Abuse against women, depression, and infant morbidity: a primary care cohort study in Brazil.

BACKGROUND

The relationship between abuse against women and maternal depression as risk factors for infant morbidity is unclear.

PURPOSE

To describe the association of prenatal and postnatal abuse against women on infant physical morbidity and examine the potential mediating effect of maternal depression on these associations.

METHODS

Prospective cohort study of 375 women from pregnancy (16th-36th week) to the fifth month postpartum, who attended 18 primary care units in Southern Brazil between 2006 and 2008. Abuse and depression were measured at the prenatal and postnatal interviews using standardized instruments. Infant outcomes were diarrhea and respiratory infection during the first 5 months after birth. Analyses were conducted in 2010.

RESULTS

Overall, 35% of participants reported having suffered abuse during pregnancy and/or in the postnatal period. In addition, 10.1% reported infant diarrhea and 20.5% respiratory infection. Infants of mothers abused at the postnatal period were at increased risk for diarrhea (adjusted relative risk [RR]=2.20, 95% CI=1.15, 4.19) and for respiratory infection (adjusted RR=1.68, 95% CI=1.12, 2.52). There was no mediating effect of depression for either outcome.

CONCLUSIONS

Postnatal abuse against women is associated with risk of infant diarrhea and respiratory infection. The current findings highlight the importance of getting abuse against women into the public health agenda.