RESUMEN
BACKGROUND: Corona Virus Disease 19 (COVID-19) is a new pandemic, declared a public health emergency by the World Health Organization, which could have negative consequences for pregnant and postpartum women. The scarce evidence published to date suggests that perinatal mental health has deteriorated since the COVID-19 outbreak. However, the few studies published so far have some limitations, such as a cross-sectional design and the omission of important factors for the understanding of perinatal mental health, including governmental restriction measures and healthcare practices implemented at the maternity hospitals. Within the Riseup-PPD COST Action, a study is underway to assess the impact of COVID-19 in perinatal mental health. The primary objectives are to (1) evaluate changes in perinatal mental health outcomes; and (2) determine the risk and protective factors for perinatal mental health during the COVID-19 pandemic. Additionally, we will compare the results between the countries participating in the study. METHODS: This is an international prospective cohort study, with a baseline and three follow-up assessments over a six-month period. It is being carried out in 11 European countries (Albania, Bulgaria, Cyprus, France, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom), Argentina, Brazil and Chile. The sample consists of adult pregnant and postpartum women (with infants up to 6 months of age). The assessment includes measures on COVID-19 epidemiology and public health measures (Oxford COVID-19 Government Response Tracker dataset), Coronavirus Perinatal Experiences (COPE questionnaires), psychological distress (BSI-18), depression (EPDS), anxiety (GAD-7) and post-traumatic stress symptoms (PTSD checklist for DSM-V). DISCUSSION: This study will provide important information for understanding the impact of the COVID-19 pandemic on perinatal mental health and well-being, including the identification of potential risk and protective factors by implementing predictive models using machine learning techniques. The findings will help policymakers develop suitable guidelines and prevention strategies for perinatal mental health and contribute to designing tailored mental health interventions. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04595123 .
Asunto(s)
COVID-19/psicología , Salud Global/estadística & datos numéricos , Trastornos Mentales/epidemiología , Periodo Posparto/psicología , Mujeres Embarazadas/psicología , Adulto , Europa (Continente)/epidemiología , Femenino , Humanos , Embarazo , Estudios Prospectivos , Factores Protectores , Proyectos de Investigación , Factores de RiesgoRESUMEN
La salud mental perinatal refiere a los procesos psicosociales que ocurren en el embarazo, parto y puerperio. Se realizó un estudio con diseño cuanti-cualitativo, con muestreo por cuotas, con embarazadas y puérperas de tres hospitales en dos provincias argentinas en pandemia por Covid-19. Se realizó una encuesta presencial a 300 mujeres. Los resultados indican un leve aumento del tiempo dedicado a los cuidados y una disminución del dedicado al trabajo remunerado. Se encontró una gran preocupación por los cambios en la atención sanitaria, el cuidado y salud de sus hijos/as y la gestión cotidiana del cuidado. Se registró alta incidencia de ansiedad en embarazadas y depresión puerperal. Estudiar la salud mental materna y la organización de los cuidados bajo la perspectiva de género permite una comprensión más integral de los padecimientos de las mujeres madres entendidas como sujetos sociales.
A saúde mental perinatal refere-se aos processos psicossociais que ocorrem durante a gravidez, o parto e o período pós-parto. Foi realizado um estudo de desenho quanti-qualitativo, com amostragem por cotas, com gestantes e puérperas de três hospitais de duas províncias argentinas durante a pandemia de Covid-19. Uma pesquisa presencial foi realizada com 300 mulheres. Os resultados indicam ligeiro aumento do tempo de cuidado e diminuição do tempo dedicado ao trabalho remunerado. Foi encontrada grande preocupação entre as mulheres com as mudanças nos cuidados de saúde, no cuidado e na saúde dos seus filhos e na gestão diária dos cuidados. Foi registrada alta incidência de ansiedade em gestantes e depressão pós-parto. Estudar a saúde mental materna e a organização do cuidado na perspectiva de gênero permite uma compreensão mais abrangente do sofrimento das mulheres mães entendidas como sujeitos sociais.
