Resiliencia y apoyo social frente a trastornos depresivos en gestantes sometidas a violencia de género / Resilience and social support compared to depressive disorders in pregnant women subjected to domestic violence

RESUMEN

Objetivo: Establecer que las gestantes sometidas a violencia tienen menor prevalencia de síntomas depresivos cuando tienen un adecuado nivel de resiliencia y/o apoyo social. Material y Métodos: Estudio observacional transversal analítico multivariado en tres hospitales de Lima, Perú (Instituto Nacional Materno Perinatal, Hospital Docente Madre Niño ôSan Bartoloméõ y Hospital Nacional Arzobispo Loayza), realizado en 593 gestantes que acudieron a consulta prenatal. Instrumentos Cuestionario de la Medida del Abuso Doméstico (DAAQ), Cuestionario de Apoyo Social Percibido (MOS-SSS), Escala de Resiliencia de Wagnild y Young (RS) y Escala de Depresión Postnatal de Edinburgo (EPDS) para la detección de casos probables. Se trabajó con un intervalo de confianza del 95% y un nivel de significancia de 0.05. Resultados: 481 (81.1%) gestantes viven con su pareja, dedicándose a labores hogareñas exclusivas 410 (69.1%); tenían antecedente de aborto previo 161 (27.2%), eran primigestas 218 (36.5%) y 435 (73.4%) iniciaron su consulta pre natal en el primer trimestre. Sufrieron alguna forma de violencia durante el embarazo 159 (26.8%), siendo la violencia psicológica la más frecuente con 152 casos (25.6%). La prevalencia de casos probables de depresión mayor fue de 34.1% (202/593), la que se elevó a 59.1% (94/159) al considerar sólo gestantes violentadas; las gestantes violentadas presentaron niveles significativamente menores de apoyo social (59.1% vs. 67.29%; p<0.001) y de resiliencia (129.87% vs. 136.26%; p<0.001) en comparación con las gestantes no violentadas. Las medidas de asociación ajustadas respecto a depresión mayor revelaron un OR de 3.31 (IC 95% 2.20-4.97; p<0.001) para antecedente de violencia durante el embarazo, 0.28 (IC95% 0.18-0.41; p<0.001) para adecuado apoyo social y 0.62 (IC95% 0.42-0.92; p<0.001) para alta resiliencia. Conclusiones: Nuestros resultados evidencian asociación significativa entre el antecedente de violencia...

ABSTRACT

Objective: To demonstrate that pregnant women subjected to violence have lower prevalence of depressive symptoms when they present an appropriate level of resilience and/or social support. Methods: a cross-type multivariate analytical uncontrolled study at three hospitals in Lima, Peru, in 593 pregnant women attending prenatal care. Instruments The Domestic Abuse Assessment Questionaire (DAAQ), the Medical Outcome Study-Social Support Survey (MOS-SSS), the Resilience Scale of Wagnild and Young (RS) and the Edinburgh Postnatal Depression Scale (EPDS). The results were calculated with a 95% confidence interval and a significance level of 0.05. Results: 481 (81.1%) of pregnant women live with their partners, 69.1% dedicated exclusively to work from home, 27.2% referred history of abortion, 36.5% were primigravida and 435 (73.4%) went to its first consultation in the first quarter of pregnancy. 159 womens had a history of violence during pregnancy (26.8%), psychological violence was the most prevalent with 152 (25.6%) cases, the prevalence of depressive symptoms was 34.1% (202/593), while in the group of violated women the prevalence was higher 59.1% (94/159), this group also had significantly lower levels of social support (59.1% vs. 67.29%; p<0.001) and resilience (129.87% vs. 136.26%; p<0.001). The calculation of adjusted measures of association, regarding the presence of major depression, showed an OR 3.31 (CI95% 2.20-4.97; p<0.001) for a history of violence during pregnancy, an OR = 0.28 (CI 0.18-0.41; p <0.001) for adequate social support and an OR = 0,62 (CI95% 0.42-0.92; p<0.001) for high resilience. Conclusions: Our study demonstrates a significant association between the background of violence during pregnancy and the presence of probably antenatal depression. The group of violated women have lower levels of resilience and social supports than women non violated...