Vicenta Escribà-Agüir

Chronic extreme long working hours (LWH) have been found consistently associated with poor health status. However, the evidence for moderately LWH (41–60 h a week) is contradictory. Although poor job quality has been proposed as one of the mechanisms of this relationship, there are almost no studies about LWH and job quality. The objectives of this study were to analyze the association between moderately LWH and job quality in the EU27, as well as to examine differences by welfare regimes and gender. This is a cross-sectional study based on data from the 2010 European Working Conditions Survey. A subsample of employees from the EU27 aged 16–64 years who worked 30–60 h a week was selected (12,574 men and 8787 women). Overall, moderately LWH were not consistently associated with poor job quality except among women from Eastern European countries. Therefore, in the EU27 poor job quality does not seem to explain the relationship between moderately LWH and poor health status. The findings among women from Eastern European countries may be related to their weakened position in the labor market and to their work-family conflict resulting from a process of re-familisation that constrains their choices for a good job.

The growing demand for labour flexibility has resulted in decreasing employment stability that could be associated with poor mental health status. Few studies have analysed the whole of the work force in considering this association since research on flexible forms of employment traditionally analyses employed and unemployed people separately. The gender division of work, and family characteristics related to employment situation, could modify its association with mental wellbeing. The objective of the study was to examine the relationship between a continuum of employment stability and mental health taking into account gender and partner/marital status. We selected 6859 men and 5106 women currently salaried or unemployed from the 2006 Spanish National Health Survey. Employment stability was measured through a continuum from the highest stability among employed to lowest probability of finding a stable job among the long-term unemployed. Mental health was measured with the 12-item version of the General Health Questionnaire. Logistic regression models were fitted for each combination of partner/marital status and gender. In all groups except among married women employment stability was related to poor mental health and a gradient between a continuum of employment stability and mental health status was found. For example, compared with permanent civil servants, married men with temporary contract showed an aOR = 1.58 (95%CI = 1.06–2.35), those working without a contract aOR = 2.15 (95%CI = 1.01–4.57) and aOR = 3.73 (95%CI = 2.43–5.74) and aOR = 5.35 (95%CI = 2.71–10.56) among unemployed of up to two years and more than two years, respectively. Among married and cohabiting people, the associations were stronger among men. Poor mental health status was related to poor employment stability among cohabiting women but not among married ones. The strongest association was observed among separated or divorced people. There is a rise in poor mental health as the distance from stable employment grows. This result differs according to the interaction with gender and partner/marital status. In Spain this relationship seems to follow a pattern related to the gender division of work in married people but not in other partner/marital situations. Family and socioeconomic context can contribute to explain previous mixed results. Recommendations for research and for action are given.

Objective: To assess the reliability, accuracy, and construct validity of the Spanish Abuse Assessment Screen (AAS) among pregnant women using the Spanish version of Index of Spouse Abuse (ISA) as a reference standard.Design and Sample: Cross‐sectional survey. A total of 1,329 pregnant women were selected in nine primary care centers during 2008–2009.Measures: The Spanish ISA was self‐administered first, followed by the AAS, administered by the midwife. Sensitivity, specificity, and predictive values of the Spanish AAS were compared with the Spanish version of the ISA as a reference standard.Results: Percentage of agreement between initial and retest administration of the Spanish AAS was high, from 96.4% to 100%. Specificity was for all types of abuse above 97%, but sensitivity values were much lower (33.3%, 22.9%, 6.9%, for severe physical abuse, minor psychological abuse, and minor physical abuse, respectively). The sensitivity of severe psychological abuse was perfect. Construct validity was good.Conclusion: The Spanish AAS has good test‐retest reliability, specificity, and construct validity. The sensitivity was good for severe psychological abuse and moderate for severe physical abuse. Further formal psychometric evaluations, in other languages from countries with low prevalence of abuse, remains a priority for clinical and research efforts in pregnancy domestic violence screening.

L’article interroge le rôle des violences conjugales ainsi que des violences intrafamiliales sur les décisions reproductives des femmes. Les auteures analysent des données recueillies par questionnaire auprès de l’ensemble des femmes admises dans un hôpital de Trieste (en Italie) au cours d’une même période, les unes étant venues pour accoucher, les autres pour interrompre volontairement leur grossesse. Elles montrent que les secondes sont plus exposées aux violences que les premières. Parmi celles qui ont subi des violences, la décision d’avorter est davantage le fait des femmes les plus favorisées. L’interruption de la grossesse se révèle être un acte d’autonomisation vis-à-vis de leur conjoint, tandis que celles qui mettent un enfant au monde tout en subissant des violences apparaissent socialement plus désavantagées.

