence. The prevalence of physical violence was higher in single/ divorced/separated women, in those who witnessed physical aggression in childhood and with positive CMD screening. Conclusion: among the gender-specific demands, violence against women deserves special attention, since it is a recurring offense that causes irreparable damage to the physical and psychological health of the victims, thus constituting a public health problem. Actions to promote health and peace culture must be worked on from childhood.(AU)

Desde una perspectiva de salud pública, la carga desproporcionada de enfermedades físicas y psiquiátricas en el sistema penitenciario presenta un reto y una oportunidad para la acción interdisciplinaria en todo el mundo. Objetivo: verificar la prevalencia y los factores asociados con la violencia en el pasado de las presas en CampinasSP. Método: estudio transversal con 1.013 reeducandas. Se realizó un análisis de regresión logística múltiple. Resultados: el 40,3% de las mujeres sufrió violencia psicológica y el 31,2% violencia física / sexual. La tez no blanca (OR = 1,40; IC 95%: 1,09 ­ 1,81), el uso de tranquilizantes (OR = 1,40; IC 95%: 1,04-1,93), la violencia física reportada antes de los 15 años (OR = 1,40; IC 95%: 1,05-1,87) y el trastorno mental común (OR = 1,95; IC 95%: 1,47-2,60) está asociados a la violencia psicológica. La prevalencia de violencia física fue mayor en las mujeres solteras / divorciadas / separadas, en aquéllas que presenciaron agresiones físicas en la infancia y con rastreo positivo de trastornos mentales comunes ( TMC). Conclusión: entre las demandas específicas de género, se debe prestar especial atención a la violencia contra las mujeres, ya que es un delito recurrente que causa daños irreparables a la salud física y psicológica de las víctimas, lo que resulta en un problema de salud pública. Deben trabajarse desde la infancia acciones para promover la salud y la cultura de paz. (AU)

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Mental disorders are present in four of the ten main causes of incapacity across the world. This article aims to analyze the prevalence of Common Mental Disorders (CMD) in incarcerated women and associated factors. A cross-sectional study was conducted with a population of 1,013 women incarcerated in a female prison. The prevalence of CMD was assessed by the SRQ-20. The hierarchical logistic regression was the method of analysis used to search for independent associations between sociodemographic, lifestyle, morbidity and violence variables with CMD and strength of association. The prevalence of CMD was 66.7%. The following variables were independently and positively associated with CMD: lack of income, hypertension, tranquilizers, physical inactivity, smoking, scabies/pediculosis, psychological violence in the year before being arrested, and having witnessed psychological violence in the family in childhood/adolescence. Interdisciplinary activities among health, justice and education institutions can contribute to a qualified assessment of women before admission into the prison system. This can enable an approach that does not exacerbate or trigger the onset of CMD, contributing to the improvement in living conditions and for better health and recovery strategies.

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Abstract Mental disorders are present in four of the ten main causes of incapacity across the world. This article aims to analyze the prevalence of Common Mental Disorders (CMD) in incarcerated women and associated factors. A cross-sectional study was conducted with a population of 1,013 women incarcerated in a female prison. The prevalence of CMD was assessed by the SRQ-20. The hierarchical logistic regression was the method of analysis used to search for independent associations between sociodemographic, lifestyle, morbidity and violence variables with CMD and strength of association. The prevalence of CMD was 66.7%. The following variables were independently and positively associated with CMD: lack of income, hypertension, tranquilizers, physical inactivity, smoking, scabies/pediculosis, psychological violence in the year before being arrested, and having witnessed psychological violence in the family in childhood/adolescence. Interdisciplinary activities among health, justice and education institutions can contribute to a qualified assessment of women before admission into the prison system. This can enable an approach that does not exacerbate or trigger the onset of CMD, contributing to the improvement in living conditions and for better health and recovery strategies.

