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1.
Early Hum Dev ; 152: 105286, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33276222

RESUMO

OBJECTIVE: Limited information is available regarding barriers to breastfeeding during the COVID-19 lockdown. STUDY DESIGN: This study was designed as a non-concurrent case-control study on breastfeeding initiation practices, defined according to WHO, in women giving birth during lockdown, between March 8 and May 18, 2020, in the COVID-19 'hotspot' in Northeastern Italy (study group), with an antecedent puerperae-matched group (control group). Exclusive, complementary, and formula feeding practices were collected from maternal charts at hospital discharge, on the second day post-partum, when puerperae filled out the Edinburg Postnatal Depression Scale (EPDS). RESULTS: The COVID-19 study group presented significantly lower exclusive breastfeeding rates than the control group who members gave birth the previous year (-15%, p = 0.003), as a consequence of the significantly higher prevalence of complementary feeding practices in the former (+20%, p = 0.002). Conversely, the COVID-19 study group showed significantly higher EPDS scores (8.03 ± 4.88 vs. 8.03 ± 4.88, p < 0.005) and higher anhedonia (0.56 ± 0.65 vs. 0.18 ± 0.38, p < 0.001) and depression (0.62 ± 0.60 vs. 0.39 ± 0.44, <0.001) subscale scores. In the general linear model analysis, women practicing exclusive breastfeeding showed significantly lower EPDS scores in comparison with those practicing complementary (p = 0.003) and formula feedings (p = 0.001). Furthermore, the highest EPDS scores were observed in women adopting formula feeding, mainly during the COVID-19 quarantine (p = 0.019). CONCLUSION: This study indicates that hospital containment measures adopted during lockdown in the 'hotspot' COVID-19 epidemic area of Northeastern Italy have a detrimental effect on maternal emotions and on breastfeeding exclusivity practices.


Assuntos
Aleitamento Materno/psicologia , Controle de Doenças Transmissíveis , Adulto , Estudos de Casos e Controles , Depressão Pós-Parto/epidemiologia , Comportamento Alimentar , Feminino , Humanos , Lactente , Recém-Nascido , Mães/psicologia , Prevalência
2.
Belo Horizonte; Faculdade de Medicina da UFMG; 20200000. 45 p.
Monografia em Português | LILACS, BDENF - Enfermagem, Coleciona SUS | ID: biblio-1129036

RESUMO

A XVII Jornada Acadêmica de Saúde mental é um evento que busca aproximar os estudantes de cursos variados do campo de estudo da Saúde Mental. Além de aulas ministradas na forma de palestras, os acadêmicos são convidados a produzirem trabalhos para serem apresentados aos demais participantes, ampliando o leque de assuntos abordados. Além de proporcionar aos estudantes interessados maior contato com temas específicos da área, a produção de resumos para apresentação é uma ferramenta para aprimoramento das técnicas de escrita e produção de conteúdo. Elaborar os trabalhos amplia os conhecimentos dos alunos sobre escrita científica e os aproxima do meio acadêmico científico. Ademais, o contato com professores e pesquisadores da área, que orientam os participantes durante o processo, cria canais de comunicação e abre novas oportunidades para os estudantes. Para esta edição do evento, os trabalhos foram selecionados pela Comissão Científica da Jornada, que verificou um alto nível nas submissões. Aqueles mais originais, relevantes e bem produzidos foram aprovados e compõem esse livro, mostrando à comunidade a qualidade dos estudantes e do conteúdo apresentado na XVII JASME. Os assuntos discutidos nos próximos capítulos, desenvolvidos por estudantes de cursos da área da saúde, abrangem a saúde mental por variados ângulos e sob diversas abordagens. Escolher alguns trabalhos significa, necessariamente, prescindir de outros. Cientes do desafio de estabelecer uma coletânea que tivesse o padrão de qualidade e a feição da UFMG sem nos obnubilar pela subjetividade, estabelecemos critérios objetivos e submetemos cada resumo à apreciação independente de pelo menos três integrantes da junta científica para apreciação. Por fim, aferimos que não houve divergência de rigor entre os subgrupos e selecionamos os trinta melhores, ou seja, os mais inovadores, bem escritos, objetivos e bem fundamentados. Procuramos, diante dos diversos recortes da pandemia da COVID-19, incluir aqueles que, em vez de vagos de tão abrangentes, descreviam impactos tangíveis, mensuráveis e inusitados, isto é, Relacionados a grupos que não têm sido abordados pela grande mídia e tampouco pelo profissional de saúde médio. Assim, cremos que os resumos a seguir são os que mais bem abordam tanto questões atemporais em saúde mental quanto aquelas que emergiram nos últimos meses e ainda não sabemos por quanto tempo perdurarão. Os trabalhos tratam desde questões relacionadas aos fatores de risco para o desenvolvimento de transtornos psiquiátricos aos aspectos do tratamento farmacológico. Com uma perspectiva atual e relevante para as condições de saúde vigente, as temáticas se relacionam com diversas áreas da saúde mental, como as consequências da pandemia da SARS-COV2, aspectos da saúde mental em jovens e idosos, condutas da saúde mental na saúde primária, psicofarmacologia, transtornos psiquiátricos.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Esquizofrenia , Isolamento Social/psicologia , Suicídio , Transtorno Bipolar , Idoso , Cannabis/toxicidade , Ácidos Graxos Ômega-3/uso terapêutico , Saúde Mental , Adolescente , Pessoal de Saúde/psicologia , Infecções por Coronavirus , Depressão Pós-Parto , Depressão , Alcoolismo , Pandemias , Transtorno do Espectro Autista , Hipotireoidismo/psicologia
3.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(10): 1215-1222, 2020 Oct 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33268583

