Epidemiological picture of pregnant and postpartum women admitted to mental health beds in a high-risk public maternity hospital, Piauí, Brazil

Abstract

Introduction: Mental disorders, alcohol/drug use, social vulnerability, interpersonal/self-inflicted violence are serious risk factors in the pregnancy-puerperal cycle, associated with complications for the mother-baby binomial. Aim: To find out the epidemiological profile of pregnant and postpartum women admitted to mental health beds at a public maternity hospital, a high-risk referral center in Piauí. Method: This is a retrospective, descriptive, quantitative, documentary study that analyzed secondary data identified in hospital admission records and electronic medical records (MV® System), from November 1, 2016 to October 31, 2023, on the patients treated in the mental health beds of the high-complexity Maternity Hospital, part of the SUS network, in Teresina, Piauí. The study was approved by the Research Ethics Committee of the State University of Piauí, opinion no. 5.978.742/2023. Results and Discussion: 461 patients were admitted, predominantly aged between 21 and 30 (45.2%); brown (40.7%); incomplete primary education (13.7%); single (66.5%); with preserved family ties (29.7%), while 3.0% were homeless; living in Teresina (53.5%) or coming from other municipalities in Piauí (43%). The most prevalent psychopathological conditions were: depressive disorder (16.1%); anxiety disorder (14.1%); schizophrenia (10.2%); bipolar affective disorder (8.3%); postpartum depression (3.7%); mixed anxiety and depressive disorder (2.8%); mental disability (2%); personality disorder with emotional instability (0.9%). In addition, 30% of pregnant and postpartum women (138) were using harmful psychoactive substances, including, respectively, illicit drugs (38.4%); alcohol, tobacco, illicit drugs (34.1%); alcohol and illicit drugs (8.7%); 6.5% tobacco and illicit drugs (6.5%); tobacco (5.8%); alcohol (3.6%); alcohol, tobacco (2.9%). In terms of crisis situations, 57.5% had a psychosocial crisis; 15.5% had a psychiatric crisis of the psychotic break type; 8.2% had self-injurious behavior without suicidal intent; 17.2% had attempted suicide. In addition, 7.4% of the patients were victims of violence, especially domestic violence (4.1%) and rape (1.1%). With regard to therapeutic itineraries, 22.6% of pregnant and puerperal women reported having had experiences, above all, in the CAPS (9.1%), in various devices (6.3%) and in the Psychiatric Hospital (4.3%). Conclusion: The evidence shows that the creation of an institutional epidemiological database is crucial in order to strengthen longitudinal mental health surveillance actions and the qualification of specialized care by multi-professional health teams, with an emphasis on an expanded clinic, comprehensiveness and effective coordination with the Psychosocial Care Network and the Stork Network.