Childhood trauma and depressive symptoms in pregnant adolescents in Southern Brazil

  • Renata Aver Bretanha Ribeiro
  • Bárbara Borges Rubin
  • Rochele Dias Castelli
  • Mariana Bonati de Matos
  • Fernanda Teixeira Coelho
  • Fábio Monteiro da Cunha Coelho
  • Karen Amaral Tavares Pinheiro
  • Ricardo Azevedo da Silva
  • Luciana de Avila QuevedoEmail author
  • Ricardo Tavares Pinheiro
Original article



This study aimed to investigate the association between child maltreatment and depressive symptomatology during gestation in adolescents.


This was a cross-sectional study with pregnant adolescents aged 12 to 19 years. Data were collected with the Beck Depression Inventory, Childhood Trauma Questionnaire, and Mini International Neuropsychiatric Interview.


Compared to adolescents who did not experience each type of neglect or abuse, experiencing them was associated with a higher proportion of depressive symptoms: emotional neglect PR = 1.4 (95% CI 1.1; 1.8); physical neglect PR = 1.7 (95% CI 1.3; 1.7); emotional abuse PR = 1.8 (95% CI 1.4; 2.2); and physical abuse PR = 1.3 (95% CI 1.1; 1.7).


This study demonstrates the association between childhood experiences and mental health in adolescence, especially in vulnerable samples, such as pregnant adolescents. This finding reveals the importance of studying early trauma in life and enabling preventive help, especially in adolescents. High-quality evidence of perinatal mental health problems should be generated to make pregnancy safer for women in low- and middle-income countries.


Childhood trauma Depression Pregnancy Pregnancy adolescents Adolescence Depressive symptoms Trauma Abuse Pregnant 



National Council of Scientific and Technological Development (CNPq).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants included in the study or their parents.


