THE INFLUENCE OF SOCIAL AND POLITICAL VIOLENCE ON THE RISK OF PREGNANCY COMPLICATIONS

Background. Events in Chile provided an opportunity to evaluate health effects associated with exposure to high levels of social and political violence. Methods. Neighborhoods in Santiago, Chile, were mapped for occurrences of sociopolitical violence during 1985-86, such as bomb threats, military presence, undercover surveillance, and political demonstrations. Six health centers providing prenatal care were then chosen at random: three from "high-violence" and three from "low-violence" neighborhoods. The 161 healthy, pregnant women due to deliver between August 1 and September 7, 1986, who attended these health centers were interviewed twice about their living conditions. Pregnancy complications and labor/delivery information were subsequently obtained from clinic and hospital records. Results. Women living in the high-violence neighborhoods were significantly more likely to experience pregnancy complications than women living in lower violence neighborhoods (OR = 5.0; 95% CI = 1.9-12.6; p < 0.01). Residence in a high-violence neighborhood was the strongest risk factor observed; results persisted after controlling for several sets of potential confounders. Conclusion. Living in areas of high social and political violence increased the risk of pregnancy complications among otherwise healthy women.