Department of Preventive Medicine, University of São Paulo, Rua Dr Mário Ferraz 135/42, São Paulo, Brazil.
Matern Child Health J. 2013 Sep;17(7):1297-303. doi: 10.1007/s10995-012-1127-3.
To estimate whether there is a temporal association between Postpartum Depression (PPD) and intimate partner violence (IPV), and to assess the potential role of social support on this relationship. A cross-sectional study was conducted between January 2006 and March 2007 with 701 low income women who received prenatal and postpartum care in primary health care units of the public sector in São Paulo, Brazil. The Self-Report Questionnaire (SRQ-20) was used to assess the presence of PPD. Structured standardized questionnaires were used to assess IPV and social support. The prevalence of PPD was estimated with a 95 % confidence interval. Crude and adjusted prevalence ratios were calculated using Poisson regression to examine the association between PPD and exposure variables. Values of p < 0.05 were considered statistically significant. The prevalence of PPD was 27.9 % (95 %CI 24.6:31.2). The prevalence of psychological IPV was 38.6 %, physical IPV 23.4 %, and sexual IPV 7.1 %. The multivariate analysis showed that PPD was strongly associated with current psychological and physical/sexual violence, after controlling for confounding factors, and less so with past (prenatal or lifetime) IPV. Presence of social support was an independent protective factor for PPD. Identifying and addressing intimate partner violence, including psychological violence, in the postpartum period should be considered as part of a comprehensive approach to caring for new mothers.
评估产后抑郁症(PPD)与亲密伴侣暴力(IPV)之间是否存在时间关联,并评估社会支持在此关系中的潜在作用。
这是一项 2006 年 1 月至 2007 年 3 月期间在巴西圣保罗市公立部门基层医疗单位进行的一项横断性研究,共纳入 701 名接受产前和产后护理的低收入妇女。采用自报问卷(SRQ-20)评估 PPD 的存在。采用结构化标准化问卷评估 IPV 和社会支持。采用 95%置信区间估计 PPD 的患病率。采用泊松回归计算粗患病率比和调整后的患病率比,以检验 PPD 与暴露变量之间的关联。p 值<0.05 被认为具有统计学意义。
PPD 的患病率为 27.9%(95%CI 24.6:31.2)。心理 IPV 的患病率为 38.6%,身体/性 IPV 的患病率为 23.4%,性 IPV 的患病率为 7.1%。多变量分析显示,在控制混杂因素后,PPD 与当前心理和身体/性暴力密切相关,与过去(产前或终生)的 IPV 相关性较弱。社会支持的存在是 PPD 的一个独立保护因素。
在产后期间,应将识别和处理亲密伴侣暴力(包括心理暴力)视为关爱新妈妈的综合方法的一部分。