Analysis of the relationship between domestic violence during pregnancy and delay in neuropsychomotor development in two Brazilian cohorts, with distinct socioeconomic realities

Abstract

Violence against women is a chronic problem in Brazil that affects all social classes. Despite recent advances in legislation and social changes in the way of seeing violence against women, little was noticed in the reduction of violence rates. Viewed as a complex social phenomenon, the victimization of women is strongly related to the victim's social context, being more frequent in poorer areas and with black victims. One of the most impactful forms of violence against women is violence against pregnant women, which represents a double aggression, bringing consequences for both the mother and the fetus. Its deleterious neonatal effects are widely recognized in the literature, with a significant increase in the risk of preterm and low birth weight newborns. However, little is known about the relationship between violence during pregnancy and neuropsychomotor development (NPMD) in these children. Our project proposes to study this relationship from the perspective of causal inference, considering that, whether through direct pathways related to epigenetic reprogramming mechanisms, or indirectly mediated by neonatal outcomes or psychosocial factors, there must be a delay in DNPM related to violence suffered during pregnancy. For this purpose, data from the BRISA birth cohorts will be used, which followed more than 2800 pregnant women in the cities of São Luís (MA) and Ribeirão Preto (SP), from prenatal care to the second year of the children's life. The cohort data will allow us to test our hypothesis considering the socioeconomic context of the studied families and each city, as well as elucidate possible causal pathways and clarify mediators that explain the phenomenon, including neonatal and psychosocial outcomes related to violence against pregnant women. (AU)