Ansiedade no puerpério: prevalência e fatores de risco

Abstract

RESUMOObjetivos: estimar a prevalência de ansiedade puerperal (AP) e fatores de risco associados, em amostra de mulheres de clínica privada. Métodos: foi realizado estudo de corte transversal com 299 mulheres, atendidas em consulta ginecológica de rotina, durante o período de agosto de 2000 a maio de 2003. Foram utilizados o STAIT (Spielberger State-Trait Anxiety Inventory), para avaliação de ansiedade puerperal, e um questionário com dados sociodemográficos e obstétricos. Os critérios de inclusão foram: puérperas sem história atual ou passada de depressão ou tratamento psiquiátrico, alcoolismo ou abuso de drogas e cujos filhos estavam vivos. As prevalências de AP-traço e AP-estado que avaliam, respectivamente, características de personalidade e ansiedade transitória, segundo o STAIT, foram estimadas, conjuntamente com o intervalo de confiança (IC) 95%. Estimaram-se os odds ratios (OR) e os intervalos de confiança de 95%, na avaliação da associação entre AP e as variáveis explicativas. Utilizou-se o teste do χ PALAVRAS-CHAVE:Ansiedade; Transtornos puerperais; Fatores de risco; Prevalência ABSTRACT Purpose: postpartum anxiety (PPA) is highly prevalent and has important consequences on mother and newborn. The aim of the present study was to estimate the prevalence of PPA and its risk factors, in a sample of women attending a private setting. Methods: a cross-sectional study was performed with 299 women, at a routine gynecological visit, from August 2000 to May 2003. The Spielberger State-Trait Anxiety Inventory (STAIT) and a questionnaire with sociodemographic data and obstetric data were used. Inclusion criteria were: women with no past or present history of depression, psychiatric treatment, alcohol or drug abuse and whose children were alive. The prevalences of PPA-trace and PPA-state, that evaluate characteristics of personality and transitory anxiety, respectively, were estimated with 95% confiance intervals (CI). Odds ratios and 95% CI were used to examine the association between PPA and exposure variables. Hypothesis testing was done by the χ 2 test or χ 2 test for linear trend, when categories were ordered. A p value < 0.05 was considered to be statistically significant. Results: the prevalences of PPA-state and PPA-trace were 44.8% (CI 95%: 39.1 -50.7) and 46.1% (CI 95%: 40.4 -52.0, respectively). Formal agreement between scales was moderate (kappa = 0.55; p≤0.001). By univariate analysis, lower mother income and presence of newborn complications were associated with PPA-state and PPA-trace. Lower maternal age and greater number of alive children were associated with PPA-trace and PPA-state, respectively. By multivariate analysis, PPAtrace and PPA-state were associated with higher mother income (OR:0.39; IC 95%: 0.21 -0.74, p=0,005; OR:0.46; IC 95%: 0.24 -0.87, p=0.02) and presence of complications in newborns (OR:2.15; IC 95%: 1.02 -4.54, p=0.04) (OR:2.47; IC 95%: 1.16 -5.25, p=0.02), respectively. PPA-trace was associated with greater maternal age (OR:0.34; IC 95%: 0.13 -0.88, p=0.008), while PPAstate ...

Associação entre indicadores de risco ao desenvolvimento infantil e estado emocional materno

“…The results of this research showed, in accordance with many studies 1,9,14,16,17,21,24,25 , that the maternal state tends to influence the mother--baby relationship, given the association between maternal altered states and the presence of risks to child development. They also showed that there is an important association between depression and anxiety in our sample, which entails some reflections.…”

Pregnancy anxiety: A systematic review of current scales

“…Consonni et al (2010) for example, utilised both the STAI-S and STAI-T to assess maternal anxiety in early pregnancy yet only the STAI-S to assess maternal anxiety in late pregnancy. They rely previous use in a postpartum sample as indicative of validity (Faisal-Cury and Menezes, 2006). Admittedly maternal anxiety may encompass the postpartum period however given that maternal anxiety was not defined, the breadth of their construct is unclear.…”

Ansiedade e depressão de mães de recém-nascidos com malformações visíveis

“…Assim, Britton (2005) A ansiedade é um estado emocional que tem componentes fi siológicos e psicológicos, que abrangem sensações de medo, insegurança e antecipação apreensiva, pensamento dominado por idéias de catástrofe ou incompetência pessoal, aumento do estado de vigília, tensão e dor muscular, sensação de constrição respiratória, tremor e inquietação e vários desconfortos somáticos conseqüentes da hiperatividade do sistema nervoso autônomo (Gorenstein & Andrade, 2000). Existem evidências de que tem efeito negativo na galactopoese e sobre a qualidade de vínculo mãe/bebê (Chatterton & cols., 2000;Faisal-Cury & Menezes, 2006). Há evidências, inclusive, de repercussões emocionais dos quadros de ansiedade materna, a longo prazo, tanto na mulher, como na criança.…”