Elsevier

Obstetrics & Gynecology

Volume 94, Issue 2, August 1999, Pages 204-208
Obstetrics & Gynecology

Original Articles
Assault victim history as a factor in depression during pregnancy

https://doi.org/10.1016/S0029-7844(99)00267-7Get rights and content

Abstract

Objective: To examine the relationship between history of interpersonal assault victimization and severity of depressive symptoms during pregnancy.

Methods: Two hundred forty-eight pregnant, married women, aged 15–46 years presenting to obstetric clinics in Kuwait were assessed for lifetime history of assault victimization and other stressful events, marital conflict, family stress, and depressive symptoms using various self-report measures. An analysis of covariance was used to examine the effect of assault victim history on depression scores, using assault victim history and marital conflict as independent variables, and family stress and other stressful event scores as covariates.

Results: Assault victim history, but not marital conflict, was significant in self-reported severity of depressive symptoms, even after controlling for effects of family stress and other stressful events (F = 11.58; P < .001). Specifically, regardless of marital conflict, women with assault victim histories (mean ± standard deviation, 1.27 ± 0.15) had significantly higher depression scores than those with no assault histories (0.78 ± 0.14). Lack of statistical power might have limited detection of independent effects of marital conflict, and possible interactions between marital conflict and assault victim history.

Conclusion: Assault victim history has a significant influence on depressive symptoms in pregnant women. Routine assessment of detailed assault victim history and marital problems in obstetric patients is strongly recommended.

Section snippets

Materials and methods

All consenting obstetric outpatients at the obstetric and gynecologic clinics in Sabah Maternity Hospital and Farwaniya Hospital, two large Ministry of Health hospitals in Kuwait, were eligible. Subjects were recruited over 8 months and comprised 67% of all outpatients approached to participate. Comparison of demographics of subjects (Table 1) with yearly hospital records of women who presented for obstetric care found no significant differences and suggested that our sample was representative.

Results

Two hundred forty-eight married, pregnant women completed the study. Just over half presented to the clinic for routine prenatal care (53.2%; n = 132); the remainder were divided between high-risk pregnancies (26.6%; n = 66) and pregnancies with complications (20.2%; n = 50). Twenty-five percent (n = 62) of all subjects were pregnant for the first time; 7.6% (n = 19) had been pregnant previously but had not completed a pregnancy to viability. Over half of all subjects presented in the third

Discussion

Previous investigations5 suggested that chronic or daily stressors contribute significantly to depression during pregnancy. Family stress is especially pertinent for women in Kuwait and was found to be of significance in the multivariate analyses of stressors on depression symptoms. Consistent with previous research on psychosocial factors in depression during pregnancy, marital conflict and stressful events were also found to influence the severity of depression symptomatology in pregnant

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This study was supported by Kuwait University Research Grant MDQ 298 to MBN.

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