  1. Abujilban SK, Abuidhail J, Al-Modallal H, Hamaideh S, Mosemli O (2014) Predictors of antenatal depression among Jordanian pregnant women in their third trimester. Health Care Women Int 35:200–215. CrossRefPubMedGoogle Scholar
  2. Amorim P (2000) Mini International Neuropsychiatric Interview (MINI): validation of a short structured diagnostic psychiatric interview. Braz J Psychiatry 22:106–115. CrossRefGoogle Scholar
  3. Barbosa LP, Quevedo L, Silva GDGD, Jansen K, Magalhães P, Pinheiro RT, Silva RA (2014) Relationship between maternal depression as a risk factor for childhood trauma and mood disorders in young adults. Arch Clin Psychiatry (Sao Paulo) 41:72–76. CrossRefGoogle Scholar
  4. Barros AJ, Hirakata VN (2003) Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 3:21. CrossRefPubMedPubMedCentralGoogle Scholar
  5. Beck AT, Steer RA, Brown GK (1996) Manual for the Beck depression inventory II. Psychological Corporation, San AntonioGoogle Scholar
  6. Bolger KE, Patterson CJ (2001) Developmental pathways from child maltreatment to peer rejection. Child Dev 72:549–568. CrossRefPubMedGoogle Scholar
  7. Brazilian Association of Research Companies (2013) Brazilian Economic Classification Criteria. Accessed 31 May 2019
  8. Brown HL, Fan YD, Gonsoulin WJ (1991) Obstetric complications in young teenagers. South Med J 84:46–48. CrossRefPubMedGoogle Scholar
  9. Coelho FMC, Pinheiro RT, Silva RA, Quevedo LA, Souza LDM, Castelli RD, Matos MB, Pinheiro KAT (2013) Major depressive disorder during teenage pregnancy: socio-demographic, obstetric and psychosocial correlates. Braz J Psychiatry 35:051–056. CrossRefGoogle Scholar
  10. Cunha JÁ (2001) Manual of the Portuguese version of the Beck scales. Casa do Psicólogo, São PauloGoogle Scholar
  11. Ferri CP, Mitsuhiro SS, Barros MC, Chalem E, Guisburg R, Patel V, Prince M, Laranjeira R (2007) The impact of maternal experience of violence and common mental disorders on neonatal outcomes: a survey of adolescent mothers in Sao Paulo, Brazil. BMC Public Health 7:209. CrossRefPubMedPubMedCentralGoogle Scholar
  12. Figueiredo B, Pacheco A, Costa R (2007) Depression during pregnancy and the postpartum period in adolescent and adult Portuguese mothers. Arch Womens Ment Health 10:103–109. CrossRefPubMedGoogle Scholar
  13. Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, Holmes W (2012) Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ 90:139–149H. CrossRefGoogle Scholar
  14. Fraser AM, Brockert JE, Ward RH (1995) Association of young maternal age with adverse reproductive outcomes. N Engl J Med 332:1113–1118. CrossRefPubMedGoogle Scholar
  15. Geronimus AT (2004) Teenage childbearing as cultural prism. Br Med Bull 69:155–166. CrossRefPubMedGoogle Scholar
  16. Gilbert P, Irons C (2008) Shame, self-criticism, and self-compassion in adolescence. Adolesc Emot Dev Emerg Depress Disord. CrossRefGoogle Scholar
  17. Grassi-Oliveira R, Stein LM, Pezzi JC (2006) Translation and content validation of the Childhood Trauma Questionnaire into Portuguese language. Rev Saúde Públ 40:249–255. CrossRefGoogle Scholar
  18. Hammen C, Brennan PA (2003) Severity, chronicity, and timing of maternal depression and risk for adolescent offspring diagnoses in a community sample. Arch Gen Psychiatry 60:253–258. CrossRefPubMedGoogle Scholar
  19. Hart S, Germain R, Brassard M (1987) The challenge: to better understand and combat psychological maltreatment of children and young. In: Brassard M, Germain R, Hart S (eds) Psychological maltreatment of children and youth. Pergamon, New York, pp 3–24Google Scholar
  20. Hodgkinson SC, Colantuoni E, Roberts D, Berg-Cross L, Belcher HM (2010) Depressive symptoms and birth outcomes among pregnant teenagers. J Pediatr Adolesc Gynecol 23:16–22. CrossRefPubMedGoogle Scholar
  21. Infurna MR, Reichl C, Parzer P, Schimmenti A, Bifulco A, Kaess M (2016) Associations between depression and specific childhood experiences of abuse and neglect: a meta-analysis. J Affect Disord 190:47–55. CrossRefPubMedGoogle Scholar
  22. Joormann J, Gotlib IH (2007) Selective attention to emotional faces following recovery from depression. J Abnorm Psychol 116:80–85. CrossRefPubMedGoogle Scholar
  23. Kaplan SJ, Pelcovitz D, Labruna V (1999) Child and adolescent abuse and neglect research: a review of the past 10 years. Part I: physical and emotional abuse and neglect. J Am Acad Child Adolesc Psychiatry 38:1214–1222. CrossRefPubMedGoogle Scholar
