Assuntos
Humanos , Feminino , Gravidez , Adulto , Transtornos Puerperais/psicologia , Transtornos Puerperais/terapia , Transtorno Bipolar/terapia , Estimulação Magnética Transcraniana/métodos , Período Periparto/psicologia , Escalas de Graduação Psiquiátrica Breve , Fatores de Tempo , Resultado do Tratamento , Ideação SuicidaAssuntos
Transtorno Bipolar/terapia , Período Periparto/psicologia , Transtornos Puerperais/terapia , Estimulação Magnética Transcraniana/métodos , Adulto , Escalas de Graduação Psiquiátrica Breve , Feminino , Humanos , Gravidez , Transtornos Puerperais/psicologia , Ideação Suicida , Fatores de Tempo , Resultado do TratamentoRESUMO
Childbirth may be a traumatic experience for some women. This observational study aimed to describe the incidence of traumatic childbirth in two regional maternity services in Brazil. In addition, the study intended to determine characteristics that are associated with traumatic childbirth. A total of 328 women were interviewed, up to 72 hours postpartum, between July and November 2010. Women were screened for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMI-IV) criteria for traumatic event using the item A of SCID-I interview for PTSD. Socio-demographic and obstetrical variables, pain score, previous trauma and dissociative experiences in women with and without traumatic childbirth were compared. A total of 53 (16.2%) of the sample fulfilled the criteria for a traumatic event. It observed that some socio-demographic and obstetrical variables may be considered as associated with traumatic childbirth, such as an intermediate level of schooling, high risk pregnancy, obstetrical complications during pregnancy, primiparity, a high pain score, forceps, episiotomy, prematurity, obstetrical complications at birth or with the baby, baby needing hospital care, dissociative experience peripartum, no satisfaction with maternity care, not being well informed of the progress of labor and previous trauma related to urban violence, sexual abuse or domestic violence. Childbirth may be a traumatic event for Brazilian. In this sample traumatic childbirth was associated with pain, previous trauma, dissociative experiences and some socio-demographic and obstetrical variables. Traumatic childbirth constitutes an important mental health problem and need more attention from health.
El parto puede ser una experiencia traumática para algunas mujeres. Este estudio observacional tuvo como objetivo describir la incidencia del parto traumático en dos servicios regionales de maternidad en Brasil. Además, el estudio pretendía determinar las características asociadas con el parto traumático. Un total de 328 mujeres fueron entrevistadas, hasta 72 horas después del parto, entre julio y noviembre de 2010. Las mujeres fueron seleccionadas para el Manual Diagnóstico y Estadístico de los Trastornos Mentales, Cuarta Edición (DSMI-IV) para el evento traumático utilizando el ítem A de SCID- entrevisto para estrés postraumático. Se compararon variables sociodemográficas y obstétricas, puntuación de dolor, trauma previo y experiencias disociativas en mujeres con y sin parto traumático. Un total de 53 (16,2%) de la muestra cumplieron los criterios para un evento traumático. Se observó que algunas variables sociodemográficas y obstétricas pueden considerarse asociadas con el parto traumático, como un nivel intermedio de escolaridad, un embarazo de alto riesgo, las complicaciones obstétricas durante el embarazo, la primiparidad, un alto puntaje de dolor, fórceps, episiotomía, prematuridad, obstetricia Lactancia que necesita atención hospitalaria, experiencia disociativa periparto, ausencia de satisfacción con la atención de maternidad, no estar bien informado sobre el progreso del parto y trauma previo relacionado con la violencia urbana, el abuso sexual o la violencia doméstica. El parto puede ser un evento traumático para el brasileño. En esta muestra el parto traumático se asoció con dolor, traumatismo previo, experiencias disociativas y algunas variables sociodemográficas y obstétricas. El parto traumático constituye un importante problema de salud mental y necesita más atención de la salud
Assuntos
Humanos , Feminino , Gravidez , Adulto , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Período Pós-Parto/psicologia , Transtornos Puerperais/psicologia , Brasil , Inquéritos e Questionários , Depressão Pós-Parto , Parto/psicologia , Angústia Psicológica , Serviços de Saúde MaternaRESUMO
The postpartum period represents a very particular time in women's life, the beginning of a new bond, the maternity. As many times, beginnings are such turbulent, intense. In this period the women suffers deep changes in their hormonal status, with its body and changes and affective oscillations. Women are often so labile at this time, ranging from happiness to deep sadness. The vast majority suffers the blues, a benign form of mild depressive state. On the other hand, 20% may have a major depressive episode, and a much less percentage will suffer the most disruptive postpartum syndrome, the postpartum psychosis. In this paper it will be described the symptomatology of such cases, the most important treatment approaches and will focus on the clinical dilemma of using psychotropic medications during breastfeeding.
