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Coping Style and Depressive Symptomatology during Pregnancy in a Private Setting Sample

  • Alexandre Faisal-Cury (a1), Mariangela Gentil Savoia (a1) and Paulo Rossi Menezes (a1)

to evaluate the association of antenatal depressive symptomatology (AD) with life events and coping styles, the hypothesis was that certain coping strategies are associated to depressive symptomatology.


we performed a cross sectional study of 312 women attending a private clinic in the city of Osasco, São Paulo from 27/05/1998 to 13/05/2002. The following instruments were used: Beck Depression Inventory (BDI), Holmes and Rahe Schedule of Recent Events (SSRS), Folkman and Lazarus Ways of Coping Questionnaire and questionnaire with social-demographic and obstetric data. Inclusion criteria: women with no past history of depression, psychiatric treatment, alcohol or drug abuse and no clinical-obstetrical complications. Odds ratios and 95% CI were used to examine the association between AD (according to BDI) and exposures variables. Hypothesis testing was done with X2 tests and a p value < .05.


AD occurred in 21.1% of pregnant women. By the univariate analyses, education, number of pregnancies, previous abortion, husband income, situation of marriage and score of SSRS were associated with AD. All coping styles were associated with AD, except seeking support and positive reappraisal. By the multivariate analyses, four coping styles were kept in the final model: confront (p = .039), accepting responsibility (p < .001), escape-avoidance (p = .002), problem-solving (p = .005).


AD was highly prevalent and was associated with maladaptive coping styles.


evaluar la asociación de la sintomatología depresiva antenatal (AD), con acontecimientos de la vida y estilos de afrontamiento, la hipótesis era que ciertas estrategias de afrontamiento se asocian a síntomas depresivos.


Se realizó un estudio transversal con 312 mujeres que asistían a una clínica privada en la ciudad de Osasco, São Paulo desde 27/05/1998 a 13/05/2002. Los instrumentos utilizados fueron: el Inventario de Depresión de Beck (BDI), la escala de reajuste social de Holmes y Rahe (SRRS), la escala de estrategias de afrontamiento (ways of Coping)de Folkman y Lazarus y un cuestionario de datos socio-demográficos y obstétricos. Criterios de inclusión: mujeres sin antecedentes de depresión, tratamiento psiquiátrico, o de abuso de drogas o alcohol y sin complicaciones clínico-obstétricas. Se utilizaron Odds ratios y IC del 95% para examinar la asociación entre AD (según BDI) y las variables de exposición. La prueba de hipótesis se llevó a cabo con tests de ⊠2 y un valor de p < ,05.


AD se produjo en el 21,1% de las mujeres embarazadas. Con el análisis univariado, la educación, el número de embarazos, abortos anteriores, los ingresos del marido, la situación del matrimonio y la puntuación de SRRS se relacionan con AD. Todos los estilos de afrontamiento se asocian con AD, con excepción de la búsqueda de apoyo y la reevaluación positiva. Utilizando el análisis multivariado, cuatro estilos de afrontamiento se mantuvieron en el modelo final: enfrentamiento (p = ,039), aceptar responsabilidad (p < ,001), huida-evitación (p = ,002), y resolución de problemas (p = ,005).


La AD fue altamente prevalente y se asocia con conductas de afrontamiento mal adaptadas.

