Archives of Women's Mental Health

, Volume 20, Issue 2, pp 297–309 | Cite as

Childhood sexual abuse, intimate partner violence during pregnancy, and posttraumatic stress symptoms following childbirth: a path analysis

  • Aline Gaudard e Silva de OliveiraEmail author
  • Michael Eduardo Reichenheim
  • Claudia Leite Moraes
  • Louise Michele Howard
  • Gustavo Lobato
Original Article


The aim of the study was to explore the pathways by which childhood sexual abuse (CSA), psychological and physical intimate partner violence (IPV) during pregnancy, and other covariates relate to each other and to posttraumatic stress disorder (PTSD) symptoms in the postpartum period. The sample comprised 456 women who gave birth at a maternity service for high-risk pregnancies in Rio de Janeiro, Brazil, interviewed at 6–8 weeks after birth. A path analysis was carried out to explore the postulated pathways between exposures and outcome. Trauma History Questionnaire, Conflict Tactics Scales and Posttraumatic Stress Disorder Checklist were used to assess information about exposures of main interest and outcome. The link between CSA and PTSD symptoms was mediated by history of trauma, psychiatric history, psychological IPV, and fear of childbirth during pregnancy. Physical IPV was directly associated with postnatal PTSD symptoms, whereas psychological IPV connection seemed to be partially mediated by physical abuse and fear of childbirth during pregnancy. The role of CSA, IPV, and other psychosocial characteristics on the occurrence of PTSD symptoms following childbirth as well as the intricate network of these events should be acknowledged in clinic and intervention approaches.


Intimate partner violence Childhood sexual abuse Posttraumatic stress disorder Postpartum Path analysis 



This study was funded by the Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro/FAPERJ (grant no. E-26/111.161/2011). AGSO was supported by the FAPERJ (grant no. E-26/101.563/2014). MER was supported partially by the Brazilian National Research Council (grant no. 302224/2013-0).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki Declaration. Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Aline Gaudard e Silva de Oliveira
    • 1
    Email author
  • Michael Eduardo Reichenheim
    • 1
  • Claudia Leite Moraes
    • 1
    • 2
  • Louise Michele Howard
    • 3
  • Gustavo Lobato
    • 4
  1. 1.Department of Epidemiology, Institute of Social MedicineRio de Janeiro State UniversityRio de JaneiroBrazil
  2. 2.Medical SchoolEstácio de Sá UniversityRio de JaneiroBrazil
  3. 3.Institute of PsychiatryKing’s College LondonLondonUK
  4. 4.Fernandes Figueira Institute, Oswaldo Cruz FoundationRio de JaneiroBrazil

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