Depression in Women with Recurrent Miscarriages - an Exploratory Study

The Abuse Assessment Screen (AAS), the Edinburgh Postnatal Depression Scale (EPDS) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess violence, depression and the use of substances among women with recurrent miscarriages. The population corresponded to patients receiv-ing prenatal care from June to August 2014. Multiple logistic regression was used to assess the multivariable relationship between depression and sociodemographic, psychosocial and medical characteristics (p < 0,10).

Results:

The prevalence of depression was of 41.3% (95% confidence interval [CI] 1/4 28.3-55.7%). One third of the pregnant women (32.6%) reported emotional or physical violence, and 13% were classified as abusing or addicted to tobacco according to ASSIST. History of psychiatric diseases was associated with depression (p 1/4 0.005). Violence during life demonstrated a modest association (p 1/4 0.073) with depression, as well as the number of miscarriages (p 1/4 0.071).

Conclusion:

Depression is a frequent disease among pregnant women with recurrent miscarriages. The results of this investigation suggest that a systematic assessment of depression and its associated conditions, such as domestic violence and the use of substances, should be part of the prenatal follow-up visits for women with recurrent miscarriages.

Keywords:
habitual abortion; post partum depression; violence against women; mental health; smoking

Variables	With depression		Without depression		p
Variables	N	%	N	%	p
Age group
18 to 30 years old	9	39.1%	14	60.9%	0.765
30 years old or more	10	43.5	13	56.5%	0.765
Marital status
Single	2	4.4%	3	6.5%	0.950
Common-law marriage	17	36.9%	24	52.2%	0.950
Occupation
Does not work outside the home	6	14.3%	10	23.8%	0.758
Works outside the home	11	26.2%	15	25.7%	0.758
Education
8 years or more of schooling	4	28.6%	10	71.4%	0.246
More than 8 years of schooling	15	46.9%	17	53.1%	0.246
Family income
< 1.5 minimum wage	4	10%	3	7.5%	0.477
> 1.5 minimum wage	14	3.5%	19	47.5%	0.477
Number of miscarriages
2	11	23.9%	11	23.9%	0.071*
3	2	4.3%	10	21.7%
4	3	6.5%	4	8.7%
5	2	10.5%	0	0%
6	0	0%	2	4.3%
8	1	2.2%	0	0%
Social support during pregnancy
Yes	16	34.8%	25	54.3%	0.368
No	3	6.5%	2	4.4%	0.368
History of psychiatric diseases
Yes	5	10.9%	0	0%	0.005*
No	14	30.4%	27	58.7%	0.005*
Tobacco abuse/dependence
Positive	4	8.7%	2	4.3%	0.176
Negative	15	32.6%	25	54.4%	0.176
History of violence
Yes	9	19.6%	6	13%	0.073*
No	10	21.7%	21	45.7%	0.073*
Violence over the past year
Yes	2	4.4%	1	2.2%	0.356
No	17	36.9%	26	56.5%	0.356
Violence during pregnancy
Yes	1	2.2%	0	0%	0.228
No	18	29.1%	27	58.7%	0.228

Variables	OR	95% CI
History of violence
No	0
Yes	3.074	0.85–11.2
Number of miscarriages
Three or more miscarriages	0
Two miscarriages	0.52	0.15–1.78

Federação Brasileira das Sociedades de Ginecologia e Obstetrícia Av. Brigadeiro Luís Antônio, 3421, sala 903 - Jardim Paulista, 01401-001 São Paulo SP - Brasil, Tel. (55 11) 5573-4919 - Rio de Janeiro - RJ - Brazil
E-mail: editorial.office@febrasgo.org.br

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[1] Address for correspondence: Sara Mota Borges Bottino, MD, PhD, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/ UNIFESP), Rua Borges Lagoa, 570 - Vila Clementino, 04038-000 São Paulo, Brazil (e-mail: sarabottino@uol.com.br)