Assuntos
Transtornos Mentais , Transtornos Puerperais/psicologia , Ansiedade/diagnóstico , Ansiedade/tratamento farmacológico , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/tratamento farmacológico , Feminino , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/tratamento farmacológico , Período Pós-Parto/psicologia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/tratamento farmacológico , Transtornos Puerperais/diagnóstico , Transtornos Puerperais/tratamento farmacológicoRESUMO
BACKGROUND: Although studies suggest the relevance of intimate partner violence (IPV) and other health-related social characteristics as risk factors for postpartum mental health, literature lacks evidence about how these are effectively connected. This study thus aims to explore how socio-economic position, maternal age, household and marital arrangements, general stressors, alcohol misuse and illicit drug abuse, and especially psychological and physical IPV relate in a framework leading to postpartum common mental disorder (CMD). METHODS: The study was carried out in five primary health care units of Rio de Janeiro, Brazil, and included 810 randomly selected mothers of children up to five postpartum months waiting for pediatric visits. The postulated pathways between exposures and outcome were based on literature evidence and were further examined using structural equation models. RESULTS: Direct pathways to postpartum CMD arose from a latent variable depicting socio-economic position, a general stressors score, and both IPV variables. Notably, the effect of psychological IPV on postpartum CMD ran partly through physical IPV. The effect of teenage pregnancy, conjugal instability and maternal burden apparently happens solely through substance use, be it alcohol misuse, illicit drug abuse or both in tandem. Moreover, the effect of the latter on CMD seems to be entirely mediated through both types of IPV. CONCLUSION: Although the theoretical model underlying the analysis still requires in-depth detailing, results of this study may have shed some light on the role of both psychological and physical IPV as part of an intricate network of events leading to postpartum CMD. Health initiatives may want to make use of this knowledge when designing preventive and intervention approaches.
Assuntos
Inquéritos Epidemiológicos/métodos , Transtornos Mentais/epidemiologia , Transtornos Puerperais/epidemiologia , Transtornos Puerperais/psicologia , Parceiros Sexuais/psicologia , Violência/psicologia , Adulto , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Brasil/epidemiologia , Comorbidade , Família/psicologia , Características da Família , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Casamento/psicologia , Casamento/estatística & dados numéricos , Idade Materna , Transtornos Mentais/psicologia , Mães/psicologia , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Violência/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVES: To study perinatal anxiety symptoms in a sample of Mexican mothers. A) To evaluate the effect of certain psychosocial factors during pregnancy on anxiety symptoms at two postpartum time intervals; and B) to determine whether this symptomatology is related to symptoms of postnatal depression. MATERIAL AND METHODS: In this secondary data analysis, 156 women were interviewed during pregnancy (T1): 149 were interviewed again at 6 weeks postpartum (T2) and 156 at 4-6 months postpartum (T3). Subjects were selected from women seeking prenatal attention at three health centers in Mexico City who presented with depressive symptomatology and/or previous history of depression. Two models were subjected to multivariate regression analysis to determine the influence of psychosocial factors in pregnancy (age, education, partner status, social support [APGAR], stress events, self-esteem [Coopersmith], depressive symptomatology [BDI-II], and anxiety [SCL-90]) on anxiety symptomatology (SCL-90) in T2 and T3. Two additional linear regression analyses were performed to evaluate the influence of prenatal anxiety symptomatology (SCL-90) on postpartum depression symptoms (BDI-II), one for each postnatal period (T2, T3). RESULTS: The variables that predicted postpartum anxiety symptomatology in T2 were anxiety symptoms and lack of social support; in T3 they were anxiety symptoms, lack of a partner, and lack of social support. Prenatal anxiety symptoms predicted postpartum depressive symptomatology at both postpartum intervals (T2, T3). CONCLUSIONS: Untreated prenatal anxiety symptomatology is predictive of symptoms of anxiety and depression in the postpartum period, suggesting the need for timely detection and treatment. Women lacking social support or partners are a population particularly vulnerable to anxiety symptoms, and merit interventions that address these issues.
