Mode of Delivery and Maternal Sensitivity: Effects on the Socioemotional Development of Children at One Year of Age / Tipo de parto y sensibilidad materna: Efectos en el desarrollo socioemocional de niños y niñas al año de edad

Abstract Early childhood is a period of high relevance in children's socioemotional development, establishing the basis for future development. Acquisitions during the first year of life are significant predictors of future social and emotional skills. During this period, maternal sensitivity is also essential, and there is evidence regarding its effects on the socioemotional development of the child. Considering the relevance of this competence, together with the global and national increase in cesarean rates and the possible risks associated with the type of delivery experienced, the influence of the type of delivery and the maternal sensitivity in child's socioemotional development at one year of age was analyzed. For this, an intentional non-probabilistic sample of 91 mothers with their respective children of different socioeconomic levels, who attended public or private nurseries in the city of Santiago, Chile, was studied. The instruments used were the Adult Sensitivity Scale (ESA) and the Functional Emotional Assessment Scale (FEAS). The results showed no differences in the children's socioemotional development according to the type of delivery. However, it was possible to observe an association between a higher maternal sensitivity and a more significant socioemotional development on children at one year of age. The implications of promoting maternal sensitivity are discussed to support optimal socioemotional development in infants.

Resumen La infancia temprana es un periodo de gran relevancia en el desarrollo socioemocional infantil; de hecho, es donde se sientan las bases del desarrollo futuro. En este sentido, las adquisiciones durante el primer año de vida son predictores importantes de las habilidades sociales y emocionales futuras, de modo que la sensibilidad materna, según evidencia respecto a sus efectos en el desarrollo socioemocional del niño, ha demostrado ser un aspecto fundamental durante este periodo. Teniendo esto en cuenta, y considerando la relevancia de dicha competencia, así como el alza mundial y nacional en las tasas de cesárea y los posibles riesgos asociados al tipo de parto vivenciado, el presente estudio tuvo como objetivo analizar la influencia de la sensibilidad materna y del tipo de parto en el desarrollo socioemocional infantil al año de edad. Para ello, se estudió una muestra no probabilística intencionada de 91 madres con sus respectivos hijos o hijas -de distinto nivel socioeconómico- que asistían a salas cuna públicas o privadas en la ciudad de Santiago, Chile, por medio de dos instrumentos: la escala de sensibilidad del adulto (ESA) y la functional emotional assessment scale (FEAS). En general, los resultados no mostraron diferencias en el desarrollo socioemocional de los niños según el tipo de parto, aunque sí se pudo apreciar una relación entre una mayor sensibilidad materna y un mayor desarrollo socioemocional de los niños al año de edad. Al final se discuten las implicaciones de promover la sensibilidad materna con el fin de apoyar un óptimo desarrollo socioemocional en los infantes.

Type of delivery is not associated with maternal depression.

Although many women experience depressive symptoms during the first year after childbirth, the relationship between type of delivery and maternal depression is not clear. The purpose of this study is to evaluate relationship between type of delivery and maternal depression, between 6 to 16 months after childbirth. We performed a prospective cohort study of 558 low-socioeconomic status pregnant women without depression. All participants were recruited from primary care clinics of the public sector in three administrative districts in the Western area of the city of São Paulo, Brazil. Depressive symptoms were assessed using the Self-Report Questionnaire (SRQ-20). Type of delivery was classified as uncomplicated spontaneous vaginal delivery (UVD) (no episiotomy and no more than a first-degree perineal laceration), complicated vaginal delivery (CVD) (episiotomy or more than a second-degree perineal laceration), and cesarean delivery (CD). Data about type of delivery were extracted from medical charts. Crude and adjusted risk ratios with 95% confidence intervals were estimated using Poisson regression with robust variance estimates to examine the association between type of delivery with maternal depression. Among 482 women reassessed during 6 to 16 months after delivery, 18% had symptoms of depression. According to the type of delivery, 250 (51.8%), 85 (21.7%), and 147 (30.5%) were UVD, CVD, and CD, respectively. There was no association between type of delivery and maternal depression. In comparison with women submitted to uncomplicated vaginal, women who had a cesarean or perineal trauma/episiotomy did not show greater risk of maternal depression, in the medium to long term after delivery.

Fatores associados ao tipo de parto em mulheres brasileiras: PNDS 2006 / Factors associated with the type of delivery in Brazilian women: 2006 NDHS

O objetivo do trabalho foi analisar a prevalência dos tipos de parto e fatores associados em mulheres brasileiras em idade fértil estudadas na última Pesquisa Nacional de Demografia e Saúde (PNDS). O estudo compreende um recorte da PNDS, a qual se trata de um estudo transversal, de base domiciliar, de âmbito nacional, que teve como objetivo central caracterizar a população feminina em idade fértil e as crianças menores de cinco anos. Foram descritas as prevalências de tipo de parto segundo as seguintes variáveis de exposição: macrorregiões brasileiras, situação de domicílio, idade, cor da pele, estado nutricional, escolaridade, local do pré-natal e local do parto. A significância estatística (p<0,05) foi avaliada pelo teste do qui-quadrado. A população estudada constituiu-se de 6.125 mulheres. Observou-se que 42,9 por cento das mulheres tiveram parto cesariano. A prevalência de parto cesariano foi significantemente menor, independente da macrorregião de moradia, situação de domicílio, idade, cor da pele, estado nutricional, local do pré-natal e do parto. Evidenciou-se a necessidade da continuidade na investigação dos fatores que promovem o aumento de partos cesarianos no Brasil, a fim de inverter os índices elevados, uma vez que pode levar a uma série de complicações tanto para as mães quanto para seus filhos.

The scope of this paper was to analyze the prevalence of the types of delivery and associated factors in Brazilian women of childbearing age studied in the last National Demographics and Health Survey (NDHS). The study is a national domicile-based cross-sectional analysis, seeking to establish the characteristics of the female population of child-bearing age and of children under 5 years of age. The prevalence of the type of delivery was described according to the following exposition variables: Brazilian macro-regions, location of residence, age, skin color, nutritional status, education, prenatal health unit and place of delivery. The statistical significance (p<0,05) was evaluated using the chi-square test. The population studied consisted of 6.125 women. It was revealed that 42.9 percent of the women had a caesarean section. Significantly, the prevalence of caesarean section was smaller, irrespective of macro-regions, location of residence, age, skin color, nutritional status, prenatal health unit and place of delivery. The need for further investigation into the factors behind the increase in caesarean sections in Brazil is required in order to reverse this situation, since caesarean section can lead to a series of health complications for both mother and child.