Prevalencia de trastorno mental en embarazadas / Prevalence of mental disorder in pregnant women

RESUMEN Fundamento: varias investigaciones a nivel mundial han demostrado que el embarazo influye en el curso y aparición del trastorno mental. En Cuba, sin embargo, los estudios publicados sobre esta temática son escasos. Objetivo: determinar la prevalencia de trastorno mental en embarazadas. Métodos: se realizó un estudio desde el enfoque cuantitativo, descriptivo y de corte transversal. El universo estuvo constituido por 14 386 embarazadas ingresadas en el servicio de la maternidad del hospital Vladimir Ilich Lenin desde mayo de 2018 a octubre 2019. Se seleccionaron 265 a través de un muestreo no probabilístico. Se utilizó la entrevista semiestructurada y la observación para la evaluación. La variable fue trastorno mental. Los resultados se procesaron en el paquete estadístico EPIDAT 3.1, con las tasas de prevalencias y las frecuencias absolutas y relativas. Resultados: se evidenció una prevalencia de 35,1 % (IC 95 %: 29,1-41,0) de antecedentes psicopatológicos en las gestantes estudiadas. Predominó el intento suicida, la atención por la especialidad de Psiquiatría en alguna ocasión de su vida y el trastorno de la personalidad. La prevalencia estimada de trastorno mental durante la hospitalización fue de 1,8 % (IC 95 %: 1,6-2,1). Se destacaron la ansiedad y la tristeza como alteración emocional, el trastorno de adaptación con ansiedad, y con estado de ánimo deprimido. Conclusiones: la tasa de prevalencia de antecedentes psicopatológicos en las embarazas estudiadas fue relativamente elevada. En cambio, la estimación de la prevalencia de trastorno mental durante la hospitalización se consideró baja. No obstante, se evidenció una prevalencia relativamente alta de ansiedad.

ABSTRACT Background: several researches worldwide have shown that pregnancy influences the course and appearance of the mental disorder. In Cuba, however, published studies are scarce. Objective: to determine the prevalence of mental disorder in pregnant women. Methods: a study was carried out from the quantitative, descriptive and cross-sectional approach. The universe consisted of 14 386 pregnant women admitted to the maternity service of the Vladimir Ilich Lenin hospital from May, 2018 to October, 2019. 265 were selected through a non-probabilistic sampling. The semi-structured interview and observation were used for the evaluation. The variable was mental disorder. The results were processed in the EPIDAT 3.1 statistical package, with prevalence rates and absolute and relative frequencies. Results: a prevalence of 35.1 % (95 % CI: 29.1-41.0) of psychopathological antecedents was evidenced in the pregnant women studied. The suicidal attempt, the attention for the specialty of Psychiatry in some occasion of their lives and the personality disorder predominated. The estimated prevalence of mental disorder during hospitalization was 1.8 % (95 % CI: 1.6-2.1). Anxiety and sadness were highlighted as emotional disturbance, the disorder of adaptation with anxiety, and with depressed mood. Conclusions: the prevalence rate of psychopathological antecedents in the studied pregnancies was relatively high. In contrast, the estimate of the prevalence of mental disorder during hospitalization was considered low. However, a relatively high prevalence of anxiety was evident.

Repercussões maternas do diagnóstico pré-natal de anomalia fetal / Maternal repercussions of fetal anomaly pre-natal diagnosis

Resumo Objetivo: Comparar modos de enfrentamento mediante diagnóstico pré-natal de anomalia fetal viável e inviável. Métodos: Estudo transversal de análise quantitativa em 120 gestantes realizado em centro de referência de medicina fetal, de janeiro a dezembro de 2014. Os dados foram obtidos por meio de entrevista semiestruturada contendo características sociodemográficas; antecedentes pessoais e obstétricos; e aplicação do inventário de estratégias de enfrentamento de coping. Teste qui quadrado, teste exato de Fisher ou razão de verossimilhança foram utilizados para comparar variáveis categóricas entre malformação viável e inviável. O teste t de Student foi usado para variáveis contínuas e quando necessária, foi aplicada a Análise de Variância. Resultados: Houve diferença significativa da estratégia autocontrole entre as gestantes com diagnóstico de inviabilidade fetal e as com fetos viáveis. Conclusão: As gestantes com diagnóstico de anomalia fetal inviável apresentaram maior tendência à estratégia de autocontrole que as com feto viável.

Abstract Objective: To compare coping strategies for congenital abnormalities pre-natal diagnosis of viable and nonviable fetuses. Methods: Quantitative cross-sectional study of 120 pregnant women, conducted in a center of excellence of fetal medicine, from January to December, 2014. Data were obtained through the following: semi-structured interviews which included socio-demographic information, personal and obstetrics history, and use of the coping strategies inventory. The tests used to compare categorical variations between viable and non-viable malformations were the chi-squared test, and Fisher's exact test or likelihood ratios. Student's t-test was used for continuous variables, and when necessary, it the Analysis of Variance was used. Results: There were significant differences in the self-control strategy between pregnant women diagnosed with a non-viable fetus compared to those diagnosed with a viable fetus. Conclusion: Pregnant women diagnosed with a non-viable fetal anomaly presented a greater tendency to use the self-control strategy than those diagnosed with a viable fetus.