  24. Kendler KS, Karkowski LM, Prescott CA (1999) Casual relationship between stressful life events and the onset of major depression. Am J Psychiatry 156:837–841. CrossRefPubMedGoogle Scholar
  25. Kronenberg ME, Hansel TC, Brennan AM, Osofsky HJ, Osofsky JD, Lawrason B (2010) Children of Katrina: lessons learned about postdisaster symptoms and recovery patterns. Child Dev 81:1241–1259. CrossRefPubMedGoogle Scholar
  26. Lara MA, Navarrete L, Nieto L, Le HN (2015) Childhood abuse increases the risk of depressive and anxiety symptoms and history of suicidal behavior in Mexican pregnant women. Braz J Psychiatry 37:203–210. CrossRefPubMedGoogle Scholar
  27. Leung BM, Kaplan BJ (2009) Perinatal depression: prevalence, risks, and the nutrition link—a review of the literature. J Am Diet Assoc 109:1566–1575. CrossRefPubMedGoogle Scholar
  28. Lindert J, von Ehrenstein OS, Grashow R, Gal G, Braehler E, Weisskopf MG (2014) Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis. Int J Public Health 59:359–372. CrossRefPubMedGoogle Scholar
  29. Loaiza E, Liang M (2013) Adolescent pregnancy: a review of the Evidence. UNFPA. Accessed 31 May 2019
  30. Meltzer-Brody S, Boschloo L, Jones I, Sullivan PF, Penninx BW (2013) The EPDS-Lifetime: assessment of lifetime prevalence and risk factors for perinatal depression in a large cohort of depressed women. Arch Womens Ment Health 16:465–473. CrossRefPubMedGoogle Scholar
  31. Montgomery E, Just-Østergaard E, Jervelund SS (2019) Transmitting trauma: a systematic review of the risk of child abuse perpetrated by parents exposed to traumatic events. Int J Public Health 64:241–251. CrossRefPubMedGoogle Scholar
  32. Moreno MMA, Coelho Junior NE (2012) Trauma: the reverse of memory. Ágora (Rio J) 15:47–61. CrossRefGoogle Scholar
  33. Negele A, Kaufhold J, Kallenbach L, Leuzinger-Bohleber M (2015) Childhood trauma and its relation to chronic depression in adulthood. Depress Res Treat 2015:1–11. CrossRefGoogle Scholar
  34. Pereira PK, Lovisi GM, Lima LA, Legay LF (2010) Obstetric complications, stressful life events, violence and depression during pregnancy in adolescents at primary care setting. Arch Clin Psychiatry (Sao Paulo) 37:216–222. CrossRefGoogle Scholar
  35. Shapero BG, Black SK, Liu RT, Klugman J, Bender RE, Abramson LY, Alloy LB (2014) Stressful life events and depression symptoms: the effect of childhood emotional abuse on stress reactivity. J Clin Psychol 70:209–223. CrossRefPubMedGoogle Scholar
  36. Silva R, Jansen K, Souza L, Quevedo L, Barbosa L, Moraes I, Horta B, Pinheiro R (2012) Sociodemographic risk factors of perinatal depression: a cohort study in the public health care system. Braz J Psychiatry 34:143–148. CrossRefPubMedGoogle Scholar
  37. Sugaya L, Hasin DS, Olfson M, Lin KH, Grant BF, Blanco C (2012) Child physical abuse and adult mental health: a national study. J Trauma Stress 25:384–392. CrossRefPubMedPubMedCentralGoogle Scholar
  38. Tekin A, Meriç C, Sağbilge E, Kenar J, Yayla S, Özer ÖA, Karamustafalioğlu O (2016) The relationship between childhood sexual/physical abuse and sexual dysfunction in patients with social anxiety disorder. Nord J Psychiatry 70:88–92. CrossRefPubMedGoogle Scholar
  39. Vaughn-Coaxum RA, Wang Y, Kiely J, Weisz JR, Dunn EC (2018) Associations between trauma type, timing, and accumulation on current coping behaviors in adolescents: results from a large, population-based sample. J Youth Adolesc 47:842–858. CrossRefPubMedGoogle Scholar
  40. Victora CG, Huttly SR, Fuchs SC, Olinto MT (1997) The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol 26:224–227. CrossRefPubMedGoogle Scholar
  41. World Health Organization & International Society for Prevention of Child Abuse and Neglect (2006) Preventing Child Maltreatment: a guide to taking action and generating evidence.;jsessionid=7A892AB098B539E74A5C413AD8A949AA?sequence=1. Accessed 31 May 2019

Copyright information

© Swiss School of Public Health (SSPH+) 2019

Authors and Affiliations

  • Renata Aver Bretanha Ribeiro
    • 1
  • Bárbara Borges Rubin
    • 1
  • Rochele Dias Castelli
    • 1
  • Mariana Bonati de Matos
    • 1
  • Fernanda Teixeira Coelho
    • 1
  • Fábio Monteiro da Cunha Coelho
    • 1
  • Karen Amaral Tavares Pinheiro
    • 1
  • Ricardo Azevedo da Silva
    • 1
  • Luciana de Avila Quevedo
    • 1
    Email author
  • Ricardo Tavares Pinheiro
    • 1
  1. 1.Postgraduate Programme in Health and BehaviorCatolic University of Pelotas-UCPelPelotasBrazil

Personalised recommendations