Resumo Método Transtornos mentais estão presentes em quatro das dez principais causas de incapacidade em todo o mundo. O objetivo deste artigo é analisar a prevalência e os fatores associados ao transtorno mental comum entre mulheres encarceradas. estudo transversal realizado com uma população de 1.013 mulheres encarceradas em uma prisão feminina. A prevalência de TMC foi avaliada através do SQR-20. O modelo de regressão logística hierárquica foi o método de análise utilizado para verificar associações independentes entre as variáveis sociodemográfica, estilo de vida, morbidade e violência com TMC e sua força de associação. A prevalência de TMC foi de 66,7%. Foram de forma independente e positivamente associadas com TMC as variáveis: falta de renda, hipertensão, uso de tranquilizantes, sedentarismo, tabagismo, sarna/pediculose, violência psicológica no ano antes de ser presa e ter testemunhado violência psicológica na família quando criança/adolescente. Atividades interdisciplinares entre as instituições de saúde, justiça e educação podem contribuir para uma avaliação qualificada das mulheres antes da admissão no sistema prisional, assim como contribuir para a melhoria das condições de vida e de melhores estratégias de saúde e recuperação.

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OBJECTIVE: to analyze risk factors for cardiovascular disease in prison institution staff. METHODS: this was a cross-sectional study with a sample of 127 staff of both sexes; prevalence ratios (PR) were estimated adjusted for age and education, as were the respective 95% confidence intervals (95%CI). RESULTS: higher proportions of waist circumference ratios were found above the recommended values (58.1%) and the accumulation of two risk factors for females (33.8%); among males there was higher prevalence of abnormal glucose levels (PR=10.73 - 95%CI 1.31;87.92) and blood pressure (PR=2.63 - 95%CI 1.31;6.50). CONCLUSION: the risk factors for cardiovascular disease found among staff in this study were waist circumference, glucose levels and blood pressure above the recommended values; these health risks can to be addressed through health promotion and disease prevention measures, as well as effective attention to those who are already sick.

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In Brazil, in 2012, 6.4% of the prison population was made up of women. The aim of the study was to verify the coverage of the Pap smear according to sociodemographic characteristics and health problems reported among incarcerated women. Cross-sectional study conducted from August 2012 to July 2013, considering the records of 702 inmates aged between 25 and 64 years and the duration of imprisonment (not less than 12 months). The average age of the women surveyed was 34.7 years. The performance of cervical cytology was reported by 26.3% of inmates. There were no difference in prevalence according to selected variables. The containment condition enables the implementation of preventive measures such as offering and realization of Pap smear for most inmates. The observed results are worrying and differ significantly from those presented in the national diagnosis on the health of incarcerated women.

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RESUMO: No Brasil, em 2012, 6,4% da população carcerária era constituida por mulheres. O objetivo do estudo foi verificar a cobertura do exame de Papanicolaou segundo características sociodemográficas e problemas de saúde referidos entre mulheres encarceradas. Estudo transversal realizado entre agosto de 2012 e julho de 2013. Consideraram-se os registros de 702 reeducandas com idade entre 25 e 64 anos de idade e tempo de reclusão igual ou superior a 12 meses. A média de idade das mulheres entrevistadas foi de 34,7 anos. A realização de citologia oncótica cervical foi referida por 26,3% das reeducandas. Não foram encontradas diferenças nas prevalências segundo variáveis selecionadas. A condição de confinamento possibilita a implementação de ações preventivas, como o oferecimento e a realização do exame de Papanicolaou para a maioria das reeducandas. Os resultados observados são preocupantes e divergem de forma importante daqueles apresentados em diagnóstico nacional sobre a saúde das mulheres encarceradas.

ABSTRACT: In Brazil, in 2012, 6.4% of the prison population was made up of women. The aim of the study was to verify the coverage of the Pap smear according to sociodemographic characteristics and health problems reported among incarcerated women. Cross-sectional study conducted from August 2012 to July 2013, considering the records of 702 inmates aged between 25 and 64 years and the duration of imprisonment (not less than 12 months). The average age of the women surveyed was 34.7 years. The performance of cervical cytology was reported by 26.3% of inmates. There were no difference in prevalence according to selected variables. The containment condition enables the implementation of preventive measures such as offering and realization of Pap smear for most inmates. The observed results are worrying and differ significantly from those presented in the national diagnosis on the health of incarcerated women.