Perinatal mental health refers to the psychosocial processes that occur during pregnancy, childbirth and the postpartum period. A study was carried out with a quantitative-qualitative design, with quota sampling, with pregnant and postpartum women from three hospitals in two Argentine provinces during the Covid-19 pandemic. An in-person survey was conducted with 300 women. The results indicate a slight increase in care time and a decrease in time dedicated to paid work. A great concern was found among women about changes in health care, the care and health of their children, and the daily management of care. A high incidence of anxiety in pregnant women and postpartum depression was recorded. Studying maternal mental health and the organization of care from a gender perspective allows for a more comprehensive understanding of the suffering of women mothers understood as social subjects.
RESUMEN
RESUMEN INTRODUCCIÓN: La salud mental perinatal está relacionada con los procesos fisiológicos, psicológicos y socioculturales implicados en la concepción, embarazo, parto, puerperio y vínculo temprano, e incluye a la díada madre-bebé. El objetivo de este trabajo fue indagar el impacto de la pandemia por COVID-19 en la salud mental perinatal, específicamente con relación a la depresión posparto (DPP) y las diversas preocupaciones que manifestaron las mujeres en este contexto. MÉTODOS: Se realizó un estudio de corte transversal a través de una encuesta cara a cara con preguntas abiertas y cerradas. Se trabajó con una muestra no probabilística en tres hospitales (dos de la provincia de Entre Ríos y uno de la provincia de Buenos Aires). RESULTADOS: El 68% de las mujeres mostraron indicadores de DPP evaluada con la Escala de Edimburgo, es decir, manifestaron haberse sentido infelices y con dificultades para dormir, con miedo, tristeza, preocupación y pensamientos negativos, en la última semana. Existen relaciones significativas entre la depresión puerperal, el hospital, la cantidad de personas con las que conviven las puérperas y el estado de salud. DISCUSIÓN: Esta investigación permitió generar información útil para mejorar prácticas, intervenciones y políticas que redunden en garantía de derechos en salud mental perinatal.
ABSTRACT INTRODUCTION: Perinatal mental health is related to the physiological, psychological and sociocultural processes involved in conception, pregnancy, childbirth, puerperium and early bonding, and includes the mother-baby dyad. The objective of this work was to investigate the impact of the COVID-19 pandemic on perinatal mental health, specifically in relation to postpartum depression (PPD) and the various concerns expressed by women in this context. METHODS: A cross-sectional study was conducted through a face-to-face survey with open and closed questions. It used a non-probabilistic sample in three hospitals (two from the province of Entre Ríos and one from the province of Buenos Aires). RESULTS: Sixty-eight percent of the women showed indicators of PPD according to the Edinburgh Scale, that is, they stated that they felt unhappy and had difficulty sleeping, with fear, sadness, worry and negative thoughts, in the last week. There are significant relationships between PPD, the hospital, the number of people with whom postpartum women live, and health status. DISCUSSION: This research generated useful information to improve practices, interventions and policies guaranteeing rights in perinatal mental health.
