Complicações obstétricas, eventos estressantes, violência e depressão durante a gravidez em adolescentes atendidas em unidade básica de saúde

Abstract

ResumoContexto: A depressão é um transtorno psiquiátrico comum entre as adolescentes grávidas e está associada a diversos fatores de risco. Objetivos: Estimar a prevalência da depressão em adolescentes grávidas e identificar os principais fatores de risco. Métodos: Dados seccionais foram coletados de 120 gestantes adolescentes atendidas em uma unidade básica de saúde do Rio de Janeiro. Os instrumentos utilizados foram o Composite International Diagnostic Interview (CIDI), para diagnosticar a depressão; a escala Stressful Life Events, para avaliar a presença de eventos estressantes; o Abuse Assessment Screen (AAS), para o rastreamento de violência contra a mulher durante a gestação. Resultados: A prevalência de depressão gestacional foi de 14,2% (IC: 8,7-21,9), sendo os principais fatores associados: história anterior de depressão, sangramento anômalo e hospitalização na atual gravidez, história de acidente, incêndio ou catástrofe e maus-tratos durante a vida. Conclusões: Os resultados reforçam que a investigação dos fatores de risco, o diagnóstico e o tratamento da depressão devem ser parte integrante do atendimento pré-natal a adolescentes grávidas.Pereira PK, et al. / Rev Psiq Clín. 2010;37(5):216-22 Palavras-chave: Depressão, gravidez na adolescência, estudos transversais, prevalência, fatores de risco. AbstractBackground: Depression is a common psychiatric disorder among pregnant adolescents and it is associated with several risk factors. Objectives: This study aimed to assess the prevalence and associated factors of depression in pregnant adolescents. Methods: Sectional data were collected among 120 pregnant adolescents attending in a basic health unit in Rio de Janeiro. The following research instruments were used: the Composite International Diagnostic Interview (CIDI) to diagnose depression, the Stressful Life Events to assess stressful life events, the Abuse Assessment Screen (AAS) to screening violence against woman during pregnancy. Results: The prevalence of gestational depression was 14.2% (CI 95% 8.7-21.9) and associated factors were: history of depression before pregnancy, bleeding and hospitalization during pregnancy, history of accidents and catastrophes, and emotional or physical abuse during their life. Discussion: These results suggest that screening of risk factors, diagnosis and treatment of depression should be provided in the antenatal care of pregnant adolescents.

Factors associated with the probability of common mental disorders in pregnant women: a cross-sectional study

“…8 Results from a study performed with pregnant adolescents showed an association between depression and episodes of bleeding. Adolescents who had this complication were 6.7 times more likely to have depression, 17 evidence that corroborates the results expected for this study.…”

“…3 Although the present (9) has felt sad lately (43.5%); (10) has cried more than usual (52.3%); (11) finds it difficult to perform daily activities satisfactorily (43.2%); (12) finds it difficult to make decisions (27.7 %); (13) study did not investigate violence, it should be emphasized that there is scientific evidence indicating that this phenomenon is associated with CMD, especially intimate partner violence. 3,[16][17][18] A prospective cohort study conducted in Ghana and the Ivory Coast with 1,030 women in their 3 rd trimester of pregnancy, in different age groups, revealed high percentages of depression (28.9%) and anxiety (14.2%). Anxiety was directly associated with age and women aged more than 30 years were the most susceptible ones (30.6±5.5).…”

Depression in pregnancy. Prevalence and associated factors

“…Depression is a common disorder that affects people of all genders, ages and experiences, affecting 154 million people around the world. 2 Women are twice more likely to develop depression than men. One in five women will have at least one depressive episode throughout life, with the greatest risk during the reproductive Depression is the most prevalent psychiatric disorder that occurs during pregnancy 2,4 and its deleterious effects bring severe consequences for maternal and fetal health.…”

“…2 Women are twice more likely to develop depression than men. One in five women will have at least one depressive episode throughout life, with the greatest risk during the reproductive Depression is the most prevalent psychiatric disorder that occurs during pregnancy 2,4 and its deleterious effects bring severe consequences for maternal and fetal health. These effects include low birth weight, decreased Apgar score, prematurity, 5 decreased head circumference, poor development in the first year of life and suicidal ideation by the mother with attempts to self-extermination.…”

Exposição pré-natal ao etanol: toxicidade, biomarcadores e métodos de detecção

“…Estudos concordam que as mulheres são mais vulneráveis aos efeitos do etanol por suas peculiaridades fisiológicas, metabólicas e hormonais 7,8 . O uso de álcool, associado a outros fatores como gravidez indesejada, baixa renda, estresse e violência durante o período gestacional, contribui para o aparecimento de doenças psiquiátricas maternas como episódios de mania, depressão maior e até risco de suicídio [9][10][11] . Crianças expostas ao álcool desde a concepção e durante o seu desenvolvimento podem sofrer efeitos dramáticos.…”