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RESUMO Objetivo: Avaliar o perfil sociodemográfico e as condições de saúde de mulheres encarceradas. Método: Estudo transversal com 1.013 mulheres, realizado em penitenciária feminina. Resultados: Idade média de 30,8 anos; baixa escolaridade; cobertura de exame de Papanicolaou e vacinação; altas prevalências de obesidade; Transtorno Mental Comum; e uso abusivo de tabaco. Considerações: Ações de promoção da saúde; prevenção de doenças e atenção aos agravos devem ser desenvolvidas junto a essa população, assim como ações de recuperação social, como estudo e trabalho. Desenvolvimento de pesquisas em instituições fechadas possibilita ampliar o conhecimento e estabelecer parcerias entre a sociedade e o setor prisional.

ABSTRACT Aim: To evaluate the socio-demographic profile and health conditions of incarcerated women. Method: Cross-sectional study with 1,013 women conducted in female penitentiary. Results: The average age of 30.8 years; low level of education; Papanicolaou test coverage and vaccination; high prevalence of obesity; Common Mental Disorder; and abusive use of tobacco. Considerations: Health promoting actions, disease prevention and attention to grievances must be developed with this population, as well as actions towards social recovery, such as study and work. Research development in closed institutions allows for expanding knowledge and establishing partnerships between the society and the prison sector.

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OBJETIVO: analisar fatores de risco para doença cardiovascular em servidores de instituição prisional. MÉTODOS: estudo transversal com amostra de 127 servidores de ambos os sexos; foram estimadas as razões de prevalência (RP) ajustadas por idade e escolaridade, e respectivos intervalos de confiança de 95% (IC95%). RESULTADOS: observaram-se maiores proporções de circunferência da cintura acima dos valores recomendados (58,1%) e de acúmulo de dois fatores de risco, no sexo feminino (33,8%); entre os homens, observaram-se maiores prevalências de níveis alterados de glicose (RP=10,73 - IC95% 1,31;87,92) e de pressão arterial (RP=2,63 - IC95% 1,31;6,50). CONCLUSÃO: os fatores de risco para doenças cardiovasculares encontrados nos servidores avaliados foram circunferência de cintura e níveis da glicose e pressão arterial acima dos valores recomendados; esses fatores de risco para a saúde podem ser enfrentados com medidas de promoção e prevenção de agravos, somadas à efetiva atenção com aqueles que já se encontram doentes.

OBJECTIVE: to analyze risk factors for cardiovascular disease in prison institution staff. METHODS: this was a cross-sectional study with a sample of 127 staff of both sexes; prevalence ratios (PR) were estimated adjusted for age and education, as were the respective 95% confidence intervals (95%CI). RESULTS: higher proportions of waist circumference ratios were found above the recommended values (58.1%) and the accumulation of two risk factors for females (33.8%); among males there was higher prevalence of abnormal glucose levels (PR=10.73 - 95%CI 1.31;87.92) and blood pressure (PR=2.63 - 95%CI 1.31;6.50). CONCLUSION: the risk factors for cardiovascular disease found among staff in this study were waist circumference, glucose levels and blood pressure above the recommended values; these health risks can to be addressed through health promotion and disease prevention measures, as well as effective attention to those who are already sick.

OBJETIVO: analizar factores de riesgo para enfermedad cardiovascular en servidores de una institución penitenciaria. MÉTODOS: estudio transversal de 127 servidores de ambos sexos; fueron estimadas razones de prevalencia (RP) ajustados para edad y educación e, intervalos de confianza al 95% (IC95%). RESULTADOS: observamos mayores proporciones de circunferencia de cintura encima de los valores recomendados (58,1%) y acumulación de factores de riesgo en mujeres (33,8%); entre los hombres, hubo mayor prevalencia de niveles anormales de glucosa (RP=10,73 - IC95% 1,31;87,92) y presión arterial (RP=2.63 IC95% 1,31;6,50). CONCLUSIÓN: los factores de riesgo para enfermedades cardiovasculares en los servidores evaluados fueron circunferencia de cintura, niveles de glucosa y presión arterial encima de los valores recomendados; los servidores tienen riesgos de salud que deben ser abordados a través de acciones de promoción y prevención, sumados a una atención efectiva en personas ya enfermas.

