Domestic violence predicts depression in both pregnancy and postpartum periods

Objective: Pregnancy and postpartum periods are the most risky periods for occurrence of a mental illness and/or exacerbation of an existing disease. First trimester of pregnancy is important for adaptation for pregnancy and rapid hormonal changes. Pregnant women have many mental and emotional processes, conşicts and hesitations especially in first trimester. Postpartum period is a time which mothers have physiological changes and lots of new roles and responsibilities in the transition to parenthood. In women, depressive disorder is the most common mental illness and its occurrence is the highest level in this period. In this study, it is aimed to determine the related factors with depression in pregnancy and the postpartum.

Method: This study was executed with females, which have previously participated a research about the prevalence of depressive disorders in the first trimester period of pregnancy. 360 participants, who could be reached again at sixth week of postpartum were included to the study. A sociodemographic data questionnaire that we prepared was applied on the women who agreed to participate to the study and the women have been scanned for depression with The Edinburgh Postpartum Depression Scale. Women with 12/13 cut- off point of EPDS have been evaluated by SCID-I to confirm the diagnosis for clinical depression. Hamilton Depression Rating Scale was applied to determine the intensity of clinical depression.

Results: In this study, the frequency of depressive disorders at postpartum was found 35%. The factors associated with postpartum depression were determined as miscarriages, unscheduled pregnancy, smoking, unoccupied husband, baby’s birth complications and low infant birth. The history of depression in the first trimester of pregnancy, anamnesis of a previous mental illness, a previous physical illnesses, exposure to violence in the current pregnancy, also the baby is staying in the incubator after birth and not breastfeeding baby were determined as predictors for postpartum depression. Unscheduled pregnancy, smoking and unoccupied husband were found to be associated with depression in the women who have depression both in the first trimester and postpartum period. The history of the previous mental illnesses and the violence in the current pregnancy were determined as predictors for being depressive both in the first trimester of pregnancy and postpartum period.

Conclusion: History of having a depressive disorder in the first trimester, previous mental illnesses and previous physical illnesses were determined as risk factors for depression at postpartum period. Additionally this study evaluated the risk factors for the period of the pregnancy and postpartum period together as a follow up study. The women in pregnancy and postpartum period are known to face with violence which is the common problem in the society. In this study, exposure to violence seems a step in front of the other risk factors because of the fact that it was a predictor for depressive disorder in both first trimester and postpartum period. The results of this research suggest that exposure to violence is one of the most important problem for women and should be sought routinely in psychiatric interviews among all other facilities of both mother and baby.