Later Effects of Psychological Abuse During Pregnancy

Deborah Cowley, MD

Disclosures

Journal Watch. 2010;30(19) 

In This Article

Abstract and Introduction

Abstract

Postpartum depression risk increases with psychological abuse, even without physical or sexual violence.

Introduction

Intimate partner violence affects 4% to 8% of pregnant women in the U.S. and is associated with postnatal depression. However, the effects of psychological violence on postpartum depression are unclear. To assess whether intimate partner violence during pregnancy, especially psychological abuse, is associated with later postnatal depression, researchers prospectively followed pregnant, mostly low-income women (age range, 18–49) enrolled in primary-care clinics in northeast Brazil through the postpartum period. Interviews took place during the third trimester and an average of 8 months later.

Of 1045 women with complete data, 321 (31%) reported partner violence during pregnancy. Psychological violence (insults, humiliation, intimidation, or threats) was most common (294 women [28% of the sample]); 123 women reported physical violence, and 60 reported sexual violence, typically along with psychological violence. Postpartum depressive symptoms were reported by 270 women (26%). The risk for postpartum depressive symptoms was highest in women reporting physical or sexual violence plus psychological violence. Risk for depressive symptoms increased progressively with greater frequency of psychological violence (from 18% of women with no psychological abuse to 63% in those most frequently abused). Even in the absence of physical or sexual violence and after adjustment for potentially confounding factors, psychological violence, especially when more frequent, significantly increased depression risk.

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