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Objetivo: descrever a experiência da inserção e do desenvolvimento de uma disciplina “Violência, Saúde e Gênero” em um curso de graduação em enfermagem.Método: relato de experiência fundamentado nas vivências como docente que ministrou a disciplina “Violência, Saúde e Gênero” na Faculdade de Jaguariúna (FAJ)- SP. Resultados: a disciplina específica sobre o tema possibilitou que os alunos falassem sobre o assunto, permitindo amplas discussões, sendo que muitos relataram experiências com suas diversas tipologias (autoinfligida, interpessoal, coletiva) e suas diferentes naturezas (física, sexual, psicológica, privação ou negligência), vivenciadas por eles ao longo da vida. Conclusão: introduzir a disciplina sobre a violência trouxe resultados positivos, pois possibilitaram amplas discussões e reflexões sobre o tema, desmistificação do assunto e melhor preparação dos futuros enfermeiros para lidar com a problemática.

Aim: to describe the experience of the inclusion and development of a courseentitled "Violence, Health and Gender " in an undergraduate program of Nursing.Methods: experience report based on experiences as a professor who taught the course "Violence, Health and Gender" at the Faculty of Jaguariuna (FAJ) - SP. Results: the specific course on the topic enabled the students to talk about the subject, allowing wide discussions. Many of the students reported their experiences throughout life with different types of violence (self-inflicted, interpersonal, collective) and their different natures (physical, sexual, psychological, neglect or deprivation). Conclusion: introducing a course about violence has brought positive results, enabling extensive discussions and reflections on the topic, deconstruction of myths about the subject and better preparation for the future nurses to deal with the issue.

Objetivo: describir la experiencia de la integración y el desarrollo de ladisciplina "Violencia, Salud y Género", en un curso de graduación en enfermería. Método: relato de experiencia sobre los conocimientos adquiridos como docente de la asignatura "Violencia, Género y Salud" en la Facultad de Jaguariuna (FAJ) - SP. Resultados: la asignatura específica sobre el tema permitió a los estudiantes hablar sobre el tema, lo que hace posible un amplio debate, y muchos relataron sus experiencias con diversas tipologías (auto-infligida, interpersonal, colectiva) y sus diferentes naturalezas (física, sexual, psicológica, negligencia o privación) experimentadas por ellos durante toda la vida. Conclusión: introducir la asignatura sobre la violencia trajo resultados positivos, ya que permite amplios debates y reflexiones sobre el tema, desmistificación del asunto y una mejor preparación de las futuras enfermeras para enfrentar la problemática.

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BACKGROUND: domestic violence during pregnancy remains an unsolved and neglected social problem despite the recognised adverse physical and mental health consequences. OBJECTIVE: to examine the association between domestic violence (psychological violence and physical or sexual violence) and health problems self-reported by pregnant women. METHODS: a cross-sectional analysis from a cohort study of 1,379 pregnant women attending prenatal care in public primary care units in Campinas, São Paulo, Brazil. Data were collected by interviewing women when they enroled for prenatal care. Domestic violence and alcohol abuse were ascertained by validated questionnaires. Referred morbidities, undesirable behaviours and sociodemographic characteristics were also recorded. Univariate analyses were used to estimate prevalence and unadjusted odd ratios. Multivariate logistic regression was used to identify the independent association between psychological violence and physical or sexual violence during pregnancy and women's health outcomes. FINDINGS: psychological violence and physical or sexual violence were reported by 19.1% (n=263) and 6.5% (n=89) of the pregnant women, respectively. Psychological violence was significantly associated with obstetric problems [odds ratio (OR) 1.95; 95% confidence interval (CI) 1.39-2.73], premature rupture of membranes (OR 1.64, 95% CI 1.01-2.68), urinary tract infection (OR 1.71, 95% CI 1.19-2.42), headache (OR 1.75, 95% CI 1.25-2.40) and sexual risk behaviours (OR 2.28, 95% CI 1.18-4.41). Physical or sexual violence was significantly associated with: obstetric problems (OR 1.72, 95% CI 1.08-2.75), premature rupture of membranes (OR 2.11, 95% CI 1.14-3.88), urinary tract infection (OR 2.05, 95% CI 1.26-3.34), vaginal bleeding (OR 1.95, 95% CI 1.10-3.43) and lack of sexual desire (OR 3.67, 95% CI 2.23-6.09). CONCLUSION: domestic violence during pregnancy was associated with adverse clinical and psychological outcomes for women. These results suggest that a well-organised health-care system and trained health professionals, as well as multisectorial social support, are necessary to prevent or address the negative influence of domestic violence on women's health in Brazil.

