Prevalence of AA and AD were high in this sample of women attending a private care setting, particularly AA state and trace. AA and AD were associated with similar socio-demographic and socio-economic risk factors, suggesting some common environmental stressors may be involved.

Objetivos: estimar a prevalência de depressão puerperal (DP) sua associação com transtorno mental comum (TMC) nas mulheres atendidas por duas unidades do Programa de Saúde da Família (PSF) da cidade de São Paulo e identificar os fatores de risco associados à DP. Métodos: estudo de corte transversal com 70 puérperas atendidas nas Unidades do PSF, Fazenda da Juta II e Jardim Sinhá, entre outubro de 2003 e fevereiro de 2004. Como instrumentos utilizaram-se: questionário com informações sociodemográficas econômicas e dados obstétricos e perinatais; Self-Report Questionnaire 20 (SRQ-20), para rastreamento de TMC e a Edinburgh Post-Natal Depression Scale (EPDS), para avaliação de DP. Para testar as associações entre variáveis explicativas (fatores de risco) e a presença de DP foram utilizados os testes t de Student, χ 2 e χ 2 de tendência linear, quando indicados. Para avaliar a concordância entre a EPDS e o SRQ foi utilizado o coeficiente de concordância kappa (κ). Resultados: a prevalência de TMC e de DP foi de 37,1%. As escalas apresentaram boa concordância (κ = 0,75). As variáveis explicativas idade materna, cor, escolaridade, ocupação e estado civil, além de idade, ocupação e instrução do companheiro, renda familiar, número de gestações, paridade, abortamentos, filhos vivos, partos prematuros, idade gestacional, tipo do parto, planejamento da gestação, Apgar de 1° e 5° minuto, sexo e peso do recém-nascido e aleitamento materno não apresentaram significância estatística. Quanto maior a percepção de suporte social do marido, menor a prevalência de DP (p=0,03). Conclusão: devido à alta prevalência e impacto negativo sobre a mãe e seu filho, é valioso sensibilizar o profissional de saúde para a importância da DP. The following instruments were used: questionnaire with sociodemographical-economic data and obstetric and perinatal data; Self-Report Questionnaire 20 (SRQ-20), for screening of MMD, and Edinburgh Post-Natal Depression Scale (EPDS), for evaluation of PPD. To verify association between explanatory variables and PPD, Student's t test, χ 2 or linear trend χ 2 were utilized when indicated. To evaluate concordance between scales (EPDS and SRQ-20) kappa (κ) coefficient correlation was used. Results: the prevalence of PPD and MMD was 37.1%. Scales presented a good concordance (κ=0.75). The explanatory variables age, ethnicity, years of education, profession, and marital status, besides partner's profession and years of education, familiar income, number of pregnancies, parity, miscarriage, number of alive children, premature deliveries, gestational age, type of delivery, planning of actual pregnancy, score of Apgar (first and five minutes), newborn sex and weight, and breastfeeding did not show significant statistical association. A greater perception of social support from the partner was associated with lower prevalence of PPD (p=0.03). Conclusion: because of its high prevalence and negative impact upon mother and child, it is worthwhile to sensitize health care professionals about the importance of PPD PALAVRA...

To estimate the prevalence of common mental disorders (CMD) and factors associated with these disorders among pregnant women of low socio-economic status (SES) in São Paulo. We performed a cross-sectional study with 831 women in their 20th to 30th weeks of pregnancy, who were attending antenatal clinics in primary care in São Paulo, Brazil. CMD were assessed with the Clinical Interview Schedule-Revised. Crude and adjusted prevalence ratios and 95%CI were calculated to examine the association between CMD and exposure variables. The prevalence of CMD was 20.2% (95%CI 17.5 to 23.0). Age at current pregnancy and at first delivery, current obstetric complications, not having friends in the community, living in a crowded household, lower occupational status and history of previous psychiatric treatment were all independently associated with increased prevalence of CMD. CMD is highly prevalent among pregnant women of low SES seen in primary care settings in São Paulo. A combination of distal and proximal psychosocial factors increase the risk for CMD. Primary health care professionals need to be aware of how common CMD in such settings and properly trained to deal with CMD during pregnancy.

