Pregnancies resulting from sexual violence to girls 10-13 years of age in the state of Maranhão, Brazil, between 2012 and 2022: estimates of frequency, notification coverage, and perinatal outcomes

Abstract

The aim of the present study was to analyze the fertility rate, pregnancy outcomes, and rape notification coverage in pregnancies among girls 10 to 13 years of age in the state of Maranhão, Brazil. An ecological study was conducted with data from the Brazilian Information System on Live Births, Brazilian Mortality Information System, Brazilian Hospital Information System, and the Brazilian Information System for Notifiable Diseases in the period from 2012 to 2022 as well as the 2022 Demographic Census. Pregnancies among girls 10 to 13 years of age were analyzed, considering both registered and estimated rates and including those ending at 14 years with a probable date of conception at 13 years of age. Pregnancy outcomes among girls 10 to 13 years of age were compared to those among women 20 to 29 years of age. Notification coverage was determined by comparing reported cases of rape to the total number of registered and estimated pregnancies. The fertility rate and notification coverage in pregnancies among girls 10 to 13 years of age were analyzed according to the Regional Health Unit. A fertility rate of 1.7 per 1,000 was found, with an increase of 2.5 times when including estimated pregnancies. A total of 1,410 cases of rape were reported, corresponding to 29.1% of registered pregnancies and 11.5% of estimated pregnancies. Heterogeneity was found in fertility rates and notification coverage according to the Regional Health Unit of residence. Negative outcomes were up to four times higher in pregnancies involving girls 10 to 13 years of age compared to women 20 to 29 years of age, but the frequency of legal abortion was lower. The inequalities identified and the high negative outcomes in pregnancies involving girls 10 to 13 years of age underscore the need for public policies that prioritize protection and care provided for this group.