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Este estudo procurou analisar a percepção da violência doméstica referida por mulheres vítimas desse tipo de violência e comparar com a percepção de gestantes, vítimas ou não desse evento, assim como buscar subsídios para o planejamento e execução de estudo de coorte sobre violência doméstica entre gestantes. Realizamos pesquisa qualitativa exploratória com seleção intencional dos sujeitos, utilizando-se a técnica de grupo focal. Os sujeitos constaram de vinte e quatro mulheres subdivididas em dois grupos: (1) treze mulheres acompanhadas no Centro de Referência e Apoio às Mulheres Vítimas de Violência Doméstica e (2) onze mulheres grávidas atendidas no pré-natal de Unidade Básica de Saúde, selecionadas independente de serem ou não expostas à violência. Os conteúdos das falas das mulheres foram organizados em categorias temáticas e analisados, tendo-se percebido que a compreensão sobre violência doméstica é expressa de forma semelhante por mulheres, que vivenciem ou não a situação. A compreensão e discussão dos tópicos propostos para esses grupos possibilitaram o desenvolvimento de uma abordagem mais adequada das mulheres pesquisadas. O conteúdo das perguntas e sua formulação foram considerados de fácil compreensão pelas mulheres de ambos os grupos.

This study sought to compare the perception of domestic violence of women, victims of this kind of violence, with the perception of pregnant women, victims or not of domestic violence, as well as to search for elements allowing for the planning and execution of a cohort study on domestic violence among pregnant women. A qualitative exploratory research was conducted using the technique of convenience sampling for selecting a focal group. The subjects were twenty four women divided into two groups: (1) thirteen women from a follow-up group from a Referral Center for victims of domestic violence, and (2) eleven pregnant women that were participating in the pre-natal care program in a primary care unit, selected independently of suffering domestic violence or not. The data collected were transcribed, conceptually decoded and qualified for qualitative analysis. The contents of the women's discourse were analyzed on the basis of thematic categories. It was observed that domestic violence was perceived in a similar way by both studied groups, independently from the fact of having or not experienced a situation of this kind. The understanding and discussion of the topics proposed for the groups allowed developing a more appropriate approach to the studied women. The way the questions were formulated in the questionnaire was considered of easy understanding by both groups of women.

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This study sought to compare the perception of domestic violence of women, victims of this kind of violence, with the perception of pregnant women, victims or not of domestic violence, as well as to search for elements allowing for the planning and execution of a cohort study on domestic violence among pregnant women. A qualitative exploratory research was conducted using the technique of convenience sampling for selecting a focal group. The subjects were twenty four women divided into two groups: (1) thirteen women from a follow-up group from a Referral Center for victims of domestic violence, and (2) eleven pregnant women that were participating in the pre-natal care program in a primary care unit, selected independently of suffering domestic violence or not. The data collected were transcribed, conceptually decoded and qualified for qualitative analysis. The contents of the women's discourse were analyzed on the basis of thematic categories. It was observed that domestic violence was perceived in a similar way by both studied groups, independently from the fact of having or not experienced a situation of this kind. The understanding and discussion of the topics proposed for the groups allowed developing a more appropriate approach to the studied women. The way the questions were formulated in the questionnaire was considered of easy understanding by both groups of women.

