Abstract
To analyze whether there is an association between conformity to male and female gender norms and the Edinburgh Postnatal Depression Scale (EPDS) score as an indicator of depression during pregnancy, a cross-sectional study was made to a sample of 200 pregnant women being seen at any of the public primary care centers in Segovia (Spain) for the prenatal care. A score of 13 points or higher on the Spanish version of the EPDS is considered to be an indicator of antenatal depression. The Conformity to Feminine Norms Inventory (CFNI-84) and the Conformity to Masculine Norms Inventory (CMNI-94) were used to determine the degree of conformity to gender norms. Descriptive and inferential statistics, as well as multivariate analysis, were carried out. Logistic regression analysis showed the Nice in Relationships Subscale score to be associated with a decreased risk of depression (OR = 0.88; 95%CI 0.79–0.98; p = 0.029). In addition, the CMNI total score, as well as the Self-Reliance subscale, were associated with an increased risk of depression (OR = 1.04; 95%CI 1.01–1.07; p = 0.022; OR = 1.30; 95%CI 1.08–1.55; p = 0.004, respectively). An association between conformity to male gender norms and nonconformity to some female gender norms in pregnant women and a score on the EPDS indicating depression during pregnancy was found. Particularly, an increase in the CMNI total score was associated to increased risk of suffering depression in the pregnant women studied.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alvarado R, Jadresic E, Guajardo V, Rojas G (2015) First validation of a Spanish-translated version of the Edinburgh postnatal depression scale (EPDS) for use in pregnant women. A Chilean study. Arch Womens Ment Health 18(4):607–612. https://doi.org/10.1007/s00737-014-0466-z
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington
Aparicio García ME, Fernández-Castilla B, Giménez-Páez MA, Piris Cava S, Fernández-Quijano I (2018) Influence of feminine gender norms in symptoms of anxiety in the Spanish context. Ansiedad y Estrés 24(2):53–154
Brabete AC, Sánchez-López MP, Cuéllar-Flores I, Rivas-Diez R (2013) The impact of gender norms on alcohol and tobacco use at Romanians. Procedia Soc Behav Sci 78:230–234
Cialdini RB, Kallgren CA, Reno RR (1991) A focus theory of normative conduct: a theoretical refinement and reevaluation of the role of norms in human behavior. In: Berkowitz L (ed) Advances in experimental social psychology, vol 24. Academic, San Diego, pp 201–234
Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. EEUU: Laurence Erlbaum Associates, Hillsdale, pp 19–40
Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 150(6):782–786
Cuellar-Flores I, Sánchez-López MP, Dresch V (2011) El Inventario de Conformidad con las Normas de Género Masculinas (CMNI) en la población española. Anales de Psicología 27(1):170–178
Esteban-Gonzalo S, Aparicio-García ME, Esteban-Gonzalo L (2017) Employment status, gender and health in Spanish women. Women & Health 58(7):744–758. https://doi.org/10.1080/03630242.2017.1353574
Gelaye B, Rondon M, Araya R, Williams MA (2016) Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry 3(10):973–982. https://doi.org/10.1016/S2215-0366(16)30284-X
Gordon AR, Krieger N, Okechukwu CA, Haneuse S, Samnaliev M, Charlton BM, Austin SB (2017) Decrements in health-related quality of life associated with gender nonconformity among U.S. adolescents and young adults. Qual Life Res 26(8):2129–2138. https://doi.org/10.1007/s11136-017-1545-1
Grigoriadis S (2016) Unipolar major depression during pregnancy: epidemiology, clinical features, assessment, and diagnosis. https://www.uptodate.com. Accessed 12 Jan 2016
Grigoriadis S (2019) Unipolar major depression during pregnancy: epidemiology, clinical features, assessment, and diagnosis. https://www.uptodate.com. Accessed 23 Jul 2019
Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, Steiner M, Mousmanis P, Cheung A, Radford K, Martinovic J, Ross LE (2013) The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 74(4):e321–e341. https://doi.org/10.4088/JCP.12r07968
Howard LM, Molyneaux E, Dennis CL, Rochat T, Stein A, Milgrom J (2014) Non-psychotic mental disorders in the perinatal period. Lancet 384(9956):1775–1788. https://doi.org/10.1016/S0140-6736(14)61276-9
Kendler KS, Gardner CO (2014) Sex differences in the pathways to major depression: a study of opposite-sex twin pairs. Am J Psychiatr 171(4):426–435. https://doi.org/10.1176/appi.ajp.2013.13101375
Kozinszky Z, Dudas RB (2015) Validation studies of the Edinburgh Postnatal Depression Scale for the antenatal period. J Affect Disord 176:95–105. https://doi.org/10.1016/j.jad.2015.01.044
Kuehner C (2017) Why is depression more common among women than among men? Lancet Psychiatry 4(2):146–158. https://doi.org/10.1016/S2215-0366(16)30263-2
Lakens D (2013) Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol 4:863. https://doi.org/10.3389/fpsyg.2013.00863
Mahalik JR, Locke BD, Ludlow LH, Diemer MA, Scott RPJ, Gottfried M, Freitas G (2003) Development of the conformity to masculine norms inventory. Psychol Men Masculinity 4:3–25
Mahalik JR, Morray EB, Coonerty-Femiano A, Ludlow LH, Slattery SM, Smiler A (2005) Development of the conformity to feminine norm inventory. Sex Roles 52:417–435
Owen J (2011) Assessing the factor structures of the 55- and 22-item versions of the conformity to masculine norms inventory. Am J Mens Health 5(2):118–128. https://doi.org/10.1177/1557988310363817
Sánchez-López MP, Cuellar-Flores I, Dresch V, Aparicio ME (2009) Conformity to feminine norms in Spanish population. Soc Behav Pers J 37:1171–1186
Sánchez-López MP, Rivas-Diez R, Cuéllar-Flores I (2013) Masculinity and femininity as predictors of tobacco and alcohol consumption in Spanish university students. Health and Addictions 13(1):15–22
Sánchez-López MP, Saavedra AI, Dresch V, Limiñana R (2014) Conformity to traditional gender norms in a feminized occupation: the influence on health behaviors. Health 6:2775–2789
Shrivastava SR, Shrivastava PS, Ramasamy J (2015) Antenatal and postnatal depression: a public health perspective. J Neurosci Rural Pract 6(1):116–119. https://doi.org/10.4103/0976-3147.143218
Spence JT (1984) Gender identity and its implications for the concepts of masculinity and femininity. Neb Symp Motiv 32:59–95
Waters CS, Hay DF, Simmonds JR, van Goozen SHM (2014) Antenatal depression and children’s developmental outcomes: potential mechanisms and treatment options. Eur Child Adolesc Psychiatry 23:957–971. https://doi.org/10.1007/s00787-014-0582-3
Wong YJ, Ho MR, Wang SY, Miller IS (2017) Meta-analyses of the relationship between conformity to masculine norms and mental health-related outcomes. J Couns Psychol 64(1):80–93. https://doi.org/10.1037/cou0000176
Zheng S (2015) Gender norms. Glossary of terms. Gender Statistics Manual. United Nations. Available at: https://unstats.un.org/unsd/genderstatmanual/Glossary.ashx. Accessed 29 Apr 2019
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The study was developed in accordance with the international ethical recommendations for human research and clinical trials of the Declaration of Helsinki.
This research obtained a favorable report from the Commission of Research of Health Management of Segovia (CIGSS) and was financed with 7224 Euros for Research Grants issued by the Castile and León Health Authority (SACyL) in 2016, file GRS 1287/B/16.
Female participants signed a written consent form. All women scoring 13 or higher on the EPDS were referred to their primary care physician for assessment.
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Esteban-Gonzalo, L., Manso-Martínez, M.E., Botín-González, P. et al. The relationship between conformity to male and female gender norms and depression during pregnancy. Arch Womens Ment Health 22, 809–815 (2019). https://doi.org/10.1007/s00737-019-01003-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-019-01003-0