Berit Schei

The Edinburgh Postnatal Depression Scale: validation in a Norwegian community sample.

This study was undertaken to validate a Norwegian translation of the Edinburgh Postnatal Depression Scale (EPDS). The EPDS was validated against the DSM-IV criteria for major depression, derived from the PRIME-MD, in an interview study of 56 women selected from a community-based questionnaire study of 310 women 6 weeks postpartum. A score of > or =10 on the EPDS scale identified all women with major depression, giving a sensitivity of 100% (95% confidence interval; 72%-100%) and a specificity of 87% (95% confidence interval; 77%-95%). The EPDS scores were strongly correlated with the Montgomery-Asberg Depression Rating Scale in the subsample of women interviewed (n=56) and with the Hopkins Symptom Check List (SCL-25) scores in the questionnaire study (n=310). Our results with regard to the sensitivity and specificity estimates are comparable with prior validation studies; however, the confidence intervals around the estimates are wide. Nevertheless, this study confirms that the EPDS is a valid clinical screening instrument for detecting postpartum depression.

Epidemiology of endometriosis in a Norwegian county

Objective. To estimate the prevalence and incidence of endometriosis in Norwegian women aged 40 to 42, and to evaluate reproductive events and life‐style as risk factors for endometriosis as well as to evaluate related health‐problems.

The Impact of Child Sexual Abuse--A Study of a Random Sample of Norwegian Students.

The long-term impact of child sexual abuse (CSA) has most typically been concentrated on the psychological outcomes. The aim of the present study was to examine the relationship between CSA and self-reported complaints including both psychological and psychosomatic problems as well as absenteeism. A random sample of 510 female and 486 male students completed a questionnaire that included questions about CSA. The overall response rate was 75.3%. A symptom scale was constructed by asking the respondents to rate themselves on a three-category scale for 13 items concerning both psychological and somatic health problems. They were also asked to indicate how many days the problem had caused them to be absent from class or work during the year prior to the study. CSA was reported by 116 of the students (11.7%). CSA was associated with a broad range of health problems; including genital pain/infections and headache/abdominal/muscular pain as well as psychological disorders such as anxiety and suicidal ideations. A linear relationship was demonstrated between the severity of CSA and the symptom score, as well as between the severity of CSA and days absent from work. Postpubertal onset of abuse and close relationship with the offender were positively associated with the number of sick-leave days.

Fear of childbirth and history of abuse: implications for pregnancy and delivery

Background. The aim of this study was to assess the prevalence of fear of childbirth, and to find possible associations to selected sociodemographic factors and important life events. A secondary aim was to explore the relationship between these factors and pregnancy outcome. Methods. Questionnaire booklets were sent to 2680 women at 18 weeks of gestation, of whom 1452 women (54%) responded. The questionnaire included background factors (marital status, education, history of abuse, current pregnancy), W‐DEQ (measurement of fear of childbirth), and STAI (measurement of subjective anxiety). Pregnancy outcome information was recorded. Results. The prevalence of serious fear of childbirth (W‐DEQ > /100) was 5.5%. The W‐DEQ and STAI scores were positively correlated (r=/0.44, p

Gynaecological impact of sexual and physical abuse by spouse. A study of a random sample of Norwegian women

A sample of 150 women aged between 20 and 49 was randomly selected from the census of the city of Trondheim, Norway. Of the 131 eligible for the study, 13 refused to participate; the participating 118 women were interviewed by a gynaecologist. Detailed information about their present and previous spouse(s) and about sexual problems and gynaecological symptoms was obtained. Physical abuse by spouse had occurred in 20 (18%) of the 111 women who had ever lived in a relationship, and sexual abuse in 19 (17%). Eleven (10%) had experienced both physical and sexual abuse. A history of physical abuse with or without sexual abuse by spouse was associated with sexual problems in the present or in previous relationships. Reported abuse by spouse was also associated with a higher frequency of gynaecological symptoms at the time of interview.

Partner violence and health: Results from the first national study on violence against women in Norway

Background: Violence against women has long been considered a hidden health burden. Questions about violence have not been included in health surveys; hence, little is known about prevalence and the consequences for health in the general population. No national study has been conducted in Norway. Aims: To estimate the prevalence of partner violence in Norway and the relationship between victimization and somatic health and depression and anxiety and post-traumatic stress symptoms. Methods: Data collection was performed by Statistics Norway. Among a random sample of women aged 20—55 years, 2,407 women returned the questionnaire (63.3%), of whom 2,143 were ever-partnered. Selected demographic characteristics were obtained from registers. Results: In total, 26.8% of 2,143 ever-partnered women had experienced any violence by their partner during their lifetime, and 5.5% in the year before the study. Low educational level, being unmarried, separated or divorced, currently being unemployed, receiving social security benefits and having no children were significantly associated with reporting partner violence. Exposure to partner violence was associated with poor health, depressive and post-traumatic stress symptoms, gynaecological complaints, injuries, and disability, and remained so after controlling for age, education, unemployment, relationship break-up and low economic status. Conclusions: Partner violence is common and was associated with a range of somatic and mental health problems. Thus, violence against women by their partners is an important public health concern.

