Risk of depression in pregnancy among pregnant women undergoing high-risk prenatal care

Ribeiro, Gabriela de Magalhães; Cieto, Julia Ferreira; Silva, Mônica Maria de Jesus

doi:10.1590/1980-220x-reeusp-2021-0470en

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Of the maternal health variables analyzed in the present study, being in the group with a high-risk pregnancy, that is, having a disease associated with the current pregnancy, did not prove to be a risk factor for depression during pregnancy compared with a low-risk pregnancy. Unlike our findings, other studies ( 43 , 56 , 57 ) indicate that having a disease associated with pregnancy is a risk factor for depression during pregnancy. One of the most relevant aspects related to different results in the present study is the specific characterization of the group with low-risk women, mainly composed of women working in the institution’s own health department, which may generate bias.…”

Section: Discussioncontrasting

confidence: 99%

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Factors associated with depression during pregnancy in women receiving high- and low-risk prenatal care: a predictive model

Albertini,

Benute,

Francisco

et al. 2024

Front. Psychiatry

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IntroductionDepression during pregnancy can put strain on pregnant women’s interpersonal relationships, the formation of emotional bonds with the fetus, and the adaptation to the new routine and social role post-pregnancy. Some studies have associated socioeconomic factors, emotional factors, interpersonal relationships, perceived social support, gestational risk, and the occurrence of certain diseases during pregnancy with higher risk of depression.ObjectivesThis study aimed to investigate the prevalence of depression during pregnancy and associated factors in low- and high-risk prenatal patients at a Brazilian university hospital.MethodsThis study presents a retrospective and prospective cross-sectional design. A total of 684 prenatal psychological analysis records from a Brazilian tertiary university service were retrospectively evaluated to assess depression through the PRIME-MD questionnaire between 2002–2017. Between 2017 and 2018, 76 patients treated at the same service were prospectively evaluated with the aforementioned instrument. Medical records were accessed to obtain labor and birth data. Multivariate analyses assessed the association between sociodemographic, gestational or obstetric, and health variables and the presence of depression during pregnancy.ResultsA total of 760 pregnant women were included in the study, with a depression prevalence of 20.66% (n = 157). At the time of assessment, 48 (21.05%) women from the low-risk pregnancy group and 109 (20.49%) from the high-risk pregnancy group were depressed. The mean age was 30.01 ± 6.55 years in the group with depression and 29.81 ± 6.50 years in the group without depression. In the univariate analysis, there was an association of risk for depression with absence of paid work, absence of a partner, low family income and diagnosis of epilepsy, being a protective factor the presence of diabetes during pregnancy. However, in the multivariate analysis, a lower family income, not having a partner at the time of the assessment, and the prevalence of epilepsy were independently associated with an increased risk of depression during pregnancy.ConclusionThis study showed that 1 in 5 women had depression during pregnancy, with no association with obstetric risk, but those women living in unfavorable economic conditions, without a partner, and having epilepsy were at increased risk of depression.

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Section: Discussioncontrasting

confidence: 99%

“…However, this association was not maintained throughout pregnancy. Another study ( 43 ) with pregnant women treated at a university hospital in the city of São Paulo identified that participants with a partner had an 89% lower risk of depression during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with depression during pregnancy in women receiving high- and low-risk prenatal care: a predictive model

Albertini,

Benute,

Francisco

et al. 2024

Front. Psychiatry

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“…In this context, the higher risk of depression in the first trimester of pregnancy reiterates the importance of universal screening, as recommended internationally by various organizations such as the American College of Obstetricians and Gynecologists ( 32 ) , the US Preventive Services Task Force ( 33 ) , and the American College of Nurse-Midwives ( 34 ) , but unfortunately not implemented in Brazil. This measure would enable early intervention to prevent the development of depressive disorders, facilitate timely referral of pregnant women to specialized mental health care if necessary, and reduce healthcare costs ( 35 ) .…”

Section: Discussionmentioning

confidence: 99%

Risk of depression during pregnancy in usual risk antenatal care

Silva,

Serrano,

Porcel

et al. 2023

Rev. Latino-Am. Enfermagem

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Objective: to identify the risk of depression during pregnancy among pregnant women receiving routine prenatal care and the associated factors. Method: a cross-sectional study, carried out with 201 pregnant women, in a routine prenatal clinic of a university maternity hospital. Data were collected using an electronic form containing a characterization instrument and the Escala de Risco de Depressão na Gravidez (Depression during Pregnancy Scale). The dependent variable was the risk of depression during pregnancy. Statistical analysis was performed by calculating the Odds Ratio and using the Chi-square and Fischer’s Exact tests. Results: among the participants, 68.2% had a higher risk of depression during pregnancy. There was a statistically significant association between a higher risk of depression during pregnancy and occupation (p=0.04), that is, unemployment (OR=2.00) doubled the risk of depression. Conclusion: the high prevalence of the risk of depression during pregnancy indicates the necessity of planning, prioritizing, and integrating mental health into prenatal health services, especially in the primary healthcare environment, by health managers and policymakers.

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“…For example, some medical problems that lead to NICU admission are diagnosed prenatally (e.g., genetic conditions and cardiac diagnoses), which can contribute to fears about the infant’s development and well-being throughout the pregnancy. High-risk pregnancies are associated with postpartum and post-traumatic stress, depression, and anxiety, and mental health concerns during pregnancy can be compounded by a potentially traumatic birth [ 7 ]. NICU mothers are also more likely to perceive childbirth as traumatic compared to well-baby mothers.…”

Section: Introductionmentioning

confidence: 99%

Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care

Williams,

Parlier-Ahmad,

Thompson

et al. 2023

Children

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Postpartum depression (PPD), postpartum anxiety (PPA), and post-traumatic stress disorder (PTSD) among birthing people have increased substantially, contributing to adverse maternal/infant dyad outcomes, with a high prevalence in the neonatal intensive care unit (NICU). Despite calls for trauma-informed care in the NICU and high rates of post-traumatic stress, little research has examined the rates of or the relationships between peripartum mood and adverse child experiences (ACEs) in NICU mothers or evaluated which peripartum traumas are most distressing. This study employed structural equation modeling (SEM) to explore whether peripartum-related traumas and NICU-related stressors mediated the associations between ACEs and mental health outcomes in 119 lower-income, racially diverse mothers in a Level IV NICU. Mental health concerns were prevalent and highly comorbid, including 51.3% PPA, 34.5% PPD, 39.5% post-traumatic stress, and 37% with ≥4 ACEs. The majority (53.8%) of mothers endorsed multiple peripartum traumas; NICU admission was the most common trauma (61%), followed by birth (19%), pregnancy (9%), and a medical event in the NICU (9%). Our SEMs had good fit and demonstrated that ACEs predicted peripartum distress. Trauma-informed care efforts should employ transdiagnostic approaches and recognize that women commonly present to the NICU with childhood trauma history and cumulative peripartum traumas.

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Risk of depression in pregnancy among pregnant women undergoing high-risk prenatal care

Cited by 5 publications

References 19 publications

Factors associated with depression during pregnancy in women receiving high- and low-risk prenatal care: a predictive model

Factors associated with depression during pregnancy in women receiving high- and low-risk prenatal care: a predictive model

Risk of depression during pregnancy in usual risk antenatal care

Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care

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