A Prospective Study of Emotional Disorders in Childbearing Women

Abstract

A group of first-time mothers (119) were interviewed repeatedly at fixed intervals during their pregnancies and until their babies were a year old; they were then followed up at four years. A similar investigation was carried out on 38 other primiparae and 39 multiparae, but only postnatally. The incidence of depressive neurosis rose significantly in early pregnancy and in the first three months after delivery (10 per cent and 14 per cent of the main sample respectively). Subjects mainly suffered either from antenatal or postnatal depression, not both. Marital conflict and severe doubts about having the baby were associated with depression at either time. Bereavement and preterm birth were the only life events to relate with the onset of depression and bereavement had a greater impact during pregnancy. Depressed mothers were more likely to express negative or mixed feelings about their three-month-old babies. Many who had become depressed for the first time in their lives continued to experience psychological problems for up to four years after childbirth.

The Functions of Postpartum Depression

“…With the exception of maternal perceptions of paternal investment, all important correlates of PPD are supported, at least in part, by objective measures, including hospital charts, researcher ratings of mother-infant interactions, face-to-face interviews and observations, income levels, and unemployment status Campbell et al 1992;Hopkins et al 1987;Kumar and Robson 1984;O'Hara et al 1984;Paykel et al 1980;Warner et al 1996;Whiffen and Gotlib 1989). The validity of the paternal investment data is supported by longitudinal studies where the maternal perception of paternal support was collected prepartum when the mothers were not depressed (Gotlib et al 1991) and where the father's mood (assessed by the father's self-report) predicted the mother's future mood (assessed by the mother's self-report).…”

“…Similarly, Campbell et al (1992) found that not being happy about the pregnancy distinguished women with PPD from those without. Finally, Kumar and Robson (1984) found that women with PPD had significantly more often considered an abortion.…”

“…Similarly, "negative emotions while with the baby" are significantly correlated with PPD (Affonso and Arizmendi 1986), as are "negative or detached feelings for the baby" (Kumar and Robson 1984).…”

“…While PI theory makes it clear why a mother who has an infant with problems or who is receiving insufficient social sup- Campbell and Cohn 1991 Pregnancy and delivery complications * Campbell et al 1992 Minor pregnancy and delivery complications (e.g., elevated blood pressure, gestational diabetes, prolonged labor)* O 'Hara 1984 Obstetric risk factors (abnormal weight gain during pregnancy, abnormal uterine size, preeclampsia, significant bleeding, abnormal presentation, fever in labor, and the presence of meconium-stained amniotic fluid) accounted for 19% of the variance in depressive symptomology Paykel et al 1980 Subjective stress of pregnancy; Objective rating of labor complications Postnatal problems Atkinson and Rickel 1984 PPD in men predicted by perception that infant was below average Hopkins et al 1987 Infant complications accounted for 12% of variability in depression scores* Kumar and Robson 1984 Premature baby* Whiffen and Gotlib 1989 Mental development at 2 months; infants more tense, less happy, and have lower endurance at 2 months* Unexpected correlations O'Hara et al 1982 PPD associated with less complicated deliveries Paykel et al 1980 PPD associated with less complicated deliveries…”

Incentivo À Amamentação Exclusiva Na Perspectiva Das Puérperas

“…Os três primeiros meses após o parto são particularmente importantes em relação a qualquer outra etapa de vida da mulher, pois nessa fase ela apresenta a maior taxa de risco de internação decorrente de um transtorno psiquiátrico (5) .…”