Programa de Pós-Graduação Integrado em Saúde Coletiva, Universidade Federal de Pernambuco, Hospital das Clínicas, Cidade Universitária, Recife, PE, Brazil.
Lancet. 2010 Sep 11;376(9744):903-10. doi: 10.1016/S0140-6736(10)60887-2. Epub 2010 Sep 6.
Partner violence against women is common during pregnancy and might have an adverse effect on the mental health of women after delivery. We aimed to investigate the association of postnatal depression with psychological, physical, and sexual violence against women by their intimate partners during pregnancy.
In a prospective cohort study undertaken in Recife, northeastern Brazil, between July, 2005, and December, 2006, we enrolled pregnant women (aged 18-49 years) in their third trimester of pregnancy who were attending primary health-care clinics. The women were interviewed during pregnancy and after delivery. The form of partner violence in pregnancy was assessed with a validated questionnaire, and the Edinburgh postnatal depression scale was used to measure postnatal depression. Associations were estimated with odds ratios (ORs), adjusted for confounding factors contributing to the association between postnatal depression and intimate partner violence.
1133 pregnant women were eligible for inclusion in the study, of whom 1045 had complete data for all variables and were included in the analysis. 270 women (25.8%, 95% CI 23.2-28.6) had postnatal depression. The most common form of partner violence was psychological (294 [28.1%, 25.4-31.0]). Frequency of psychological violence during pregnancy was positively associated with occurrence of postnatal depression, and although this association was attenuated after adjustment, women reporting the highest frequency of psychological violence were more likely to have postnatal depression even after adjustment (adjusted OR 2.29, 95% CI 1.15-4.57). Women who reported physical or sexual violence in pregnancy were more likely to develop postnatal depression (OR 3.28, 2.29-4.70), but this association was substantially reduced after adjustment for psychological violence and confounding factors.
Psychological violence during pregnancy by an intimate partner is strongly associated with postnatal depression, independently of physical or sexual violence. This finding has important policy implications since most social policies focus on prevention and treatment of physical violence.
Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, e Insumos Estratégicos, and Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazil).
怀孕期间伴侣对女性的暴力行为很常见，可能会对女性产后的心理健康产生不良影响。我们旨在研究怀孕期间女性遭受伴侣心理、身体和性暴力与产后抑郁之间的关联。
在 2005 年 7 月至 2006 年 12 月期间，我们在巴西东北部累西腓进行了一项前瞻性队列研究，纳入了处于妊娠晚期（18-49 岁）并正在初级保健诊所就诊的孕妇。在妊娠期间和分娩后对这些女性进行了访谈。使用经过验证的问卷评估妊娠期间伴侣暴力的形式，并用爱丁堡产后抑郁量表来衡量产后抑郁。使用优势比（ORs）来估计关联，同时调整与产后抑郁和亲密伴侣暴力之间关联的混杂因素。
共有 1133 名孕妇符合纳入研究的条件，其中 1045 名孕妇有所有变量的完整数据，并纳入了分析。270 名女性（25.8%，95%CI 23.2-28.6）患有产后抑郁。最常见的伴侣暴力形式是心理暴力（294 例[28.1%，25.4-31.0]）。怀孕期间心理暴力的发生频率与产后抑郁的发生呈正相关，尽管在调整后这种关联减弱，但报告心理暴力频率最高的女性即使在调整后也更有可能患上产后抑郁（调整后的 OR 2.29，95%CI 1.15-4.57）。报告怀孕期间遭受身体或性暴力的女性更有可能患上产后抑郁（OR 3.28，2.29-4.70），但这种关联在调整心理暴力和混杂因素后大大降低。
怀孕期间亲密伴侣的心理暴力与产后抑郁密切相关，独立于身体或性暴力。这一发现具有重要的政策意义，因为大多数社会政策都侧重于预防和治疗身体暴力。
科学、技术和战略投入秘书处的科学和技术部以及巴西国家科学与技术发展理事会（巴西）。
