To investigate the relationship between violence and the nutritional status of pregnant women, and whether mental health could be a mediator in this relationship.

Cross-sectional study. Violence and mental health status were investigated using the following questionnaires: World Health Organization Violence Against Women (WHO-VAW), Abuse Assessment Screen (AAS), Patient Health Questionnaire (PHQ-9), and General Health Questionnaire (GHQ). Demographic, socioeconomic, obstetric, and lifestyle factors (smoking/alcohol consumption) were also investigated. The nutritional status of the women was assessed by the body mass index.

Data were collected from February 2021 to August 2022 in Araraquara city, Brazil.

Four hundred pregnant women recruited at 34 health units and the municipal maternity hospital.

Experience of violence was reported by 52.2% of the women and psychological violence in the last 12 months was the most prevalent type of domestic violence (19.5%). Approximately 43% of the women showed mental health changes and 59.7% had a risk of major depression. Women with mental health changes had an increased risk (OR=2.34) of obesity. Psychological violence in the last 12 months was associated with obesity (p=0.01) when mediated by mental health changes. The mediation effect was significant (β=0.708; 95%BCa CI=0.004-1.460), with mental health changes mediating 46.1% of the relationship between psychological violence and obesity.

The relationship between psychological violence and obesity during pregnancy was mediated by changes in mental health. This original study shows that nutritional status is not limited to biological factors and highlights the importance of social, mental, and psychological factors.

This cross-sectional study, carried out from 2021 to 2022, investigated the factors associated with domestic violence in 400 Brazilian pregnant women during the COVID-19 pandemic. Violence was assessed with the World Health Organization's Violence Against Women questionnaire and the Abuse Assessment Screen. Demographic, socioeconomic, obstetric, lifestyle and mental health data were collected.

Violence at any time in their lives was reported by 52.2% of the women, and psychological violence was the most prevalent type (19.5%). Violence was associated with being single and mental health changes. Pregnant women exposed to any lifetime violence and psychological violence were, respectively, 4.67 and 5.93 times more likely to show mental health changes compared with women with no reported violence.

Training health professionals involved in prenatal care in the early detection of single women and women with mental health changes could be important in preventing domestic violence.