Prevalence of postpartum depression symptoms and their association with violence: a cross-sectional study, Cariacica, Espírito Santo, Brazil, 2017

Santos, Dherik Fraga; Silva, Ranielle de Paula; Tavares, Fábio Lúcio; Primo, Cândida Caniçali; Maciel, Paulete Maria Ambrósio; Souza, Renata Santos de; Leite, Franciéle Marabotti Costa

doi:10.1590/S1679-49742021000400002

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Original Article • Epidemiol. Serv. Saúde 30 (4) • 2021 • https://doi.org/10.1590/S1679-49742021000400002 linkcopy

Prevalence of postpartum depression symptoms and their association with violence: a cross-sectional study, Cariacica, Espírito Santo, Brazil, 2017^*

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective To assess the prevalence of postpartum depression symptoms among puerperal women and their association with violence.

Methods This was a cross-sectional study with puerperal women cared for at a public maternity hospital in Cariacica, ES, Brazil, in 2017. A questionnaire prepared by the authors and validated instruments were used. Pearson’s chi-square test was performed in the analysis and association was expressed in prevalence ratios (PR) and 95% confidence intervals (95%CI).

Results Postpartum depression symptom prevalence was 36.7% (95%CI 31.6;42.0). Total family income was inversely associated with this prevalence (p<0.05). Mothers who were single (PR=1.75 - 95%CI 1.17;2.64), wished to abort (PR=1.96 - 95%CI 1.50;2.56), drank alcohol during pregnancy (PR=1.37 - 95%CI 1.00;1.86), experienced intimate partner violence in their lifetime (PR=1.94 - 95%CI 1.38;2.73), and during pregnancy (PR=1.41 - 95%CI 1.07;1.85), had higher prevalence of depression symptoms.

Conclusion Postpartum depression symptoms are associated with marital status, wanting to abort, alcohol consumption during pregnancy and intimate partner violence.

Keywords:
Depression, Postpartum; Women’s Health; Postpartum Period; Violence Against Women; Intimate Partner Violence

Variables	n (%)	Prevalence % (95%CI)^a	p-value
Age (years)			0.014^b
14-19	82 (24.9)	48.8 (38.1;59.6)
20-29	173 (52.4)	35.3 (28.5;42.7)
30-44	75 (22.7)	26.7 (17.8;37.9)
Race/skin color			0.556^b
White	40 (12.1)	37.5 (23.8;53.5)
Black	82 (24.8)	41.5 (31.2;52.5)
Brown	188 (57.0)	35.6 (29.1;42.8)
Other	20 (6.1)	25.0 (10.5;48.6)
Religion			0.064^b
No	92 (27.9)	44.6 (34.7;54.9)
Yes	238 (72.1)	33.6 (27.9;39.9)
Schooling			0.003^b
Up to complete elementary education	197 (59.7)	44.2 (37.3;51.2)
Up to complete high school education	125 (37.9)	25.6 (18.7;34.0)
Up to complete higher education	8 (2.4)	25.0 (5.6;65.0)
Marital status			0.009^b
Married	93 (28.2)	26.9 (18.8;36.9)
Common law marriage	172 (52.1)	36.6 (29.7;44.1)
Single/dating	65 (19.7)	50.8 (38.7;62.8)
Total family income (minimum wages)			0.004^b
Up to 1	146 (44.2)	45.9 (37.9;54.1)
2-3	153 (46.4)	31.4 (24.5;39.2)
4 or more	31 (9.4)	19.3 (8.8;37.3)
Number of prenatal appointments			0.001^b
Up to 5	132 (40.0)	47.7 (39.3;56.3)
6 or more	198 (60.0)	29.3 (23.3;36.0)
Illness during pregnancy			0.031^b
No	256 (77.6)	33.6 (28.0;39.6)
Yes	74 (22.4)	47.3 (36.1;58.7)
Preference for baby’s sex			0.027^b
No	171 (51.8)	30.9 (24.5;38.4)
Yes	159 (48.2)	42.8 (35.2;50.6)
Type of delivery			0.949^b
Surgical	118 (35.8)	36.4 (28.2;45.5)
Vaginal	212 (64.2)	36.8 (30.5;43.5)
Number of pregnancies			0.584^b
1	126 (38.2)	34.1 (26.3;42.9)
2-3	147 (44.5)	36.7 (29.3;44.9)
4 or more	57 (17.3)	42.1 (29.2;55.3)
History of miscarriage			0.270^b
No	259 (78.5)	35.14 (29.5;41.2)
Yes	71 (21.5)	42.2 (31.2;54.1)
Wanting to abort			<0.001^b
No	277 (83.9)	30.3 (25.2;36.0)
Yes	53 (16.1)	69.8 (56.1;80.7)
Use of alcoholic beverage			0.001^b
No	296 (89.7)	33.8 (28.6;39.4)
Yes	34 (10.3)	61.8 (44.4;76.6)
Use of drugs			0.059^b
No	319 (96.7)	35.3 (30.6;41.2)
Yes	11 (3.3)	63.6 (32.4;86.4)
Use of cigarettes			0.005^b
No	298 (90.3)	34.2 (29.0;39.8)
Yes	32 (9.7)	59.4 (41.6;75.0)
Sexual violence before 15 years old			0.019^c
No	302 (91.5)	34.8 (29.6;40.3)
Yes	28 (8.5)	57.1 (38.3;74.1)
Intimate partner violence during lifetime			<0.001^b
No	180 (54.6)	22.2 (16.7;28.9)
Yes	150 (45.4)	54.0 (45.9;61.9)
Intimate partner violence during pregnancy			<0.001^b
No	291 (88.2)	32.0 (26.8;37.6)
Yes	39 (11.8)	71.8 (55.6;83.8)

Variables	Crude PR^a	95%CI^b	p-value^c	Adjusted PR^a	95%CI^b	p-value^c
Level 1 - Sociodemographic characteristics
Age (years)			0.013			0.329
14-19	1.00			1.00
20-29	0.72	(0.54;0.98)		0.86	(0.62;1.18)
30-44	0.55	(0.35;0.85)		0.70	(0.43;1.13)
Religion			0.057			0.547
No	1.00			1.00
Yes	0.75	(0.56;1.00)		0.92	(0.69;1.22)
Schooling			0.005
Up to complete elementary education	1.00			1.00		0.119
Up to complete high school education	0.58	(0.41;0.81)		0.69	(0.48;0.99)
Up to complete higher education	0.57	(0.17;1.90)		1.03	(0.28;3.86)
Marital status			0.008			0.012
Married	1.00			1.00
Common law marriage	1.36	(0.92;2.01)		1.24	(0.84;1.83)
Single/dating	1.88	(1.25;2.85)		1.75	(1.17;2.64)
Total family income (minimum wages)			0.006			0.012
Up to 1	1.00			1.00
2-3	0.68	(0.51;0.97)		0.70	(0.52;0.93)
4 or more	0.42	(0.20;0.88)		0.45	(0.21;0.96)
Level 2 - Obstetric and gynecological characteristics
Number of prenatal appointments			0.001			0.051
Up to 5	1.00			1.00
6 or more	0.61	(0.46;0.81)		0.75	(0.57;1.00)
Illness during pregnancy			0.024			0.219
No	1.00			1.00
Yes	1.40	(1.05;1.89)		1.19	(0.90;1.58)
Preference for baby’s sex			0.028			0.083
No	1.00			1.00
Yes	1.38	(1.03;1.84)		1.28	(0.97;1.68)
Wanting to abort			<0.001			<0.001
No	1.00			1.00
Yes	2.30	(1.79;2.96)		1.96	(1.50;2.56)
Level 3 - Behavioral characteristics
Use of alcoholic beverage			<0.001			0.047
No	1.00			1.00
Yes	1.83	(1.34;2.49)		1.37	(1.00;1.86)
Use of drugs			0.016			0.758
No	1.00			1.00
Yes	1.78	(1.11;2.85)		1.10	(0.61;1.98)
Use of cigarettes			0.001			0.312
No	1.00			1.00
Yes	1.73	(1.25;2.40)		1.18	(0.85;1.63)
Level 4 - Experience of sexual violence
Sexual violence before 15 years old			0.006			0.125
No	1.00			1.00
Yes	1.64	(1.15;2.35)		1.37	(0.92;2.03)
Level 5 - Lifetime history of intimate partner violence
Intimate partner violence during lifetime			<0.001			<0.001
No	1.00			1.00
Yes	2.43	(1.78;3.32)		1.94	(1.38;2.73)
Level 6 - History of intimate partner violence during pregnancy
Intimate partner violence during pregnancy			<0.001			0.016
No	1.00			1.00
Yes	2.25	(1.73;2.91)		1.41	(1.07;1.85)

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Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 (61) 3315-3464 - Brasília - DF - Brazil
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[TFN3] a) 95%CI: 95% confidence interval; b) Pearson’s chi-square test; c) Fisher’s exact test.

Level 1	Sociodemographic characteristics	Age
		Religion
		Schooling
		Marital status
		Total family income
Level 2	Obstetric and gynecological characteristics	Number of prenatal appointments
		Illness during pregnancy
		Preference for baby’s sex
		Wanting to abort
Level 3	Behavioral characteristics	Use of alcoholic beverage
		Use of drugs
		Use of cigarettes
Level 4	Experience of sexual violence	Sexual violence before 15 years old
Level 5	Lifetime history of intimate partner violence	Intimate partner violence during lifetime
Level 6	History of intimate partner violence during pregnancy	Intimate partner violence during pregnancy

Prevalence of postpartum depression symptoms and their association with violence: a cross-sectional study, Cariacica, Espírito Santo, Brazil, 2017*

Abstract

Prevalence of postpartum depression symptoms and their association with violence: a cross-sectional study, Cariacica, Espírito Santo, Brazil, 2017^*