Teenage pregnancy: use of drugs in the third trimester and prevalence of psychiatric disorders

Abstract

A b s t r a c t Objective: To determine the prevalence of psychiatric disorders during pregnancy, the prevalence of cocaine and marijuana use during the third trimester of gestation and the socio-demographic characteristics of a population of low-income teenagers. Method: One thousand pregnant teenagers were evaluated using the Composite International Diagnostic Interview, and a sociodemographic and socio-economic questionnaire at the obstetric center of a public hospital in São Paulo, Brazil. Hair sample was collected for analysis. Results: Of the 1000 pregnant teenagers interviewed, 53.6% were poor, 90.4% were unemployed, 92.5% were financially dependant and 60.2% dropped out of school. Those using drugs during the third trimester of pregnancy were equal to 6% (marijuana: 4%, cocaine: 1.7%, both: 0.3%). Those having at least one psychiatric disorder equaled 27.6%. The most frequent diagnoses were depression (12.9%), posttraumatic stress disorder (10.0%) and anxiety disorders (5.6%). Discussion: Unstructured families, dropping out of school, unemployment and a low level of professional training are all contributing factors to the maintenance of an unfavorable socio-economic environment in which there is a high prevalence of cocaine and marijuana use during the third trimester of pregnancy and an abnormally high incidence of psychiatric disorders.Keywords: Pregnancy in adolescence; Substance-related disorders; Mental disorders; Psychosis substance-induced; Perinatal mortality (Public Health) Resumo Objetivo: Determinar, em adolescentes de baixa renda, a prevalência de transtornos psiquiátricos durante a gravidez, a prevalência de uso de cocaína e maconha no terceiro trimestre de gestação e descrever suas características sociodemográficas. Método: Mil adolescentes grávidas foram avaliadas por meio do Composite International Diagnostic Interview e de um questionário sociodemográfico e socioeconômico no centro obstétrico de um hospital público de São Paulo. Dessas, foi colhida amostra para análise de fios de cabelo. Resultados: Das mil pacientes entrevistadas, 53,6% têm baixa renda, 60,2% abandonaram a escola, 90,4% estão desempregadas e 92,5% são financeiramente dependentes, 6% usaram drogas durante o terceiro trimestre da gravidez (maconha: 4%, cocaína: 1,7%, ambos: 0,3%) e 27,6% tiveram ao menos um transtorno psiquiátrico. Os diagnósticos mais freqüentes foram: depressão (12,9%), transtorno de estresse pós-traumático (10,0%) e ansiedade (5,6%). Discussão: Famílias desestruturadas, evasão escolar, desemprego e baixa capacitação profissional são fatores que contribuem para a manutenção desta situação socioeconômica desfavorável, cenário no qual são elementos importantes a alta prevalência de uso de cocaína e maconha no 3º trimestre da gravidez e de transtornos psiquiátricos.Descritores: Gravidez na adolescência; Transtornos relacionados ao uso de substâncias; Transtornos mentais; Psicoses induzidas por substâncias; Mortalidade perinatal (Saúde Pública)

Depression during pregnancy: prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil

“…The following risk factors were associated with increased odds of antenatal depression: (1) having a casual job (i.e., occasional employment doing low-paying work); (2) history of a previous self-reported depression or of any prior psychiatric treatment; (3) an unplanned pregnancy; and (4) several recent (past-year) stressful life events (loss of a confidant, serious physical illness and financial difficulties). The prevalence of major depression during pregnancy (14.2%) was not remarkably different from most previous reports based on studies conducted in Brazil 4,7,13,14,26,29,37 . In these studies the antenatal major depressive disorder prevalence ranged from 13% to 20.8%.…”

“…a study that reported an antenatal depression prevalence of 37.9%) reported prevalence rates ranging from 13% to 20.8% 4,7,12,14,26,29,37 . The validity of these findings still needs to be established as the majority of these studies focused on pregnant adolescents 4,26,29,37 and women receiving prenatal care in obstetric out-patient clinics in hospital settings 7,12,14,26,29 . These samples are likely to be biased because women with high-risk pregnancies are more likely to seek prenatal care in hospitals.…”

“…Thus, prevalence rates of depression during pregnancy were significantly higher in low-income countries. The main risk factors associated with these differences are past history of psychiatric disorders, poor antenatal care, poor nutrition, stressful life events, economic deprivation and gender based violence, which are more prevalent in developing countries 4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29 .…”

Cumulative Vulnerability: A Case Study on intrafamilial violence, Drug Addiction and Adolescent Pregnancy

“…Furthermore, it constitutes a tool for critical awareness of people. A study has shown that the educational process results in behavior change when the reciprocal group dialogue and the life experience of communities are taken into consideration (18) .…”

“…Studies have indicated that factors such as dysfunctional families, truancy, unemployment and low professional training contribute to the maintenance of an unfavorable socioeconomic situation and to the high prevalence of cocaine and marijuana use by pregnant adolescents and those with psychiatric disorders (18,19) . Another study that corroborates these results found that the use of chemical substances, such as marijuana and alcohol, is correlated with the phenomenon of adolescent pregnancy because in many cases experience with drugs precedes adolescent pregnancy.…”