The purpose of this study was to estimate the prevalence of postpartum depression (PPD) and its relationship with life events (LE) and patterns for coping. We performed a cross-sectional study of 113 women, on the 10(th) day of puerperium, at the Obstetric Clinic of the São Paulo University Medical School. The study was based on the following: Pitt (1967) and Stein (1980) Scales, Beck Depression Inventory (1961), Holmes and Rahe Schedule of Recent Events (1967), Folkman and Lazarus Ways of Coping (1985) and questionnaire of social-demographic and obstetric data. Logistic regression was performed to calculate prevalence of PPD and its association with several risk factors. The significance level was defined at 5%. The prevalence of PPD was 15.9% (IC 9.7% to 24.0%). According to the multivariate analyses, the variables of coping with distancing, number of children and ethnic origin were significant. There were no association between PPD and LE. The depressed puerperal women have a low educational level, greater number of children and resort to inadequate coping strategies, such as distancing. This pattern of coping might be an etiological factor of the PPD as well as a reaction to their difficult life environment.

OBJECTIVE:To study factors related to preference for cesarean delivery, among pregnant women without medical complications. METHODS:A cross-sectional study was carried out among 156 pregnant women, in a private clinic in the city of Osasco, State of São Paulo, from October 2000 to December 2001. The pregnant women were at 28 weeks of pregnancy or more, with no formal contraindication for vaginal delivery at the time of the interview. Sociodemographic data and past and present obstetric history were assessed by applying a questionnaire. The pregnant women were specifically asked what their current preference for delivery was. Pearson's Chi-square test and logistic regression for multivariate analysis were performed with a 5% significance level. RESULTS:Sixty-seven pregnant women (42.9%) said they had little motivation to undergo vaginal delivery. In the multivariate analysis, the following variables were statistically significant: previous vaginal birth (p=0.001; ORadj=0.04; 95% CI=0.01-0.12); husband's monthly income greater than 750 reais (p=0.006, ORadj=3.44; 95% CI=1.38-8.33). The women with a previous vaginal delivery presented 25-fold lower chance of choosing cesarean delivery. The opinion that the previous delivery experience was unsatisfactory was marginally associated with the main outcome (p=0.06; ORadj=0.42; 95% CI=0.16-1.05). CONCLUSIONS:Motivation for cesarean delivery is associated with influences such as the type and degree of satisfaction with previous delivery and income.

CMD prevalence is high among low-income and low-risk pregnant women attended by public health services in a middle-income country, but not confer an increased risk for adverse obstetric outcome.

Antenatal and postnatal depression are highly prevalent in the primary care setting.

OBJECTIVETo assess the determinants of exclusive breastfeeding abandonment.METHODSLongitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied to identify depressive symptoms in the first and second meetings, with a score of ≥ 12 considered as the cutoff point. Socioeconomic, demographic, and obstetric variables were investigated, along with emotional conditions and the new mothers’ social network during pregnancy and the postpartum period.RESULTSThe prevalence of exclusive breastfeeding abandonment at 30, 60, and 120 days postpartum was 53.6% (n = 90), 47.6% (n = 80), and 69.6% (n = 117), respectively, and its incidence in the fourth month compared with the first was 48.7%. Depressive symptoms and traumatic delivery were associated with exclusive breastfeeding abandonment in the second month after childbirth. In the fourth month, the following variables were significant: lower maternal education levels, lack of homeownership, returning to work, not receiving guidance on breastfeeding in the postpartum period, mother’s negative reaction to the news of pregnancy, and not receiving assistance from their partners for infant care.CONCLUSIONSPsychosocial and sociodemographic factors were strong predictors of early exclusive breastfeeding abandonment. Therefore, it is necessary to identify and provide early treatment to nursing mothers with depressive symptoms, decreasing the associated morbidity and promoting greater duration of exclusive breastfeeding. Support from health professionals, as well as that received at home and at work, can assist in this process.