Sintomas depressivos maternos no puerpério imediato: fatores associados

Sintomas de depressão pós-parto e sua associação com as características socieconômicas e de apoio social

Resumo Objetivo verificar a prevalência de sintomas de depressão pós-parto em puérperas atendidas em uma maternidade pública e sua associação com características socioeconômicas e de apoio social. Método estudo epidemiológico, analítico, do tipo transversal, em uma maternidade pública conduzido de agosto a outubro de 2017. A amostra de 330 puérperas foi entrevistada por meio da aplicação de um formulário, para mensuração da presença de sintomas de depressão pós-parto. Foi utilizada a escala de depressão pós-natal de Edimburgo. Já para mensuração do apoio social, foi utilizado o instrumento Medical Outcomes Study. A medida de associação adotada foi a razão de prevalência (RP) com intervalos de confiança de 95% (IC95%), e aplicada a regressão de Poisson ajustada. Resultados a prevalência de sintomas de DPP foi de 29,7%. A idade entre 14 e 24 anos (PR:1,60; 95%CI: 1,10–2,34), ter até 8 anos de escolaridade (RP:1,39; IC95%:1,01–2,14) e o baixo nível de suporte social afetivo (RP:1,52; IC95%:1,07–2,14) e emocional (RP:2,12; IC95%:1,41-3,19) estiveram associados à maior prevalência de sintomas de DPP. Conclusão e implicações para a prática nesse contexto, os profissionais de saúde podem possuir um papel essencial no qual podem desenvolver, em conjunto, um plano de cuidados de acordo com as necessidades da mulher em período gravídico-puerperal.

Prevalence of anxiety and depression disorder and associated factors during postpartum in puerperal women

Abstract Objectives: to check the prevalence of anxiety and depression disorder and associated factors during the postpartum period in puerperal women in the city of Ponta Grossa, Paraná. Methods: cross-sectional study conducted in an outpatient clinic for newborn care in the city of Ponta Grossa, Paraná, Brazil, in 2016 and 2017. 250 puerperal women were evaluated with the application of a form to collect anxiety/depression, socioeconomic and gestational data. Descriptive and multiple correspondence analyses were performed. Results: most puerperal women (81.2%) had no depression or a mild depression, 14.4% with mild to moderate depression and 4.4% with moderate to severe depression. In relation to anxiety, 68.4% presented a minimum degree, 21.6% mild anxiety, 7.6% moderate anxiety and 2.4% severe anxiety. Concerning the associated factors with postpartum depression, no sociodemographic variables or those related to childbirth were associated. As for anxiety, yellow/indigenous skin color, lack of paternal support and having interrupted pregnancy were associated with more advanced anxiety conditions. Conclusion: there was no association between demographic and health conditions with postpartum depression; however, regarding anxiety, the yellow/indigenous skin color, the lack of paternal support and the interruption of previous pregnancies were associated with more advanced anxiety conditions.

Motherhood and COVID-19: a Digital Psychoeducational Booklet for the Coping with the Pandemic Stressors

During the pandemic of COVID-19, the Brazilian Health Ministry declared that 2-week postnatal women are a high-risk population that demands special assistance. Considering that women at the postnatal period are more susceptible to anxiety and stress symptoms, our objective is to present a digital psychoeducational booklet analyzing its validity to help this target population to cope with the stress from the new coronavirus crisis. Based on the dispositional coping theory and positive psychology, this proposal was developed as a digital booklet to promote the maternal mental health and well-being based on informational and psychoeducational approaches. Information about the COVID-19, as well as coping strategies and positive practices, were presented to provide support for the coping with pandemic stressors. To validate the booklet, 12 women answered a Google Form via WhatsApp that included a free and informed consent form, a general data protocol, and a questionnaire with validity criteria (clarity of written, practical pertinence, theoretical relevance, and presentation). Content validity coefficients (CVC) were calculated for all criteria. The participants were on average 30 years old (A.V.=23–43), and half of them had a high school degree; 50% of them self-declared white and 25% black, and 2 of them declared themselves brown and 1 yellow. All CVC were ≥ 0.96. These findings confirmed that our booklet can be considered a viable, useful, and efficient tool to help puerperium women during the pandemic, providing support for a resilient coping face to this new and critical moment.

Postpartum depression: a case-control study

BACKGROUND

Postpartum depression (PPD) is a mild to severe mood disorder, starting at 6 weeks after birth and with an incidence of approximately 25% in Brazilian puerperae. Its occurrence induce significant aggravations to maternal and child health, however, its risk factors, although known, are little explored for the appropriate diagnosis.

PURPOSE

To correlate PPD with anxiety, smoking, alcoholism, parity, type of birth, gestational and maternal age, identifying the possible risk factors that increase the probability of a puerpera developing a depressive episode.

MATERIALS AND METHODS

A case-control study performed at the Alzir Bernardino Alves Infant and Maternity Hospital in the city of Vila Velha, Espirito Santo, Brazil. The sample consisted of 227 puerperae. The cutoff point for depression was defined as >10 points according to the Edinburgh Postnatal Depression Scale (EPDS), and cutoff points for anxiety were defined as <33 points for low anxiety, between 33 and 49 for moderate anxiety and >49 for high anxiety according to the State - Trait Anxiety Inventory (STAI-T).

RESULTS

29.1% of the 227 interviewed puerperae presented PPD and were considered "cases", with the remaining being considered as "control". There was a positive correlation between PPD and anxiety. No significant correlation was observed for the other risk factors. Women with moderate anxiety presented 17.38 times more probability to develop depressive episodes, and puerperae with high anxiety presented 273 times more chance of developing PPD.

CONCLUSIONS

Our results evidenced a high percentage of puerperae with PPD related to maternal anxiety, demonstrating the importance and the necessity of increasing care for women's mental health in the gestational and puerperal periods.