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Silva MMDJ, Serrano TBDM, Porcel GDS, Monteiro BB, Clapis MJ. Risk of depression during pregnancy in usual risk antenatal care. Rev Lat Am Enfermagem 2023; 31:e3962. [PMID: 37493727 PMCID: PMC10370154 DOI: 10.1590/1518-8345.6463.3962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/08/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE to identify the risk of depression during pregnancy among pregnant women receiving routine prenatal care and the associated factors. METHOD a cross-sectional study, carried out with 201 pregnant women, in a routine prenatal clinic of a university maternity hospital. Data were collected using an electronic form containing a characterization instrument and the Escala de Risco de Depressão na Gravidez (Depression during Pregnancy Scale). The dependent variable was the risk of depression during pregnancy. Statistical analysis was performed by calculating the Odds Ratio and using the Chi-square and Fischer's Exact tests. RESULTS among the participants, 68.2% had a higher risk of depression during pregnancy. There was a statistically significant association between a higher risk of depression during pregnancy and occupation (p=0.04), that is, unemployment (OR=2.00) doubled the risk of depression. CONCLUSION the high prevalence of the risk of depression during pregnancy indicates the necessity of planning, prioritizing, and integrating mental health into prenatal health services, especially in the primary healthcare environment, by health managers and policymakers.
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Affiliation(s)
- Mônica Maria de Jesus Silva
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Tainah Barbosa de Moraes Serrano
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Giovanna da Silva Porcel
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Bruna Borlina Monteiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
| | - Maria José Clapis
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brasil
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Ribeiro GDM, Cieto JF, Silva MMDJ. Risk of depression in pregnancy among pregnant women undergoing high-risk prenatal care. Rev Esc Enferm USP 2022; 56:e20210470. [PMID: 35858012 PMCID: PMC10081607 DOI: 10.1590/1980-220x-reeusp-2021-0470en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/31/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify the risk of depression in pregnancy among pregnant women undergoing follow-up in high-risk prenatal care, to assess the factors associated with higher risk of depression in pregnancy and to compare the risk of depression in each gestational trimester. METHOD this is a descriptive, correlational, cross-sectional study, conducted with 151 pregnant women in prenatal care in a high-risk pregnancy outpatient clinic at a university hospital in the state of São Paulo, Brazil. Data were collected through an online form. Chi-square and Fisher's exact tests were performed. After the bivariate analysis, the variables were included in the logistic regression model. In the final model, the Odds Ratio was calculated. RESULTS 118 (78.1%) pregnant women had a higher risk of depression during pregnancy, which was higher in the first trimester, but without statistical significance. The number of pregnancies (OR = 0.32) and marital status (OR = 0.07) remained significantly associated with higher risk of depression during pregnancy as protective factors. CONCLUSION the results elucidate the importance of screening for depression risk and the significant need to improve access to effective interventions for preventing prenatal depression and promoting mental health.
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Affiliation(s)
| | - Julia Ferreira Cieto
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Ribeiro GDM, Cieto JF, Silva MMDJ. Risco de depressão na gravidez entre gestantes inseridas na assistência pré-natal de alto risco. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0470pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: identificar o risco de depressão na gravidez entre gestantes em acompanhamento na assistência pré-natal de alto risco, avaliar os fatores associados ao maior risco de depressão na gravidez e comparar o risco de depressão em cada trimestre gestacional. Método: estudo descritivo, correlacional, transversal, realizado com 151 gestantes em acompanhamento pré-natal em ambulatório de gestação de alto risco de um hospital universitário no estado de São Paulo, Brasil. Os dados foram coletados por um formulário online. Foram realizados os Testes do Qui-Quadrado e Exato de Fisher. Após a análise bivariada, as variáveis foram incluídas no modelo de regressão logística. No modelo final, foi calcula a Razão de Chances. Resultados: 118 (78,1%) gestantes apresentaram maior risco de depressão na gravidez, o qual foi maior no primeiro trimestre, mas sem significância estatística. O número de gestações (OR = 0,32) e o estado civil (OR = 0,07) permaneceram associados significativamente ao maior risco de depressão na gravidez como fatores de proteção. Conclusão: os resultados elucidam a importância do rastreamento do risco de depressão e a necessidade significativa de melhorar o acesso a intervenções eficazes para prevenção da depressão pré-natal e promoção da sua saúde mental.