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OBJETIVO: Identificar os fatores associados à violência doméstica contra gestantes. MÉTODOS: Foram entrevistadas 1.379 gestantes usuárias do Sistema Único de Saúde acompanhadas em unidades básicas de saúde no município de Campinas (SP). Foram analisadas a primeira e a segunda entrevistas de um estudo de coorte, aplicando-se questionário estruturado sobre violência doméstica validado no Brasil, de julho de 2004 a julho de 2006. Foram realizadas análise descritiva e regressão logística múltipla dos dados. RESULTADOS: Do total da amostra, 19,1 por cento (n=263) das gestantes reportaram violência psicológica e 6,5 por cento (n=89) violência física/sexual. Os fatores associados à violência psicológica foram: parceiro íntimo adolescente (p<0,019) e gestante ter presenciado agressão física antes dos 15 anos (p<0,001). Foram associados à violência física/sexual: dificuldade da gestante em comparecer às consultas de pré-natal (p<0,014), parceiro íntimo fazer uso de drogas (p<0,015) e não trabalhar (p<0,048). Os fatores associados à violência psicológica e física/sexual foram: baixa escolaridade da gestante (p<0,013 e p<0,020, respectivamente), gestante responsável pela família (p<0,001 e p=0,017, respectivamente) gestante ter sofrido agressão física na infância (p<0,029 e p<0,038, respectivamente), presença de transtorno mental comum (p<0,001) e parceiro íntimo consumir bebida alcoólica duas ou mais vezes por semana(p<0,001). CONCLUSÕES: Constataram-se altas prevalências das diferentes categorias de violência doméstica praticada pelo parceiro íntimo durante o período gestacional, assim como, com os diversos fatores a elas associados. Mecanismos apropriados para identificação e abordagem da violência doméstica na gestação são necessários, especialmente na atenção primária.

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OBJECTIVE: To identify the factors associated with domestic violence against pregnant women. METHODS: Interviews were conducted with 1,379 pregnant women undergoing antenatal care in basic health care units of the Brazilian Health System, within the municipality of Campinas (Southeastern Brazil). A structured questionnaire on domestic violence, validated in Brazil, was applied between July 2004 and July 2006. The first and second interviews in a cohort study were analyzed. Descriptive and multiple logistic regression analysis of the data were conducted. RESULTS: Psychological violence was reported by 19.1% (n=263) of the total sample of pregnant women and physical/sexual violence was reported by 6.5% (n=89) of them. The factors associated to psychological violence were: adolescent intimate partner (p<0.019) and the pregnant woman had witnessed physical aggression before she was 15 years old (p<0.001). The factors associated to physical/sexual violence were: difficulties encountered by the pregnant woman in attending her antenatal appointments (p<0.014), intimate partner uses drugs (p<0.015) and does not work (p<0.048). The factors associated to psychological and physical/ sexual violence were: low level of education of the interviewee (p<0.013 and p<0.020, respectively), the pregnant woman being responsible for the family (p<0.001 and p=0.017, respectively) pregnant woman had suffered physical aggression during childhood (p<0.029 and p<0.038, respectively), presence of common mental disorder (p<0.001) and intimate partner consumes alcoholic beverage twice or more weekly. (p<0.001). CONCLUSIONS: A high prevalence of different categories of domestic violence by an intimate partner during pregnancy was found as well as different factors associated with them. Appropriate mechanisms are necessary, particularly in primary health care, to identify and deal with domestic violence during pregnancy.

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OBJETIVO: Avaliar se a violência doméstica na gestação está associada a desfechos desfavoráveis na saúde do lactente, medidos pelo baixo peso ao nascer ou prematuridade. MÉTODO: Estudo de coorte prospectiva, realizado com gestantes que fizeram pré-natal em 10 Unidades Básicas de Saúde do município de Campinas (SP), durante os anos de 2004 a 2006. Foi utilizado questionário estruturado e validado no Brasil. As gestantes tiveram, no mínimo, duas e, no máximo, três entrevistas realizadas durante pré e pós-natal. Foi utilizada análise descritiva dos dados. O teste t de Student foi utilizado para comparar as médias do peso ao nascer e da idade gestacional entre os grupos de gestantes que sofreram, durante a atual gestação, violência doméstica e aqueles que não sofreram. A análise de regressão logística foi utilizada para verificar os fatores associados ao baixo peso ou prematuridade. RESULTADOS: Foram acompanhadas durante o período de pré-natal e pós-natal (n = 1.229) 89,1 por cento das gestantes; 10,9 por cento representam as perdas de acompanhamento, basicamente por mudança de endereço. O peso médio ao nascer foi de 3.233 g; idade gestacional foi em média 38,56 semanas. Apresentaram baixo peso ao nascer ou prematuridade 13,8 por cento dos recém-nascidos. Condições de risco para baixo peso ao nascer ou prematuridade foram: gestante ter tido recém-nascido prematuro em outra gestação (p < 0,005), ser tabagista (p < 0,001), ter tido parto por cesárea (p < 0,001), ser baixa a escolaridade do parceiro (p < 0,008). CONCLUSÃO: Neste estudo, não foi observada associação estatisticamente significativa entre violência doméstica perpetrada pelo parceiro e baixo peso ao nascer ou prematuridade.