Assuntos
Ansiedade/psicologia , Depressão Pós-Parto/psicologia , Complicações na Gravidez/psicologia , Psicologia , Transtornos Puerperais/psicologia , Adolescente , Adulto , Ansiedade/epidemiologia , Comorbidade , Depressão Pós-Parto/epidemiologia , Transtorno Depressivo/epidemiologia , Diagnóstico Precoce , Feminino , Humanos , Entrevista Psicológica , Casamento , Idade Materna , México/epidemiologia , Análise Multivariada , Gravidez , Complicações na Gravidez/epidemiologia , Transtornos Puerperais/epidemiologia , Autoimagem , Índice de Gravidade de Doença , Apoio Social , Estresse Psicológico/epidemiologia , Fatores de Tempo , Adulto JovemRESUMO
OBJETIVO: Traduzir, adaptar e avaliar a aplicabilidade, além de obter dados acerca da consistência interna do Postpartum Thoughts and Behavior Checklist. Esse instrumento foi elaborado especificamente para uso durante o pós-parto e identifica a presença e o conteúdo dos pensamentos intrusivos em relação ao bebê, assim como as estratégias de neutralização utilizadas após esses pensamentos. MÉTODO: A tradução do instrumento para o português foi feita por dois profissionais de saúde mental bilíngues. Posteriormente, houve uma retrotradução realizada por dois professores de inglês. A versão retrotraduzida foi avaliada pelo autor da escala e aplicada em 91 puérperas usuárias de um serviço da rede pública de saúde. RESULTADOS: A versão traduzida do Postpartum Thoughts and Behavior Checklist foi considerada equivalente ao instrumento original em inglês. As participantes não apresentaram dificuldades na compreensão dos itens do checklist. Sua consistência interna, medida pelo alfa de Cronbach, foi de 0,822. CONCLUSÃO: A versão em português do Postpartum Thoughts and Behavior Checklist pode ser considerada adequada para o uso na população estudada para avaliar pensamentos obsessivos em relação ao bebê durante o puerpério e possíveis estratégias de neutralização desses pensamentos. O checklist pode ainda trazer contribuições significativas para a prática clínica.
