Major depression in high-risk obstetric inpatients and outpatients

Abstract

OBJECTIVE: To evaluate and compare the presence of major depression in high-risk obstetric patients among ward and ambulatory patients. METHOD: An exploratory, descriptive, and cross-sectional study was carried out among 542 high-risk pregnant women divided into two groups: 278 were outpatients receiving ambulatory care, and 264 were ward patients. Both attended a public university hospital in the State of São Paulo, Brazil. Major depressive disorder was evaluated using the Brazilian version of the Primary Care Evaluation of Mental Disorders. The w 2 test was used in the statistical analysis with a level of significance of 5% (po0.05). RESULTS: Sixty women (11.0%) were diagnosed with major depression, twenty-five (9%) were outpatients and thirty-five (13%) were ward patients. There was no statistically significant difference between groups with respect to the major depression (p ¼ 0.11). Statistically significant differences were found between outpatients and ward patients as follows: insomnia or hypersomnia (po0.01); fatigue or loss of energy (p ¼ 0.02); diminished concentration (po0.01); and restlessness or psychomotor retardation (po0.01). CONCLUSIONS: Hospitalization may intensify some depressive symptoms. The high proportion of women with major depression demonstrates the need for access to psychosocial support during the pregnancy period, especially in pregnant women at high-risk.

Avaliação de depressão em gestantes e associação com desfechos de parto e nascimento

“…45,47 Ainda Estes estudos evidenciam o interesse crescente na investigação de sintomas depressivos durante a gravidez, em particular em gestações que envolvem algum tipo de risco gestacional e sua associação com as principais doenças maternas e fetais. 8,13,[58][59][60] Os resultados indicaram que os principais fatores de risco para a presença de depressão na gestação são a condição socioeconômica desfavorável, menor tempo de escolarização e eventos de vida estressantes como a presença de conflitos conjugais e familiares, a violência por parceiro íntimo, possuir outros filhos e risco gestacional associado a gestação atual. 14,32,40,56 Da mesma forma, estes estudos apontaram que a depressão na gestação leva ao prejuízo no estabelecimento do vínculo familiar entre mãe e filho, ao risco de cronificação dos sintomas depressivos, ao parto prematuro e ao baixo peso ao nascer.…”