OBJECTIVE: To investigate whether domestic violence during pregnancy is associated with unfavorable infant health outcomes, measured by low birth weight or prematurity. METHODS: This was a prospective cohort study enrolling pregnant women whose prenatal care was provided by 10 basic health units in the city of Campinas, SP, Brazil, between 2004 and 2006. A structured questionnaire was employed that had previously been validated for use in Brazil. Each mother attended a minimum of two and a maximum of three interviews during the prenatal and postnatal periods. Data were analyzed using descriptive statistics. Student's t test was used to compare means for birth weight and gestational age between mothers who had suffered domestic violence during the current pregnancy and those who had not. Logistic regression analysis was employed to identify factors associated with low birth weight or prematurity. RESULTS: During the prenatal and postnatal periods, 89.1 percent (n = 1,229) of the pregnant women were followed up, 10.9 percent being lost to follow-up, basically due to changes of address. Mean birth weight was 3,233 g; mean gestational age was 38.56 weeks. A total of 13.8 percent of the infants had low birth weight or were premature. Conditions associated with risk of low birth weight or prematurity were: mothers who had previously given birth prematurely (p < 0.005), who smoked (p < 0.001), who delivered by caesarian (p < 0.001) and whose partners had a low educational level (p < 0.008). CONCLUSIONS: In this study, no statistically significant association was observed between domestic violence perpetrated by partners and low birth weight or prematurity.

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OBJECTIVE: To investigate whether domestic violence during pregnancy is associated with unfavorable infant health outcomes, measured by low birth weight or prematurity. METHODS: This was a prospective cohort study enrolling pregnant women whose prenatal care was provided by 10 basic health units in the city of Campinas, SP, Brazil, between 2004 and 2006. A structured questionnaire was employed that had previously been validated for use in Brazil. Each mother attended a minimum of two and a maximum of three interviews during the prenatal and postnatal periods. Data were analyzed using descriptive statistics. Student's t test was used to compare means for birth weight and gestational age between mothers who had suffered domestic violence during the current pregnancy and those who had not. Logistic regression analysis was employed to identify factors associated with low birth weight or prematurity. RESULTS: During the prenatal and postnatal periods, 89.1% (n = 1,229) of the pregnant women were followed up, 10.9% being lost to follow-up, basically due to changes of address. Mean birth weight was 3,233 g; mean gestational age was 38.56 weeks. A total of 13.8% of the infants had low birth weight or were premature. Conditions associated with risk of low birth weight or prematurity were: mothers who had previously given birth prematurely (p < 0.005), who smoked (p < 0.001), who delivered by caesarian (p < 0.001) and whose partners had a low educational level (p < 0.008). CONCLUSIONS: In this study, no statistically significant association was observed between domestic violence perpetrated by partners and low birth weight or prematurity.

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OBJECTIVE: To assess factors associated with infant feeding practices on the first day at home after hospital discharge. METHODS: A total of 209 women, who had a child aged four months or less and were living in Itapira, Brazil, were interviewed during the National Immunization Campaign Day in 1999. Statistical analysis was performed using the Chi-square test and a logistic regression model was used for verifying an association between dependent and independent variables. RESULTS: Women aged 25.5 years on average and 18.2% were teenagers. Fifty-three percent of the women delivered vaginally and most vaginal deliveries (78.5%) took place in the public hospital. The prevalence of exclusive breastfeeding on the first day at home was 78.1% and 11.6% of the infants were receiving formula at this time. The only factor associated with EBF on the first day at home was being a teenaged-primiparous mother (OR=9.40; 95% CI: 1.24-71.27). This association remained statistically significant even after controlling for type of delivery and hospital where the birth took place. Feeding formula on the first day at home was only significantly associated with the hospital (i.e., birth at the city hospital was a protective factor (OR=0.33; 95% CI: 0.13-0.86), even after controlling for vaginal delivery. CONCLUSIONS: On the first day at home after hospital discharge, teenaged-primiparous mothers were more likely to exclusive breastfeeding as well as those infants born in the municipal public hospital. Further studies are needed from a multidisciplinary approach.