OBJECTIVE: To translate, adapt, evaluate the applicability, and to obtain data regarding the internal consistency of Postpartum Thoughts and Behavior Checklist. This checklist is a specific instrument for postpartum which identify the presence and the content of intrusive thoughts related to newborn as well as the neutralization strategies used after these thoughts. METHOD: The translation of the instrument into Portuguese was carried out by two bilingual mental health professionals. Afterwards, a back translation was performed by two English teachers. The back translation version was evaluated by the author of the scale and applied in 91 new mothers who were users of health public service. RESULTS: The translated version of Postpartum Thoughts and Behavior Checklist was considered equivalent to the original instrument in English. The participants did not show difficulties to understand the checklist items. The internal consistency, measured through Cronbach's alpha, was 0,822. CONCLUSION: The Portuguese version of Postpartum Thoughts and Behavior Checklist could be considered appropriated for using in studied population in order to evaluate obsessive thoughts related to newborn during postpartum and possible strategies to neutralize these thoughts. The checklist could also bring significant contributions to the clinical practice.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Comparação Transcultural , Período Pós-Parto/psicologia , Traduções , Transtorno Obsessivo-Compulsivo/psicologia , Transtornos Puerperais/psicologia , Escalas de Graduação Psiquiátrica , Psicometria/métodosRESUMO
BACKGROUND: An improvement in maternal health conditions can only be achieved when a reduction in the number of deaths is accompanied by a reduction in the frequency of severe complications of pregnancy. The objective of this study was to investigate women's experiences related to the burden of severe maternal morbidity. METHODS: This qualitative study is based on narratives of women who survived severe complications of pregnancy and who were admitted to the intensive care unit of a public university hospital in the city of Campinas, Brazil. A sample of 30 women was recruited between April 2007 and January 2008. Before hospital discharge, eligible women who agreed to participate responded to a semidirected interview. The interviews were recorded and the transcripts received a thematic analysis. RESULTS: Two major themes were identified, one more closely related to the experience of a critical illness and the other to the experience of care. A complex set of reactions was found in the women who survived, indicating the occurrence of acute stress-related disorders. CONCLUSIONS: On the basis of narratives of women who almost died during pregnancy and childbirth, we reported on an acute stress disorder that may be associated with the occurrence of severe maternal complications, which we named, the "maternal near-miss syndrome." The implementation of integrated care that encompasses the physical, psychological, social, and spiritual aspects of women's health may help to alleviate the burden that maternal complications impose on millions of women around the world.
Assuntos
Complicações do Trabalho de Parto/psicologia , Complicações na Gravidez/psicologia , Transtornos Puerperais/psicologia , Adolescente , Adulto , Brasil , Medo , Feminino , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva , Acontecimentos que Mudam a Vida , Bem-Estar Materno , Morbidade , Narração , Gravidez , Pesquisa Qualitativa , Fatores Socioeconômicos , Síndrome , Adulto JovemRESUMO
This experimental study aimed to evaluate the effect of relaxation techniques on anxiety levels, and the relation between anxiety and the concentration of Immunoglobulin A. The study was carried out in a maternity hospital in a city of the State of Espírito Santo, Brazil. The sample was composed of 60 puerperae. The information on the variables: age, education, marital status, type of childbirth, and parity were collected with a specific form; the trait and state of anxiety were based on the State Trait Anxiety Inventory (STAI/IDATE); and the level of salivary IgA was obtained through immunoturbidimetry. The application of the Mann-Whitney, Wilcoxon, and Pearson's correlation statistical tests showed a significant reduction in the levels of the state of anxiety in the experimental group (p = 0.01); there was no correlation between the trait and state variables of anxiety and the salivary IgA level; both groups (experimental and control) showed trait and state of medium-intensity anxiety.
Assuntos
Transtornos de Ansiedade , Imunoglobulina A/imunologia , Transtornos Puerperais/imunologia , Transtornos Puerperais/psicologia , Relaxamento , Saliva/imunologia , Adulto , Transtornos de Ansiedade/imunologia , Transtornos de Ansiedade/prevenção & controle , Transtornos de Ansiedade/psicologia , Feminino , Humanos , GravidezRESUMO
Este artigo apresenta um estudo realizado com o objetivo de descrever os fatores que podem estar associados à presença do sintoma tristeza no pós-parto imediato, em Tubarão (SC). É um estudo transversal com 70 mulheres, em torno do décimo dia pós-parto, realizado no Centro Materno-Infantil do Hospital Nossa Senhora da Conceição. Utilizaram-se as abordagens quantitativa e qualitativa, adotando-se como técnica de coleta de dados a entrevista estruturada com perguntas abertas e fechadas. Os dados quantitativos foram processados e analisados em um programa estatístico de epidemiologia (Epi-Info versão 6.0), utilizando-se o teste do qui-quadrado para as medidas de associação entre as variáveis, com intervalo de confiança para a inferência estatística de 95 porcento. Os resultados apontaram associação com o fator história de doença mental familiar. Os dados qualitativos foram agrupados em expressões que identificam as tendências e padrões emergentes, tendo sido evidenciado que a concretude do filho, a responsabilidade e as exigências do cuidado, os sentimentos da vulnerabilidade e as transformações enquanto mulher, influenciam na presença de tristeza no pós-parto imediato.
