Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 10/2010

01-10-2010 | Original Paper

Violence and depressive symptoms during pregnancy: a primary care study in Brazil

Authors: Patricia Manzolli, Maria Angélica Antunes Nunes, Maria Inês Schmidt, Andrea Poyastro Pinheiro, Rafael Marques Soares, Andressa Giacomello, Michele Drehmer, Caroline Buss, Juliana Feliciati Hoffmann, Silvia Ozcariz, Cristiane Melere, Carlo Nunes Manenti, Suzi Camey, Cleusa P. Ferri

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 10/2010

Login to get access

Abstract

Aim

To estimate the prevalence of violence, depressive symptoms, and associated factors during pregnancy in women attending antenatal care in Brazil.

Methods

Violence was assessed using a modified version of the abuse assessment screen (ASS), and depressive symptoms were evaluated using the primary care evaluation of mental disorders (PRIME-MD). Participants were pregnant women attending 18 primary care units in Rio Grande do Sul, Brazil, between June 2006 and April 2007. A total of 712 pregnant women participated, but only 627 of them responded the ASS.

Results

Experience of any lifetime violence was reported by 273 (43.4%) women and 114 (18.2%) reported violence during the current pregnancy. One-third of them (n = 211) reported lifetime domestic violence and 100 (15.9%) women reported this type of violence during the current pregnancy. Experience of domestic violence during pregnancy was more common in unemployed women, among those with two or more children, with a higher consumption of alcohol, and who had not planned their current pregnancy. Of the total of sample (n = 712), 198 (27.8%) women reported six or more depressive symptoms. The presence of depressive symptoms during pregnancy was associated with low educational levels, living in a household with five or more people, and with higher consumption of alcohol during pregnancy.