A history of sexual abuse and health : A Nordic multicentre study

Objectives  To determine if a history of sexual abuse is associated with objective and subjective indicators of health and if certain abusive incidents had a stronger impact on health than others.

Pregnancy and delivery for women with a history of child sexual abuse

OBJECTIVE To study whether women with a history of child sexual abuse are at increased risk of delivering low birth weight infants. Secondary aims were to study smoking habits, obstetric complications, health care use, and health complaints during pregnancy among women with a history of child sexual abuse. METHOD In a case control study, 82 women with birth of a low birth weight infant (< 2500 g) (cases) and 91 women with birth of a normal birth weight infant (controls) were interviewed about experiences of child sexual abuse. RESULTS Fourteen percent of the women disclosed a history of child sexual abuse involving at least genital touch. Birth of a low birth weight infant was not associated with a history of child sexual abuse (OR 1.03, 95% CI .44-2.40). More women with a history of child sexual abuse were smokers during pregnancy (56% vs. 31%) compared with nonabused women. Abused women reported lower age at menarche and sexual debut. Nonscheduled contacts with the antenatal care clinic and discomfort during pregnancy were more frequent among abused women when controlled for low birth weight. CONCLUSIONS Women who delivered low birth weight infants were not more likely to have experienced child sexual abuse than women who delivered nonlow birth weight infants. Abused women were unemployed and daily smokers more often than nonabused women. Some of the abused women reported more health complaints, and more use of health care services during pregnancy, but did not have more obstetric complications during pregnancy and delivery.

Predictors of women's physical health problems after childbirth.

The objectives of this study were to document the extent and the correlates of common physical health symptoms in women two months after childbirth. Of special interest was determining whether violence and depression histories increase the risk for experiencing these symptoms. Participants were recruited in six Toronto-area hospitals and were interviewed by telephone 8–10 weeks later. Two hundred of the 332 (60.2%) women who were approached completed the study. Most women (96%) reported at least one physical health symptom 2 months postnatally (Mean = 3.4, SD = 2.0). Stepwise logistic regression was conducted for each outcome. Antenatal depression was a significant predictor of excessive fatigue and bad headaches. Sick leave during pregnancy predicted postpartum backaches. Adult emotional abuse and household income were associated with bowel problems. Episiotomy, maternal complications, and planned pregnancy predicted perineal pain. Finally, being Canadian born and having an assisted vaginal delivery increased the risk for hemorrhoids while cesarean section decreased the risk. A high prevalence of physical symptoms was found in women after childbirth. History of depression and violence were implicated in the occurrence of some of these symptoms. Other important predictors included demographic, maternal, and delivery-related factors.

Prevalence of physical and sexual abuse before and during pregnancy among Swedish couples

BACKGROUND To estimate the prevalence of threats and actual acts of physical and sexual abuse during pregnancy. METHODS Two hundred and seven pregnant Swedish women married to or cohabiting with Swedish men were randomly selected from three antenatal clinics in the city of Göteborg, Sweden. A standardized questionnaire was used for personal interviews about the womens experience of physical and sexual abuse by a husband or a boyfriend at some point in the past, during the last year and during current pregnancy. RESULTS Twenty-seven point five percent of the women reported that they had been exposed to physical violence at some point in the past by their husband/boyfriend. Twenty-four and a half percent of the women had experienced some form of threat, physical or sexual violence during the last year. At some time (once or more) during their current pregnancy, the proportions of women who had been exposed to the following categories of violence, were as follows: 14.5%-symbolic violence, 14.5%-threats of mild violence, 2.9%-threats of moderate violence, 2.9%-threats of serious violence, 11%-mild violence, 4.3%-minor violence, 2.4%-moderate violence, 4.3%-serious violence and 3.3%-sexual violence. CONCLUSIONS This study demonstrates that a considerable number of women had experienced threats, physical and sexual abuse during pregnancy. There is an obvious need for screening of experience of domestic violence among pregnant women to enhance the safety of women and their unborn babies.