Assuntos
Feminino , Gravidez , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Entrevista Psicológica/métodos , Período Pós-Parto/psicologia , Estudos de Avaliação como Assunto , Estudos de Avaliação como Assunto , Saúde Mental/estatística & dados numéricos , Saúde Mental/história , Transtornos Puerperais/psicologia , Fatores de RiscoRESUMO
Maternal feeding attitudes, maternal moods and infant feeding practices during the first 6 months postpartum were assessed in 226 healthy, well-nourished Barbadian mother-infant dyads. Factor analysis of the feeding attitudes questionnaire resulted in six independent factors. The belief that breastfeeding was better than bottle-feeding was associated with higher family income, more information seeking behavior and older maternal age at the time of her first pregnancy. Women who believed that breastfeeding was better at 7 weeks postpartum were also more likely to breastfeed at concurrent and later ages, up to 6 months postpartum. This belief was also associated with less maternal depression at 7 weeks and 6 months. The association between feeding attitudes and actual feeding practices was significant even after correcting for maternal moods and other background variables. Conversely, after controlling for feeding attitudes, maternal mood at 7 weeks was still significantly associated with infant feeding practices at 6 months. Thus, feeding attitudes and maternal moods were closely linked, but each contributed independently and uniquely to different aspects of breastfeeding, especially at 6 months. These findings suggest that early intervention addressing maternal feeding attitudes, may improve the extent of breastfeeding and the health of children in this setting.
Assuntos
Aleitamento Materno , Depressão , Comportamento Alimentar , Comportamento do Lactente/fisiologia , Comportamento Materno , Mães/psicologia , Período Pós-Parto/fisiologia , Transtornos Puerperais/psicologia , Adulto , Afeto , Atitude Frente a Saúde , Barbados , Feminino , Humanos , Lactente , Estudos Longitudinais , Relações Mãe-FilhoRESUMO
The aim was to investigate factors potentially associated with minor psychiatric disorders, including maternal nutritional status variables. A cohort was studied with 479 women 15-45 years of age. The reduced General Health Questionnaire (GHQ-12 items) was applied at nine months post-partum with the 312 women who had completed follow-up. Minor psychiatric disorder was defined as a GHQ score of > or = 4 points and was treated as the response variable. Statistical analysis used hierarchical multivariate logistic regression models. The prevalence of minor psychiatric morbidity was 54.2% (95%CI: 48.6-59.7). According to the final model, the following variables remained statistically associated with minor psychiatric morbidity: level 1: total family income (1st quartile: OR = 2.71, 95%CI: 1.42-5.19; 2nd quartile: OR = 2.13; 95%CI: 1.13-4.04); level 3: body fat > or = 30% (OR = 1.66; 95%CI: 1.03-2.65). In conclusion, low income and obesity were the only factors potentially associated with minor psychiatric disorders, even after adjusting for confounding variables, while there are few studies relating maternal nutritional status and minor psychiatric morbidity.
Assuntos
Estado Nutricional , Transtornos Psicóticos/epidemiologia , Transtornos Puerperais/epidemiologia , Adolescente , Adulto , Índice de Massa Corporal , Brasil/epidemiologia , Métodos Epidemiológicos , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos Puerperais/psicologia , História Reprodutiva , Fatores SocioeconômicosRESUMO
Investigação entre gestantes e puérperas portadoras do HIV sobre quais os sentimentos que representam pelo fato de não poderem amamentar. Trata-se de estudo qualitativo realizado de outubro a dezembro de 2003 em Fortaleza-CE. Foram entrevistadas por meio de entrevista semi-estruturada cinco gestantes e oito puérperas soropositivas para HIV. De acordo com os achados, as gestantes e puérperas expressaram que a maternidade estaria completa se efetivassem o ato da amamentação. Mencionaram que o motivo de não amamentar lhes acarreta culpa, frustrações, sofrimentos, desejos interrompidos, impotência e sonhos desfeitos. Contudo, também exprimiram sentimentos de indiferença diante do fato pontual de não amamentar. Conclui-se que as mulheres com HIV manifestaram dificuldades físicas, econômicas e psicológicas ante a não amamentação...