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Silva MMDJ, Clapis MJ. Depression During Pregnancy Risk Scale: elaboration of a theoretical model. Rev Esc Enferm USP 2021; 55:e03780. [PMID: 34287488 DOI: 10.1590/s1980-220x2020027503780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 02/24/2021] [Indexed: 11/21/2022] Open
Abstract
This study aim is to propose a theoretical model on the construct risk of depression during pregnancy as an initial part of the process of building and validating the Depression during Pregnancy Risk Scale. This is a theoretical study based on the methodology recommended by Pasquali, which establishes four steps for the elaboration of the theoretical model: psychological system, property of the psychological system, dimensionality, definition of the construct. In the first step, the psychological object was defined as "risk of depression during pregnancy". Thereafter, "depression during pregnancy" was defined as the property of the psychological system. In the third step, dimensionality was established through the antecedents and consequences of depression during pregnancy, understood as its risk factors and consequences, respectively. In the fourth step, the constitutive and operational definition of the construct risk of depression during pregnancy was established. The elaboration of the theoretical model advanced when it addressed the risk of depression during pregnancy as a process that articulates several concepts in which antecedents and consequences promoting repercussions on the health of the pregnant woman are inserted; and it contributed to the development of an original scale.
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Affiliation(s)
- Mônica Maria de Jesus Silva
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Maria José Clapis
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Lenz B, Eichler A, Schwenke E, Buchholz VN, Hartwig C, Moll GH, Reich K, Mühle C, Volz B, Titzmann A, Beckmann MW, Heinrich H, Kornhuber J, Fasching PA. Mindfulness-based Stress Reduction in Pregnancy: an App-Based Programme to Improve the Health of Mothers and Children (MINDFUL/PMI Study). Geburtshilfe Frauenheilkd 2018; 78:1283-1291. [PMID: 30686833 PMCID: PMC6337919 DOI: 10.1055/a-0677-2630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 01/01/2023] Open
Abstract
Unfavourable intrauterine environmental factors increase the risk of delivery complications as well as postpartum developmental and behavioural problems in children and adolescents with ongoing effects into older age. Biomarker studies show that maternal stress and the use of alcohol and tobacco during pregnancy are associated with a higher intrauterine testosterone exposure of the child. The antenatal testosterone load, in turn, is a risk factor for lasting adverse health effects which extend into adulthood. A 15-week, mindfulness-oriented, app-based programme for the reduction of stress as well as for the reduction of alcohol and tobacco use in pregnant women is established. In the monocentre, prospective, controlled, and investigator-blinded MINDFUL/PMI (Maternal Health and Infant Development in the Follow-up after Pregnancy and a Mindfulness Intervention) study, pregnant women carry out the programme. Its effect on antenatal testosterone exposure of the child is examined by assessing the index/ring finger length ratio and other biomarkers in the 1-year-old children. In addition, the programmeʼs effects on self-regulation, the developmental status and the mental health of the children at the age of one year will be investigated. Additional aspects of the course of the pregnancy and delivery represent exploratory study objectives. This longitudinal study project is intended to improve the understanding of the impact of intrauterine environmental factors on early childhood development and health. Maternal stress as well as alcohol and tobacco use during pregnancy are modifiable factors and represent potential preventive targets.
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Affiliation(s)
- Bernd Lenz
- Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Anna Eichler
- Kinder- und Jugendabteilung für Psychische Gesundheit, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Eva Schwenke
- Frauenklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Verena N Buchholz
- Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Charlotte Hartwig
- Frauenklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Gunther H Moll
- Kinder- und Jugendabteilung für Psychische Gesundheit, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Karin Reich
- Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Christiane Mühle
- Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Bernhard Volz
- Frauenklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany.,Biostatistics and Data Management Unit, Frauenklinik des Universitätsklinikums Erlangen, Erlangen, Germany
| | - Adriana Titzmann
- Frauenklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Matthias W Beckmann
- Frauenklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Hartmut Heinrich
- Kinder- und Jugendabteilung für Psychische Gesundheit, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany.,kbo-Heckscher-Klinikum, München, Germany
| | - Johannes Kornhuber
- Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Peter A Fasching
- Frauenklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
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