Corresponding author
Correspondence concerning this article should be addressed to Alexandre Faisal-Cury. Rua Mário Ferraz, 135/32, J. Europa, São Paulo (Brazil) 01453-010. Phone/Fax: +055 011 36838196. E-mail:
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Aldwin C. M., & Revenson T. A. (1987). Does coping help?. Reexamination of the relation between coping and mental health. Journal of Personality and Social Psychology, 53, 337348.
Anderson L., Sundstrom-Poromma I., Wuff M., Astrom M., & Bixo M. (2004). Implications of antenatal depression and anxiety for obstetric outcomes. Obstetrics & Gyecology, 104, 467476.
Andrade L., Gorenstein C., Vieira Filho A. H., Tung T. C., & Artes R. (2001). Psychometric properties of the Portuguese version of the state-trait anxiety inventory applied to college students: Factor analysis and relation to the Beck Depression Inventory. Brazilian Journal of Medical and Biological Research, 34, 367374.
Areias M. E. G., Kumar R., Barros H., & Figueiredo E. (1996). Correlates of postnatal depression in mothers and fathers. British Journal of Psychiatry, 169, 3641.
Arizmendi T. G., & Affonso D. D. (1987). Stressful events related to pregnancy and postpartum. Journal of Psychosomatic Research, 31, 743756.
Beck A. T., Ward C. H., & Mendelson M. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.
Beck A. T., Steer R. A., & Garbin M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychological Review, 8, 77100.
Belsky J., & Rovine M. (1984). Social network contact, family support and the transition to parenthood. Journal of Marriage and Family, 46, 455462.
Bennett H. A., Einarson A., Taddio A., Koren G., & Einarson T. R. (2004). Prevalence of depression during pregnancy: Systematic review. Obstetrics & Gynecology, 103, 698709.
Bjorck J. P., Cuthbertson W., Thurman J. W., & Lee Y. S. (2001). Ethnicity, coping, and distress among Korean Americans, Filipino Americans, and Caucasian. Americans. Journal of Social Psychology, 141, 421442.
Chung T. K. H., Lau T. K., Yip A. S. K., Chiu H. F., & Lee D. T. (2001). Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosomatic Medicine, 63, 830834.
De Tychey C., Spitz E., & Briançon S. (2004). Prévalence de la dépression prénatale et stratégies de coping [Prevalence of perintal depresión and coping strategies]. Neuropsychiatrie de l'enfance et de l'adolescence, 52, 261265.
Demyttenaere K., Maes A., Nijs P., Odendael H., & Van Assche F. A. (1995). Coping style and preterm labor. Journal of Psychosomatic Obstetrics and Gynecology, 16, 109115.
Faisal-Cury A., Tedesco J. J. A., Kahhale S., Menezes P. R., & Zugaib M. (2004). Postpartum depression: In relation to life events and patterns of coping. Archives of Women's Mental Health, 7, 123131.
Faisal-Cury A., & Menezes P. R. (2007). Prevalence of anxiety and depression during pregnancy in a private setting sample. Archives of Women's Mental Health, 10, 2532.
Faisal-Cury A., Menezes P., Araya R., & Zugaib M. (2009). Common mental disorders during pregnancy: Prevalence and associated factors among low-income women in São Paulo, Brazil. Depression and anxiety during pregnancy. Archives of Women's Mental Health, 12, 335343.
Fatove F. O., Adeveni A. B., & Oladimeji B. Y. (2004). Emotional distress and its correlates among Nigerian women in late pregnancy. Journal of Obstetrics & Gynaecology, 24, 504509.
Felton B., & Revenson T. (1984). Coping with chronic illness: A study of illness controllability and the influence of coping strategies on psychological adjustment. Journal of Consulting and Clinical Psychology, 52, 343353.
Ferri C. P., Mitsuhiro S. S., Barros M. C., Chalem E., Guinsburg R., Patel V., … 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, 209218.
Folkman S., & Lazarus R. S. (1980). An analysis of coping in a middle-age community sample. Journal of Health and Social Behavior, 21, 219239.
Folkman S., & Lazarus R., (1985). If changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology, 48, 150170.
Folkman S., Lazarus R. S., Dunkel-Schetter C., DeLongis A., & Gruen R. J. (1986). The dynamics of a stressful encounter: Cognitive, appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 9921003.
Folkman S., & Lazarus R. S. (1986). Stress processes and depressive symptomatology. Journal of Abnormal Psychology, 95, 107113.
Folkman S., Lazarus R. S., Pimley S., & Novacek J. (1987) Age differences in stress and coping processes. Psychology & Aging, 2, 171184.
Folkman S., & Lazarus R. S. (1988). Manual for the ways of coping questionnaire. Palo Alto, CA: Consulting Psychologist Press.
Folkman S., & Lazarus R. (1988b). Coping as a mediator of emotion. Journal of Personality and Social Psychology, 54, 466475.
Gorenstein C., & Andrade L. (1996). Validation of Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Brazilian Journal of Medical and Biological Research, 29, 453457.
Gorenstein C., Andrade L., Vieira Filho A. H. G., Tung T. C., & Artes R. (1999). Psychometric properties of the Portuguese version of the Beck Depression Inventory on Brazilian college students. Journal of Clinical Psychology, 55, 553562.<553::AIDJCLP3>3.3.CO;2-4
