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

Ribeiro, Sabrina Varão Oliveira; Batista, Rosângela Fernandes Lucena; Ribeiro, Marizélia Rodrigues Costa; Pessoa, Kivania Carla; Simões, Vanda Maria Ferreira; Figueiredo, Felipe Pinheiro de; Bettiol, Heloisa

doi:10.1590/1806-93042019000100010

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Saúde Materno Infantil

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 19 (1) • Jan-Mar 2019 • https://doi.org/10.1590/1806-93042019000100010 copy

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

Authorship SCIMAGO INSTITUTIONS RANKINGS

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.

Key words
Violence against women; Pregnancy; Depression

Variables	N	%
Age (years)
Up to 19 years	145	12.7
20 to 24 years	360	31.6
25 years or more	634	55.6
TOTAL	1,139	100
Marital status
Married	249	21.8
Consensual union	658	57.7
Single / widow	213	18.7
Divorced	19	1.7
TOTAL	1,139	100
Schooling (years)^* * The total for each variable differed due to unknown values.
0 to 4 years	13	1.14
5 to 8 years	125	10.9
9 to 11 years	867	76.1
12 or more years	133	11.6
TOTAL	1,138	100
Income (minimum wages)^* * The total for each variable differed due to unknown values.
Less than 1	51	4.61
1 to 3	615	55.5
3 to 5	281	25.3
5 or more	160	14.4
TOTAL	1,107	100
Pregnant woman's occupation
None	787	51.5
Unqualified	304	28.2
Semi-qualified	459	42.6
Qualified	51	4.74
Office functions	166	15.4
Higher education professional level	59	5.48
Administrators/Managers/Directors/Property Owners	38	3.53
TOTAL	1,077	100
CCEB^a a CCBE= Brazilian Economic Class Classification; ^* * The total for each variable differed due to unknown values.
D/E	168	15.4
C	747	68.7
A/B	172	15.8
TOTAL	1,087	100.0

Variables	N	%
Violence against women	1,115	100.0
No	608	54.3
Yes	507	45.47
Depressive symptoms (during pregnancy)^* * The total for each variable differed due to unknown values.	1,133	100.0
No possibility of depression	596	52.6
Moderate symptoms	228	20.1
Severe symptoms	309	27.2
Depressive symptoms during postpartum period	1,139	100.0
With depressive symptoms	224	19.7
Without depressive symptoms	915	80.3

Indicators	Model^a a Initial and final model, there was no plausible suggestion of modification.
Chi-square (χ²)	1.507,028
Degrees of freedom	884
p	<0.001
Root Mean Square Error of Approximation	0.025
(RMSEA)	0.023 -0.027
90% Confidence Interval	0.990
Comparative fit index (CFI)	0.989

Routes and Estimates	Standardized Coefficient	Standard error	P
Latent Variable
SES
Ses BY Edu	0.463	0.051	<0.001
Ses BY Occu	0.548	0.045	<0.001
Ses BY Inc	0.684	0.043	<0.001
Ses BY Class	0.826	0.048	<0.001
EMOV
Emov BY v1	0.863	0.040	<0.001
Emov BY v2	0.886	0.038	<0.001
Emov BY v3	0.661	0.045	<0.001
Emov BY v4	0.655	0.064	<0.001
PHYV
Phyv BY v5	0.941	0.033	<0.001
Phyv BY v6	0.845	0.038	<0.001
Phyv BY v7	0.907	0.035	<0.001
Phyv BY v8	0.910	0.030	<0.001
Phyv BY v9	0.797	0.108	<0.001
Phyv BY v10	0.728	0.072	<0.001
EDINBURGH
EDINBURGH BY g59_1	0.578	0.028	<0.001
EDINBURGH BY g59_2	0.644	0.032	<0.001
EDINBURGH BY g59_3	0.651	0.023	<0.001
EDINBURGH BY g59_4	0.555	0.028	<0.001
EDINBURGH BY g59_5	0.704	0.023	<0.001
EDINBURGH BY g59_6	0.580	0.024	<0.001
EDINBURGH BY g59_7	0.868	0.013	<0.001
EDINBURGH BY g59_8	0.909	0.010	<0.001
EDINBURGH BY g59_9	0.829	0.014	<0.001
EDINBURGH BY g59_10	0.755	0.029	<0.001
SUPP
Supp BY Int	0.983	0.005	<0.001
Supp BY Emoinf	0.950	0.006	<0.001
Supp BY Effe	0.952	0.008	<0.001
Supp BY Tang	0.833	0.014	<0.001
Direct Effects
EDINBURGH ON Ses	-0.125	0.043	0.003
EDINBURGH ON Supp	-0.055	0.036	0.127
EDINBURGH ON Emov	0.131	0.054	0.016
EDINBURGH ON Phyv	0.095	0.068	0.163
Supp ON Ses	0.238	0.036	<0.001
Emov ON Ses	0.114	0.056	0.041
Emov ON Supp	-0.182	0.047	<0.001
Phyv ON Ses	-0.025	0.070	0.721
Phyv ON Supp	-0.214	0.067	0.001
Phyv ON Emov	-0.031	0.017	0.068
EDINBURGH ON Cesd	0.322	0.059	<0.001
Cesd ON Ses	-0.161	0.047	0.001
Cesd ON Supp	-0.140	0.044	0.001
Cesd ON Emov	0.408	0.046	<0.001
Cesd ON Phyv	0.390	0.053	<0.001

Routes and Estimates	Standardized Coefficient	Standard error	P
Indirect Effects
Ses 🡢 EDINBURGH
Total	-0.199	0.039	<0.001
Indirect	-0.074	0.023	0.001
Emov 🡢 EDINBURGH
Total	0.256	0.044	<0.001
Indirect	0.124	0.028	<0.001
Via Cesd	0.131	0.028	<0.001
Phyv 🡢 EDINBURGH
Total	0.221	0.056	<0.001
Indirect	0.125	0.029	<0.001

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
E-mail: revista@imip.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Authors’ contributions

Ribeiro SVO and Batista RFL - Design and planning of the study. Ribeiro SVO, Batista RFL and Ribeiro MRC - Analysis, interpretation of the data and writing of the manuscript. Pessoa KC, Simões VMF, Figueiredo FP and Bettiol H - Critical review. All authors approved the final version of the manuscript.