This study aimed at investigating the feeling of pregnant and post-partum women HIV bearers for not being able to breastfeed. It is a qualitative study held from October to December 2003, in Fortaleza - CE. Five pregnant and eight post-partum women HIV bearers were interviewed through a semi-structured interview. The results show that pregnant and puerperal women think that maternity would be complete if they could breastfeed. They said that the fact they cannot breastfeed brings guilt, frustration, suffering, unfulfilled wishes, impotence and destroyed dreams. However, they also show indifference to the important fact of not breastfeeding. It is concluded that the women with HIV manifested physical, economical and psychological difficulties because of the not breastfeeding...
Investigación entre las mujeres embarazadas y parturientes portadoras de VIH sobre cuales son los sentimientos que vivenciam por el hecho de no poder amamantar. Se trata de un estudio cualitativo realizado desde octubre hasta diciembre del 2003 en Fortaleza-Ceará. Fueron aplicadas entrevistas semi-estructuradas a cinco mujeres gestantes y ocho parturientes portadoras de VIH. Los resultados señalaron que las mujeres gestantes y las parturientes expresan que la maternidad seria completa se fuera efetivo el acto de amamentamiento. Mencionaron que el motivo de no amamantar les produce sentimientos: culpa, frustraciones, sufrimiento, deseos interrumpidos, imposibilidad y sueños no realizados. Sin embargo, también, expresaran sentimiento de indiferencia delante del hecho puntual de no amamantar. Concluimos que las mujeres con VIH manifestaron las dificultades físicas, barata y psicológicas antes de no amamantar...
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , HIV , Aleitamento Materno , Emoções , Estresse Psicológico , Medicina do Comportamento , Síndrome da Imunodeficiência Adquirida , Transtornos Puerperais/imunologia , Transtornos Puerperais/psicologiaRESUMO
BACKGROUND: The WHO recommends exclusive breast-feeding for babies up to 6 months of age. The association between maternal mental health and breast-feeding duration is contradictory. This is a case-control study to investigate this association. METHODS: 153 families with 4-month-old babies from an urban area in southern Brazil were investigated: in 51 families, breast-feeding had being discontinued (cases); in 102, babies were being breast-fed (controls). Two researchers evaluated maternal and paternal mental health during home visits using semistructured interviews and scales. RESULTS: Disorders were found in 59% of case mothers versus 48% of control mothers. Depression was the most prevalent disorder affecting both mothers and fathers. We did not identify a statistically significant association between maternal mental disorder at 4 months after delivery and early termination of breast-feeding. When the mother had mental problems during the first month after delivery, however, she was twice as likely to interrupt breast-feeding. Among the mothers with mental disorders during puerperium, 76% still had the problem 4 months postpartum. An association was observed between maternal and paternal mental health. CONCLUSIONS: Parental mental health does not seem to be associated with breast-feeding at 4 months in this culture setting where most mothers have good family and social support for breast-feeding. Maternal mental disorders during puerperium, however, may negatively affect the duration of breast-feeding.
Assuntos
Aleitamento Materno/psicologia , Transtornos Mentais/epidemiologia , Pais/psicologia , Desmame , Adolescente , Adulto , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Transtornos Puerperais/epidemiologia , Transtornos Puerperais/psicologia , Fatores de RiscoRESUMO
OBJECTIVES: This study reviewed evidence on the effect of maternal smoking on early weaning. METHODS: The following databases and journals were searched: Medline, Scientific Citation Index, Pediatrics, Journal of Pediatrics, New England Journal of Medicine, and Lancet. Analysis was restricted to studies in which infants who had never been breastfed were excluded or the prevalence of breastfeeding initiation was more than 90%. RESULTS: In smoking vs nonsmoking mothers, the random effects odds ratio for weaning before 3 months was 1.93 (95% confidence interval [CI] = 1.55, 2.40). An adjusted odds ratio of 1.50 (95% CI = 1.34, 1.68) was shown in studies that had lost-to-follow-up rates below 15% and included adequate adjustment for confounding. CONCLUSIONS: Maternal smoking increases the risk of early weaning.
Assuntos
Atitude Frente a Saúde , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Mães/psicologia , Transtornos Puerperais/psicologia , Fumar/psicologia , Desmame , Adulto , Análise de Variância , Viés , Estudos de Casos e Controles , Fatores de Confusão Epidemiológicos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Razão de Chances , Análise de Regressão , Projetos de Pesquisa , Fatores de Risco , Fatores de TempoAssuntos
Humanos , Feminino , Gravidez , Depressão/etiologia , Estrogênios/deficiência , Progesterona/deficiência , Transtornos Puerperais/psicologia , Transtornos do Humor/etiologia , Complicações na Gravidez/psicologia , Problemas Sociais/psicologia , Tireoidite/complicações , Transtornos Psicóticos Afetivos/etiologiaRESUMO
Este trabajo estudia el comportamiento del Inventario de Depresión de Beck (BDI) como instrumento diagnóstico para cuadros depresivos durante el embarazo y el puerperio. En ambas situaciones la escala muestra una elevada capacidad de discrimanción de los casos, junto a una buena consistencia interna. Se analiza la eficiencia del instrumento (sensibilidad, especificidad, valores predictivos y eficiencia global) y se discuten los diferentes puntos de corte que pudieran utilizarse
Assuntos
Humanos , Feminino , Gravidez , Transtorno Depressivo/diagnóstico , Complicações na Gravidez/psicologia , Transtornos Puerperais/psicologia , Estudos de Casos e Controles , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Testes Psicológicos/métodosRESUMO
This study was aimed at determining risk factors associated to depression in pregnancy and/or the puerperium. By means of both observer-rated, and self-rated scales a 108-expectant mother sample was assessed by the co-investigators, interviewed by the principal investigator later on. The Psychiatric Assessment Schedule was used to obtain an RDC diagnosis. The same procedure was repeated 2 to 3 months after delivery. A greater exposure to life events, prior consultation for emotional problems as well as economic difficulties arising of late were all associated to depression in pregnancy and the puerperium. Getting separated from significant persons in a woman's life, and/or difficult relationships with either husband or mother have been strongly associated to depression at both periods. As regards puerperium depression, several associations directly related to childbirth (having had a low-weight baby) or the postnatal period (lactation problems) were detected. Anxiety and depressive symptoms during pregnancy have been also clearly linked to postpartum depression. The predictive value of such risk factors is discussed. It is suggested that questions on these factors should be included into ordinary health assessments of both pregnant and puerperal women.
Assuntos
Depressão/etiologia , Complicações na Gravidez/psicologia , Adulto , Distribuição de Qui-Quadrado , Feminino , Seguimentos , Humanos , Acontecimentos que Mudam a Vida , Entrevista Psiquiátrica Padronizada , Valor Preditivo dos Testes , Gravidez , Transtornos Puerperais/psicologia , Fatores de RiscoRESUMO
Las mujeres tienen mayor riesgo que los hombres de sufrir de episodios depresivos durante los años reproductivos. En este trabajo se presentan evidencias que sugieren una relación entre las fluctuaciones de los esteroides gonadales durante el ciclo reproductivo de la mujer y los trastornos del estado de ánimo. Se discuten estas evidencias de acuerdo al modelo de kindling-sensibilización de la depresión