RESUMEN
Background: Corona Virus Disease 19 (COVID-19) is a new pandemic, declared a public health emergency by the World Health Organization, which could have negative consequences for pregnant and postpartum women. The scarce evidence published to date suggests that perinatal mental health has deteriorated since the COVID-19 outbreak. However, the few studies published so far have some limitations, such as a cross-sectional design and the omission of important factors for the understanding of perinatal mental health, including governmental restriction measures and healthcare practices implemented at the maternity hospitals. Within the Riseup-PPD COST Action, a study is underway to assess the impact of COVID-19 in perinatal mental health. The primary objectives are to (1) evaluate changes in perinatal mental health outcomes; and (2) determine the risk and protective factors for perinatal mental health during the COVID-19 pandemic. Additionally, we will compare the results between the countries participating in the study. Methods: This is an international prospective cohort study, with a baseline and three follow-up assessments over a six-month period. It is being carried out in 11 European countries (Albania, Bulgaria, Cyprus, France, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom), Argentina, Brazil and Chile. The sample consists of adult pregnant and postpartum women (with infants up to 6 months of age). The assessment includes measures on COVID-19 epidemiology and public health measures (Oxford COVID-19 Government Response Tracker dataset), Coronavirus Perinatal Experiences (COPE questionnaires), psychological distress (BSI-18), depression (EPDS), anxiety (GAD-7) and post-traumatic stress symptoms (PTSD checklist for DSM-V). Discussion: This study will provide important information for understanding the impact of the COVID-19 pandemic on perinatal mental health and well-being, including the identification of potential risk and protective factors by implementing predictive models using machine learning techniques. The findings will help policymakers develop suitable guidelines and prevention strategies for perinatal mental health and contribute to designing tailored mental health interventions.
Asunto(s)
Humanos , Femenino , Embarazo , Mujeres Embarazadas/psicología , Periodo Posparto/psicología , COVID-19/psicología , Estudios Prospectivos , Factores de Riesgo , Europa (Continente)/epidemiología , Factores Protectores , Trastornos Mentales/epidemiologíaRESUMEN
Sobre la base de entrevistas a treinta mujeres y treinta varones, residentes en el área metropolitana de Buenos Aires, acerca de sus experiencias de aborto, se reconstruyen trayectorias en las que el aborto constituye un hito. Se concluye que la ilegalidad no influye en la decisión de interrumpir un embarazo, sino en las condiciones diferenciales de su práctica clandestina; que las huellas del aborto marcan diferencialmente a las mujeres, en cuyo cuerpo es practicado, que a los varones, participantes secundarios del proceso, aunque las huellas sean perdurables tanto en mujeres como en varones. Asimismo, se muestra que en las mujeres pobres, al primer embarazo sigue un nacimiento y luego un aborto; que en las clases medias, al primer embarazo sigue el aborto y luego los hijos; y que la eventualidad de interrumpir el embarazo no se plantea sólo en situaciones excepcionales sino que forma parte del proceso desencadenado por la sospecha de un embarazo.
Tendo como base entrevistas feitas com 30 mulheres e 30 homens, residentes na área metropolitana de Buenos Aires, a respeito de suas experiências de aborto, reconstroem-se trajetórias nas quais o aborto constitui um marco. Conclui-se que a ilegalidade não influi na decisão de interromper uma gravidez, mas sim nas condições diferenciais de sua prática clandestina; que os traços do aborto marcam de forma diferente mais as mulheres, em cujo corpo é praticado, do que os homens, participantes secundários do processo, embora as marcas sejam perduráveis tanto em mulheres como em homens. Do mesmo modo, mostra-se que, nas mulheres pobres, à primeira gravidez segue-se um nascimento e depois um aborto; que nas classes médias, à primeira gravidez segue-se o aborto e depois os filhos; e que a eventualidade de interromper a gravidez não se dá só em situações excepcionais, mas sim que faz parte do processo desencadeado pela suspeita de uma gravidez.
This article presents results of the Argentine chapter of the HEXCA research project, on Heterosexualities, Contraception and Abortion in four South American cities. In-depth interviews were conducted with 30 women and 30 men residing in the Buenos Aires metropolitan area, about their experiences of abortion as a landmark in their personal trajectories. Findings show that illegality does not determine the decision to interrupt a pregnancy, but the differential conditions of its clandestine practice; abortion leaves a mark both on women and on men. For low-income women, the first pregnancy results in childbirth, then followed by an abortion; while for middle-class women the first pregnancy results in an abortion, then followed by children. The interruption of a pregnancy is not a response to exceptional situations, but an ordinary part of the process initiated by the suspicion of a pregnancy.