Gramling L. F., Lambert V. A., & Pursley-Crotteau S. (1998). Coping in young women: Theoretical retroduction. Journal of Advanced Nursing, 28, 10821091.
Hatton C., Knussen C., Slopper P., & Turner S., (1995). The stability of the ways of coping (Revised) Questionnaire over time in parents of children with Down's syndrome: A research note. Psychological Medicine, 25, 419422.
Heron J., O'Connor T. G., Evans J., Golding J., Glover V., & The ALSPAC Study Team (2004). The course of anxiety and depression through pregnancy and the postpartum in a community sample. Journal of Affective Disorders 80, 6573.
Holcomb W. L., Stone L. S., Lustman P. J., Gavard J. A., & Mostello D. J. (1996). Screening for depression in pregnancy: Characteristics of the Beck Depression Inventory. Obstetrics & Gynecology, 88, 10211025.
Holmes T. H., & Rahe R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213218.
Huizink A. C., de Medina P. G., Mulder E. J., Visser G. H., & Buitelaar J. K. (2002). Coping in normal pregnancy. Annals of Behavioural Medicine, 24, 132140.
Huizink A. C., Robles de Medina P. G., Mulder E. J., Visser G. H., & Buitelaar J. K. (2003). Stress during pregnancy is associated with developmental outcome in infancy. Journal of Child and Psychological Psychiatric, 44, 810818.
Levy-Shiff R., Dimitrovsky L., Shulman S., & Har-Even D. (1998). Cognitive appraisals, coping strategies, and support resources as a correlates of parenting and infant development. Developmental Psychology, 34, 14171427.
Lovisi G. M., López J. R. A., Coutinho E. S. F., & Patel V. (2005). Poverty, violence and depression during pregnancy: A survey of mothers attending a public hospital in Brazil. Psychological Medicine, 35, 14851492.
Manolache L., Petrescu-Seceleanu D., & Benea V. (2010). Life events involvement in psoriasis onset/recurrence. International Journal of Dermatology, 49, 636641.
Morling B., Kitayama S., & Miyamoto A. (2003). American and Japanese women use different coping strategies during normal pregnancy. Personality and Social Psychology Bulletin, 29, 15331546.
O'Hara M. W., Neunaber D. J., & Zekoski E. M. (1984). Prospective study of postpartum depression: Prevalence, course and predictive factors. Journal of Abnormal Psychology, 93, 158171.
O'Hara M.W., & Swain A. M. (1996). Rates and risk of postpartum depression: AMeta analysis. International Review of Psychiatry, 8, 3754.
Pakenham K. I., Smith A., & Rattan S. L. (2007). Application of a stress and coping model to antenatal depressive symptomatology. Psychology, Health & Medicine, 12, 266277.
Patel V., Rodrigues M., & DeSouza N. (2002) Gender, poverty, and postnatal depression: A study of mothers in Goa, India. American Journal of Psychiatry, 159, 4347.
Patel V., & Prince M. (2006). Maternal psychological morbidity and low birth weight in India. British Journal of Psychiatry, 188, 284285.
Rahman A., Bunn J., Lovel H., & Creed F. (2007). Association between antenatal depression and low birthweight in a developing country. Acta Psychiatrica Scandinavia, 115, 481486.
Rey E., Moreno Ortega M., Garcia Alonso M. O., & Diaz-Rubio M. (2009). Constructive thinking, rational intelligence and irritable bowel syndrome. World Journal of Gastroenterology, 15, 31063111.
Roesch S. C., Schetter C. D., Woo G., & Hobel C. J. (2004). Modeling the types and timing of stress in pregnancy. Anxiety, Stress & Coping, 17, 87102.
Rudnicki S. R., Graham J. L., Habboushe D. F., & Ross R. D. (2001). Social support and avoidant coping: Correlates of depressed mood during pregnancy in minority women. Women Health, 34, 1934.
Salamero M., Marcos T., Gutierrez F., & Rebull B. (1994). Factorial study of the BDI in pregnant women. Psychological Medicine, 24, 10311035.
Savoia M. G., Santana P. R., & Mejias N. P. (1996). Adaptação do Inventário de Estratégias de Folkman e Lazarus para o português. [Adaptation of the Folkman and Lazarus Inventory to Portuguese]. Revista de Psicologia da USP, 7, 83201.
Srivastava S., & Boyer J. L. (2010). Psychological stress is associated with relapse in type 1 autoimmune hepatitis. Liver International, 30, 14391447.
STATA (2005). Stata Statistical software. Texas, TX: Stata Corporation.
Steiner M., & Yonkers K. (1998). Depression in women. London, England: Martin Dunitz.
Teissedre .F., & Chabrol H. (2004). A study of the Edinburgh Postnatal Depression Scale (EPDS) on 859 mothers: Detection of mothers at risk for postpartum depression. Encephale, 30, 376381.
Vaaler A. E., Morken G., Iversen V. C., Kondziella D., & Linaker O. M. (2010). Acute Unstable Depressive Syndrome (AUDS) is associated more frequently with epilepsy than major depression. BMC Neurology, 10, 6775.
Wenzel A., Haugen E. N., Jackson L. C., & Robinson K. (2003). Prevalence of generalized anxiety at eight weeks postpartum. Archives of Women's Mental Health, 6, 4349.
Wilson L. M., Reid A. J., Midmer D. K., Biringer A., Carroll J. C., & Stewart D. E. (1996). Antenatal psychosocial risk factors associated with adverse outcomes. Canadian Medical Association Journal, 154, 785799.
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