Objective To describe the incidence and risk factors of psychological intimate partner violence (IPV) during pregnancy and the first year after childbirth. Design Longitudinal cohort study. Setting Nine primary care centers in the Valencia Region (Spain). Population A consecutive sample of 1400 women in the first trimester of pregnancy, attending the prenatal programme in the Valencia Region of Spain in 2008, with follow-up in the third trimester of pregnancy, and at 5 and 12 months postpartum. A total of 888 women (66.5%) participated in all four phases. Methods A logistic regression model was fitted using generalised estimating equations to assess the effects of previous partner violence, consumption of alcohol or illicit drugs and social support on subsequent psychological partner violence. Main outcome measure Psychological IPV during follow-up. Results We observed an increase in the incidence of psychological IPV after birth, particularly at 5 months postpartum. The strongest predictor of psychological IPV was having experienced abuse 12 months before pregnancy (OR 10.46, 95%CI 2.40–45.61). Other predictors were consumption of alcohol or illicit drugs by the partner or a family member (OR3.50, 95%CI 1.38–8.85) and lack of affective social support (OR2.83, 95%CI 1.31–6.11). Conclusions Previous abuse and psychosocial risk factors predict partner psychological abuse after birth. Monitoring psychological IPV and effective interventions are needed not only during pregnancy but also during the postpartum period.

The aim of this study was to determine the effect of isolated psychological intimate partner violence and psychosocial factors (social support and alcohol or drug use by a partner/family member) on psychological well-being (depression or poor self-perceived health status) at 5 and 12 months post-partum. A longitudinal cohort study was carried out with a consecutive sample of 1,400 women in their first trimester of pregnancy, who attended the prenatal programme in the Valencia Region (Spain) in 2008 and were followed up at 5 months and 12 months post-partum. A logistic regression model was fitted using generalized estimating equations, to assess the effect of isolated psychological intimate partner violence, social support, alcohol consumption and illicit drug use problems by a partner or family member on subsequent psychological well-being at follow-up. We observed a decrease in the incidence of poorer psychological well-being (post-partum depression and poor self-perceived health status) at 12 months post-partum. The strongest predictor of poor psychological well-being was depression (AOR = 6.83, 95 % CI: 3.44–13.58) or poor self-perceived health status (AOR = 5.34, 95 % CI: 2.37–12.02) during pregnancy. Isolated psychological IPV increased the risk of a deterioration in psychological well-being. Having a tangible social network was also a predictor of both post-partum depression and poor self-perceived health status. The effect of functional social support varied according to the type of psychological well-being indicator being used. Problems of alcohol consumption or illicit drug use by a partner or family member were a predictor of post-partum depression only. Psychological well-being during the first year after birth is highly affected by isolated psychological IPV and psychosocial factors.

The aim of this study was to determine if the effects of intimate partner violence (IPV) in the previous 12 months (current IPV) on newborn’s health, pregnancy outcomes and couple’s reproductive behaviours were different for postpartum (PP) women as compared to women who had undergone an elective abortion (EA) in Trieste (Italy). This study is part of an unmatched case–control study. The major findings are that current IPV was positively associated with previous stillbirth among both groups of women, but the association was only marginally significant. Among EA women only, current IPV was significantly associated with previous miscarriages (adjusted odds ratio, 2.41; 95 %CI, 1.13–5.14). In both groups of women, current IPV was associated with a lack of joint couple decision making about contraception; however, the magnitude of this effect was higher among PP women. This study reveals that IPV was associated with poor obstetrical history among both groups of women. But the associations of current IPV with previous EA and couple reproductive behaviours were stronger among PP women.

Background The course of depression from pregnancy to 1 year post partum and risk factors among mothers and fathers are not known. Aims (1) To report the longitudinal patterns of depression from the third trimester of pregnancy to 1 year after childbirth; (2) to determine the gender differences between women and their partners in the effect of psychosocial and personal factors on postpartum depression. Methods A longitudinal cohort study was carried out over a consecutive sample of 769 women in their third trimester of pregnancy and their partners attending the prenatal programme in the Valencian Community (Spain) and follow-up at 3 and 12 months post partum. The outcome variable was the presence of depression at 3 or 12 months post partum measured by the Edinburgh Postnatal Depression Scale. Predictor variables were: psychosocial (marital dissatisfaction, confidant and affective social support) and personal (history of depression, partner's depression and negative life events, depression during the third trimester of pregnancy) variables. Logistic regression models were fitted via generalised estimating equations. Results At 3 and 12 months post partum, 9.3% and 4.4% of mothers and 3.4% and 4.0% of fathers, respectively, were newly diagnosed as having depression. Low marital satisfaction, partner's depression and depression during pregnancy increased the probability of depression during the first 12 months after birth in mothers and fathers. Negative life events increased the risk of depression only among mothers. Conclusions Psychosocial and personal factors were strong predictors of depression during the first 12 months post partum for both mothers and fathers.