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OBJETIVO: Avaliar os fatores associados à prática de amamentação no primeiro dia em casa após a alta hospitalar. MÉTODOS: Foram realizadas 209 entrevistas com mães de lactentes, com idade até quatro meses de vida, residentes em Itapira, SP, no momento em que levaram seus filhos para serem vacinados durante a Campanha Nacional de Vacinação, em 1999. Utilizou-se de análise exploratória dos dados, teste do qui-quadrado. Verificou-se associação entre as variáveis dependentes e independentes por análise de regressão logística. RESULTADOS: Observou-se, que a idade média das mães foi de 25,5 anos e 18,2% eram mães adolescentes. Nasceram por parto vaginal 53% dos lactentes, sendo a maioria (78,5%) em hospital municipal. Constatou-se que 78,1% dos lactentes no primeiro dia em casa encontravam-se em aleitamento materno exclusivo e 11,6% já haviam consumido outros alimentos. O único fator associado à maior chance de estar amamentando exclusivamente no primeiro dia em casa foi o fato de a mãe ser adolescente e primípara (OR=9,40; IC 95% (OR)=1,24-71,27), ajustado para o tipo de parto e hospital de nascimento. Em relação ao uso de leite artificial no primeiro dia em casa, a mãe atendida no hospital municipal teve menor chance de usar leite artificial (OR=0,33; IC 95% (OR)=0,13-0,86), mesmo após o controle para o parto vaginal. CONCLUSÕES: No primeiro dia em casa após alta hospitalar, adolescentes primíparas tiveram maior chance de amamentar exclusivamente, assim como aquelas crianças que nasceram no hospital municipal. Sugere-se a realização de outros estudos, que contemplem uma abordagem multidisciplinar.

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Objetivos: analisar as práticas alimentares no primeiro ano de vida e fatores associados ao aleitamento materno e ao aleitamento materno exclusivo, no município de Itapira, SP. Métodos: inquérito realizado em 1999 com 679 lactentes menores de 12 meses no Dia Nacional de Vacinação como parte do projeto Amamentação & Municípios. A associação entre o aleitamento e as variáveis independentes condições de nascimento, uso de mamadeira, chupeta e característica maternas, foi verificada por meio de regressão logística múltipla. Resultados: a idade média da mãe foi de 25,5 anos, sendo 41,8 por cento primíparas e 51,7 por cento dos partos cirúrgicos. O peso médio ao nascer foi de 3.223g. Observou-se que 98,1 por cento dos lactentes foram amamentados nos primeiros 30 dias, porém houve introdução precoce de chá, água e outros leites. A prevalência do aleitamento materno exclusivo foi de 64,8 por cento no primeiro mês, caindo para 45 por cento e 30,1 por cento aos quatro e seis meses, respectivamente. Aos 12 meses 61,6 por cento dos lactentes eram amamentados. As variáveis associadas ao desmame foram: usar chupeta (OR 5,58; IC95 por cento: 3,94-7,89), baixo peso ao nascer (OR 2,74; IC95 por cento: 1,46 - 5,13) e hospital de nascimento (OR 1,76; IC95 por cento: 1,22 - 2,52). Para interrupção da amamentação exclusiva, nos primeiros seis meses, os resultados foram: usar chupeta (OR 4,41; IC95 por cento: 2,57 - 7,59) e parto cesárea (OR 1,78; IC95 por cento: 1,09 - 2,91). Conclusões: a prevalência observada, do aleitamento materno e aleitamento materno exclusivo, ainda está distante das atuais recomendações d OMS.

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