Social Inequality and Intimate Partner Violence: A Population-Based Study Among Pregnant Women in Southern Brazil

Intimate partner violence (IPV) during pregnancy is a global public health concern, with serious implications for maternal and fetal health. While IPV is widely studied, few population-based investigations have examined the social distribution of IPV during the prenatal period in low- and middle-income countries. This study aimed to analyze the association between IPV and markers of social inequality among pregnant women receiving primary health care (PHC) in southern Brazil. A cross-sectional, population-based study was conducted in Criciúma, Brazil, from April to December 2022. A total of 428 pregnant women in their third trimester were recruited from 48 public primary health units. Data were collected through face-to-face interviews using the World Health Organization Violence Against Women instrument. Sociodemographic variables included age, education, income, parity, and pregnancy planning. Descriptive, bivariate, and inequality analyses were performed using Pearson's Chi-square and the Slope Index of Inequality (SII). Among the participants, 13.6% (95% confidence interval [CI] [10.4, 17.6]) reported experiencing IPV during pregnancy. Higher prevalence was observed among adolescents (≤19 years) and women with monthly income below BRL 500.00. Absolute inequality in IPV was significant for income (SII = -20.1 percentage points; 95% CI [-33.7, -6.6]), indicating a disproportionate burden among economically disadvantaged women. No significant inequalities were observed for age or education. IPV during pregnancy remains a persistent and socially patterned phenomenon. Economic vulnerability emerged as a key driver of IPV, highlighting the need for intersectoral policies that address both gender-based violence and structural inequalities. Findings support the integration of IPV screening, prevention, and protection strategies within antenatal care services, particularly in contexts of high social vulnerability.