RESUMO

OBJECTIVES: To explore the application of random forest algorithm in screening the risk factors and predictive values for postpartum depression. METHODS: We recruited the participants from a tertiary hospital between June 2017 and June 2018 in Changsha City, and followed up from pregnancy up to 4-6 weeks postpartum.Demographic economics, psychosocial, biological, obstetric, and other factors were assessed at first trimesters with self-designed obstetric information questionnaire and the Chinese version of Edinburgh Postnatal Depression Scale (EPDS). During 4-6 weeks after delivery, the Chinese version of EPDS was used to score depression and self-designed questionnaire to collect data of delivery and postpartum. The data of subjects were randomly divided into the training data set and the verification data set according to the ratio of 3꞉1. The training data set was used to establish the random forest model of postpartum depression, and the verification data set was used to verify the predictive effects via the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and AUC index. RESULTS: A total of 406 participants were in final analysis. Among them, 150 of whom had EPDS score ≥9, and the incidence of postpartum depression was 36.9%. The predictive effects of random forest model in the verification data set were at accuracy of 80.10%, sensitivity of 61.40%, specificity of 89.10%, positive predictive value of 73.00%, negative predictive value of 82.80%, and AUC index of 0.833. The top 10 predictive influential factors that screening by the variable importance measure in random forest model was antenatal depression, economic worries after delivery, work worries after delivery, free triiodothyronine in first trimesters, high-density lipoprotein in third trimester, venting temper to infants, total serum cholesterol and serum triglyceride in first trimester, hematocrit and serum triglyceride in third trimester. CONCLUSIONS: Random forest has a great advantage in risk prediction for postpartum depression. Through comprehensive evaluation mechanism, it can identify the important influential factors for postpartum depression from complex multi-factors and conduct quantitative analysis, which is of great significance to identify the key factors for postpartum depression and carry out timely and effective intervention.


Assuntos
Depressão Pós-Parto , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Período Pós-Parto , Gravidez , Terceiro Trimestre da Gravidez , Escalas de Graduação Psiquiátrica , Fatores de Risco , Sensibilidade e Especificidade
4.
BMJ Open ; 10(12): e043057, 2020 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-33303470

RESUMO

INTRODUCTION: The absence of companionship during childbirth is known to be responsible for negative emotional birth experience, which can increase the risk of postpartum depression and post-traumatic stress disorder. The context of COVID-19 epidemic and the related confinement could increase the rate of negative experience and mental disorders. The main objective is to compare, in immediate post partum, the maternal sense of control during childbirth between a group of women who gave birth during confinement ('confinement' group) versus a group of women who gave birth after confinement but in the context of epidemic ('epidemic' group) versus a group of control women ('control' group; excluding confinement and epidemic context). METHODS AND ANALYSIS: This is a national multicentre prospective cohort study conducted in four French maternity units. We expect to include 927 women in a period of 16 months. Women will be recruited immediately in post partum during three different periods constituting the three groups: 'confinement'; 'epidemic' and 'control' group. The maternal sense of control will be evaluated by the Labour Agentry Scale questionnaire completed immediately in post partum. Postnatal depression (Edinburgh Postnatal Depression Scale), post-traumatic stress disorder (Impact of Event Scale-Revised) and breast feeding (evaluative statement) will be evaluated at 2 months post partum. ETHICS AND DISSEMINATION: The study was approved by the French Ethics Committee, the CPP (Comité de Protection des Personnes) SUD OUEST ET OUTRE-MER IV on 16th of April 2020 with reference number CPP2020-04-040. The results of this study will be published in a peer-reviewed journal and will be presented at relevant conferences. TRIAL REGISTRATION NUMBER: NCT04348929.


Assuntos
/psicologia , Parto/psicologia , Período Pós-Parto/psicologia , Depressão Pós-Parto/etiologia , Feminino , França , Humanos , Gravidez , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Projetos de Pesquisa , Transtornos de Estresse Pós-Traumáticos/etiologia , