Depressive symptoms and intimate partner violence in the 12 months after childbirth: a prospective pregnancy cohort study

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 119; no. 3; pp. 315 - 323
• Main Authors: Woolhouse, H, Gartland, D, Hegarty, K, Donath, S, Brown, SJ
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.02.2012; Blackwell
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Delivery. Postpartum. Lactation; Depression; Depression - diagnosis; Depression - etiology; Depression, Postpartum - diagnosis; Depression, Postpartum - etiology; Edinburgh Postnatal Depression Scale; Female; Gynecology. Andrology. Obstetrics; Humans; intimate partner violence; Logistic Models; Longitudinal Studies; Medical sciences; Middle Aged; Mood disorders; Multivariate Analysis; postnatal depression; Pregnancy; pregnancy cohort; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Report; Socioeconomic Factors; Spouse Abuse - psychology; Time Factors; Victimology; Young Adult; Mood disorder; Pregnancy; Mistreatment; Violence; Cohort study; Gynecology; Depression; Delivery; Victimology; Obstetrics
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/j.1471-0528.2011.03219.x

Please cite this paper as: Woolhouse H, Gartland D, Hegarty K, Donath S, Brown S. Depressive symptoms and intimate partner violence in the 12 months after childbirth: a prospective pregnancy cohort study. BJOG 2011;118:000–000. DOI: 10.1111/j.1471‐0528.2011.03219.x. Objective  To examine maternal depressive symptoms during and after pregnancy and explore their relationship with intimate partner violence in the 12 months after birth. Design  Prospective pregnancy cohort study of nulliparous women. Setting  Melbourne, Australia. Population  In all, 1507 eligible women completed baseline data (mean gestation 15 weeks). Analyses are presented for 1305 women who completed all follow‐up questionnaires. Methods  Women were recruited from six public hospitals at between 6 and 24 weeks of gestation. Written questionnaires were completed at recruitment and at 3, 6 and 12 months postpartum. Main outcome measures  Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Intimate partner violence was assessed using the short version of the Composite Abuse Scale. Results  Sixteen per cent of women reported depressive symptoms (EPDS ≥ 13) in the 12 months postpartum, with most women first reporting depressive symptoms in the second 6 months after birth. Around 40% of women reporting depressive symptoms at each follow up also reported intimate partner violence. Factors associated with postpartum depressive symptoms in multivariable models were: emotional abuse alone (adjusted odds ratio [OR] 2.72, 95% CI 1.72–4.13), physical abuse (adjusted OR 3.94, 95% CI 2.44–6.36), depression in pregnancy (adjusted OR 2.89, 95% CI 1.75–4.77) and unemployment in early pregnancy (adjusted OR 1.60, 95% CI 1.03–2.48). Conclusions  Screening for maternal depression at 3 months postpartum or earlier may miss over half the women with depression in the first 12 months after birth. Intimate partner violence is common among women reporting postnatal depressive symptoms and may be an important factor for health professionals to consider in their management.