r e p r o d c l i m . 2 0 1 4;2 9(2):71-79 Reprodução & Climatério h t t p : / / w w w . s b r h . o r g . b r / r e v i s t a Violence against women Domestic violence Pregnancy a b s t r a c tViolence against women is widely recognized as a serious public health problem. The pregnancy is a risk factor for increasing the violence, especially when it is related to socioeconomic conditions. The objective of this work is to ascertain the relation between violence against women during pregnancy in developed countries and in developing countries. It was performed a systematized review. It was proceeded a search of the literature through online databases MEDLINE and SciELO in December 2013, only with articles published between January 1, 2003 and November 30, 2013. The following descriptors were used for searching on the database "domestic violence" (Medical Subject Headings [MeSH]); "violence against women" (Health Sciences Descriptors [DeCS]); and "pregnancy" (Keyword). The Search strategies resulted in 71 studies. After analysis of the titles and abstracts of articles found for eligibility based on inclusion criteria, 43 articles were deleted and 28 articles were included in the final sample. The study revealed the predominance of researches developed about violence against women during pregnancy in developing countries, strengthening the strong socio-economic character related to victims and aggressors. Violência contra a mulher durante a gravidez: revisão sistematizada Palavras-chave: Violência contra a mulher Violência doméstica Gravidez r e s u m o A violência contra a mulher é amplamente reconhecida como grave problema de saúde pública a gestação se configura em um incremento ao risco de violência, especialmente quando relacionada a condiç ões sócio-econômicas. O objetivo desse trabalho é verificar a relação entre a violência contra a mulher na gestação em países desenvolvidos e países em 72 r e p r o d c l i m . 2 0 1 4;2 9(2):71-79 com desenvolvimento. Foi realizada uma revisão sistemática qualitativa. Procedeu-se busca na literatura através de bases de dados on line MEDLINE e SicELO em dezembro de 2013, limitando-se a artigos publicados entre 1 de janeiro de 2003 e 30 de novembro de 2013. Utilizaram-se os seguintes descritores para a busca na base "domestic violence" (descritor Medical Subject Headings [MeSH]); "violence against women" (descritor em Ciên-cias da Saúde [DeCS]); e "gravidez" (palavra-chave). As estratégias de buscas resultaram em 71 estudos. Após análise dos títulos e dos resumos dos artigos encontrados para elegibilidade com base nos critérios de inclusão, 43 artigos foram excluídos e 28 artigos foram incluídos na amostra final. O estudo revelou a predominância de pesquisas desenvolvidas acerca da violência contra a mulher na gestação em países em desenvolvimento, fortalecendo o forte caráter sócio-econômico relacionado às vítimas e aos agressores.
Background and Objectives: In pregnancies resulting from incest, the adolescent maintains close family and emotional relations with the aggressor, different from what occurs when pregnancy results from sexual violence by strangers. Evidence indicates that this type of relationship with the aggressor may interfere in the dynamics of such violence and the adolescent’s access to health services. Materials and Methods: The objective of this research was to describe and correlate aspects associated with pregnancy when resulting from rape of adolescents in situations of incest; rape when perpetrated by an unknown aggressor and an abortion as allowed by law was sought. Method: A cross-sectional, epidemiological study of adolescents treated at the Pérola Byington Hospital, São Paulo, Brazil, bringing an allegation of pregnancy, resulting from sexual violence and a request for abortion as allowed by law. A total of 311 adolescents, being 134 in the “pregnancy from incest group”, and 174 in the group “pregnancies resulting from rape by a stranger” were considered under the study variables; relationships were investigated using the chi-squared test and Poisson regression with robust variance. Results: The study included 137 cases (44.1%) of pregnancy resulting from incest, and 174 cases (55.9%) of pregnancy from rape by a stranger. In cases of incest, a declaration of religion (92.0%) was significantly more frequent, and the adolescents were approached in spaces considered safe or private (92.7%); the aggressor taking advantage of the adolescent’s legal condition of vulnerability as a function of age (83.3%). Cases of incest presented a lower median adolescent age and greater gestational development, with gestations being ≥ 13 weeks prevailing. Conclusion: Cases of pregnancy by incest presented indicators suggesting both proximity and relationship with the aggressor, and pregnancy at a very early age, which postponed the adolescent’s procurement of health service, and interfered negatively with abortion assistance as allowed by law.
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