Conclusion

Pregnant women attending primary care are exposed to high rates of domestic violence, and many have clinically relevant depressive symptoms. Appropriate interventions to avoid or minimize the effects of violence and mental disorders to the well-being of the mothers and their babies are urgently required. Primary care services play an important role in identifying and supporting women at risk.
Literature
1.
go back to reference Gazmararian JA, Lazorick S, Spitz AM, Ballard TJ, Saltzman LE, Marks JS (1996) Prevalence of violence against pregnant women. JAMA 275:1915–1920CrossRefPubMed Gazmararian JA, Lazorick S, Spitz AM, Ballard TJ, Saltzman LE, Marks JS (1996) Prevalence of violence against pregnant women. JAMA 275:1915–1920CrossRefPubMed
2.
go back to reference Moraes CL, Reichenheim ME (2002) Domestic violence during pregnancy in Rio de Janeiro, Brazil. Int J Gynaecol Obstet 79:269–277CrossRefPubMed Moraes CL, Reichenheim ME (2002) Domestic violence during pregnancy in Rio de Janeiro, Brazil. Int J Gynaecol Obstet 79:269–277CrossRefPubMed
3.
go back to reference Ryan D, Milis L, Misri N (2005) Depression during pregnancy. Can Fam Physician 51:1087–1093PubMed Ryan D, Milis L, Misri N (2005) Depression during pregnancy. Can Fam Physician 51:1087–1093PubMed
4.
go back to reference Josefsson A, Berg G, Nordin C, Sydsjo G (2001) Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand 80:251–255PubMed Josefsson A, Berg G, Nordin C, Sydsjo G (2001) Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand 80:251–255PubMed
5.
go back to reference Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. BMJ 323:257–260CrossRefPubMed Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. BMJ 323:257–260CrossRefPubMed
6.
go back to reference Gavin N, Gaynes B, Lohr K, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083PubMed Gavin N, Gaynes B, Lohr K, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083PubMed
7.
go back to reference Mitsuhiro SS, Chalem E, Barros MM, Guinsburg R, Laranjeira R (2006) Teenage pregnancy: use of drugs in the third trimester and prevalence of psychiatric disorders. Rev Bras Psiquiatr 28:122–125CrossRefPubMed Mitsuhiro SS, Chalem E, Barros MM, Guinsburg R, Laranjeira R (2006) Teenage pregnancy: use of drugs in the third trimester and prevalence of psychiatric disorders. Rev Bras Psiquiatr 28:122–125CrossRefPubMed
8.
go back to reference Lovisi GM, Lopez JR, Coutinho ES, Patel V (2005) Poverty, violence and depression during pregnancy: a survey of mothers attending a public hospital in Brazil. Psychol Med 35:1485–1492CrossRefPubMed Lovisi GM, Lopez JR, Coutinho ES, Patel V (2005) Poverty, violence and depression during pregnancy: a survey of mothers attending a public hospital in Brazil. Psychol Med 35:1485–1492CrossRefPubMed
9.
go back to reference Heron J, O’Connor TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73CrossRefPubMed Heron J, O’Connor TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73CrossRefPubMed
10.
go back to reference Da-Silva VA, Moraes-Santos AR, Carvalho MS, Martins ML, Teixeira NA (1998) Prenatal and postnatal depression among low income Brazilian women. Braz J Med Biol Res 31:799–804CrossRefPubMed Da-Silva VA, Moraes-Santos AR, Carvalho MS, Martins ML, Teixeira NA (1998) Prenatal and postnatal depression among low income Brazilian women. Braz J Med Biol Res 31:799–804CrossRefPubMed
11.
go back to reference Pinheiro SN, Laprega MR, Furtado EF (2005) Psychiatric morbidity and alcohol use by pregnant women in a public obstetric service. Rev Saude Publica 39:593–598CrossRefPubMed Pinheiro SN, Laprega MR, Furtado EF (2005) Psychiatric morbidity and alcohol use by pregnant women in a public obstetric service. Rev Saude Publica 39:593–598CrossRefPubMed
12.
go back to reference Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M (2004) Neonatal outcome following maternal antenatal depression and anxiety: a population-based study. Am J Epidemiol 159:872–881CrossRefPubMed Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M (2004) Neonatal outcome following maternal antenatal depression and anxiety: a population-based study. Am J Epidemiol 159:872–881CrossRefPubMed
13.
go back to reference Hedegaard M, Henriksen TB, Sabroe S, Secher NJ (1993) Psychological distress in pregnancy and preterm delivery. BMJ 307:234–239CrossRefPubMed Hedegaard M, Henriksen TB, Sabroe S, Secher NJ (1993) Psychological distress in pregnancy and preterm delivery. BMJ 307:234–239CrossRefPubMed
14.
15.
go back to reference Reichenheim ME, Moraes CL, Hasselmann MH (2000) Semantic equivalence of the Portuguese version of the abuse assessment screen tool used for the screening of violence against pregnant women. Rev Saude Publica 34:610–616CrossRefPubMed Reichenheim ME, Moraes CL, Hasselmann MH (2000) Semantic equivalence of the Portuguese version of the abuse assessment screen tool used for the screening of violence against pregnant women. Rev Saude Publica 34:610–616CrossRefPubMed
16.
go back to reference Spitzer RL, Williams JB, Kroenke K, Linzer M, DeGruy FV III, Hahn SR, Brody D, Johnson JG (1994) Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 272:1749–1756CrossRefPubMed Spitzer RL, Williams JB, Kroenke K, Linzer M, DeGruy FV III, Hahn SR, Brody D, Johnson JG (1994) Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 272:1749–1756CrossRefPubMed
17.
go back to reference Fraguas R Jr, Henriques SG Jr, De Lucia MS, Iosifescu DV, Schwartz FH, Menezes PR, Gattaz WF, Martins MA (2006) The detection of depression in medical setting: a study with PRIME-MD. J Affect Disord 91:11–17CrossRefPubMed Fraguas R Jr, Henriques SG Jr, De Lucia MS, Iosifescu DV, Schwartz FH, Menezes PR, Gattaz WF, Martins MA (2006) The detection of depression in medical setting: a study with PRIME-MD. J Affect Disord 91:11–17CrossRefPubMed
18.
go back to reference Barros AJ, Hirakata VN (2003) Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 3:21CrossRefPubMed Barros AJ, Hirakata VN (2003) Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 3:21CrossRefPubMed
19.
20.
go back to reference Kroeff LR, Mengue SS, Schmidt MI, Duncan BB, Favaretto AL, Nucci LB (2004) Correlates of smoking in pregnant women in six Brazilian cities. Rev Saude Publica 38:261–267CrossRefPubMed Kroeff LR, Mengue SS, Schmidt MI, Duncan BB, Favaretto AL, Nucci LB (2004) Correlates of smoking in pregnant women in six Brazilian cities. Rev Saude Publica 38:261–267CrossRefPubMed
21.
go back to reference Garcia-Moreno C, Jansen H, Ellsberg M, Heise L, Watts C (2005) WHO multi-country study on women’s health and domestic violence against women: initial results on prevalence, health outcomes and women’s responses. World Health Organization, Geneva Garcia-Moreno C, Jansen H, Ellsberg M, Heise L, Watts C (2005) WHO multi-country study on women’s health and domestic violence against women: initial results on prevalence, health outcomes and women’s responses. World Health Organization, Geneva
22.
go back to reference Amaro H, Fried LE, Cabral H, Zuckerman B (1990) Violence during pregnancy and substance use. Am J Public Health 80:575–579CrossRefPubMed Amaro H, Fried LE, Cabral H, Zuckerman B (1990) Violence during pregnancy and substance use. Am J Public Health 80:575–579CrossRefPubMed
23.
go back to reference Campbell JC (1998) Abuse during pregnancy: progress, policy, and potential. Am J Public Health 88:185–187CrossRefPubMed Campbell JC (1998) Abuse during pregnancy: progress, policy, and potential. Am J Public Health 88:185–187CrossRefPubMed
24.
go back to reference Pajulo M, Savonlahti E, Sourander A, Helenius H, Piha J (2001) Antenatal depression, substance dependency and social support. J Affect Disord 65:9–17CrossRefPubMed Pajulo M, Savonlahti E, Sourander A, Helenius H, Piha J (2001) Antenatal depression, substance dependency and social support. J Affect Disord 65:9–17CrossRefPubMed
Metadata
Title
Violence and depressive symptoms during pregnancy: a primary care study in Brazil
Authors
Patricia Manzolli
Maria Angélica Antunes Nunes
Maria Inês Schmidt
Andrea Poyastro Pinheiro
Rafael Marques Soares
Andressa Giacomello
Michele Drehmer
Caroline Buss
Juliana Feliciati Hoffmann
Silvia Ozcariz
Cristiane Melere
Carlo Nunes Manenti
Suzi Camey
Cleusa P. Ferri
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 10/2010
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-009-0145-y

Other articles of this Issue 10/2010

Social Psychiatry and Psychiatric Epidemiology 10/2010 Go to the issue