Violence and depressive symptoms during pregnancy in BRISA cohort: using structural equation modeling approach

Abstract

Objectives: to analyze associations among violence against pregnant women, depressive symptoms during pregnancy and maternal depression symptoms. Methods: a sample of 1,139 mothers was conducted on a prenatal cohort study in the municipality of São Luís in Brazil. Psychological and physical violence against pregnant women were measured by the World Health Organization Violence Against Woman. Depressive symptoms during pregnancy were measured by the Escala de Depressão do Centro de Estudos Epidemiológicos (CES-D) (Depression Scale for Epidemiological Studies Center) and maternal depression symptoms were measured by the Edinburgh Postnatal Depression Scale (EPDS). The conceptual model of the structural equation modeling contained socioeconomic situation, social support, psychological and physical violence and depression during pregnancy as determinants of the maternal depression symptoms. Results: maternal depression symptoms were more frequently reported by pregnant women who suffered psychological violence (Standardized Coefficient, SC=0.256; p-value, p<0.001), physical violence (SC=0.221 p<0.001) and those who presented depressive symptoms during pregnancy SC=0.322, p<0.001). Depressive symptoms during pregnancy mediated the effects on physical and psychological violence on maternal depression. Conclusions: pregnant women who were submitted to psychological and physical violence and presented depressive symptoms during pregnancy frequently reported more of having maternal depression symptoms.

Abbreviated Version of the Maternal-Fetal Attachment Scale: Evidence of Validity and Reliability

“…Each response can involve four increasing degrees of intensity on a Likert scale -never or rarely, sometimes, frequently, and always -with scores corresponding to 0, 1, 2, and 3. The score of the four positive items is inverted and added to the score of the others, which yields a final result ranging from zero to 60 points (Fernandes & Rozenthal, 2008;Ribeiro et al, 2019;Silveira & Jorge, 1998). We proceeded to categorize into: absent/light depressive symptoms (score <16), moderate (score ≥16 or ≤21), and severe symptoms (score ≥22) (Ribeiro et al, 2019).…”

“…The score of the four positive items is inverted and added to the score of the others, which yields a final result ranging from zero to 60 points (Fernandes & Rozenthal, 2008;Ribeiro et al, 2019;Silveira & Jorge, 1998). We proceeded to categorize into: absent/light depressive symptoms (score <16), moderate (score ≥16 or ≤21), and severe symptoms (score ≥22) (Ribeiro et al, 2019). The instrument showed reliable psychometric properties, with adequate results for factor, concurrent, and reliability validations in the Brazilian validation (Silveira & Jorge, 1998).…”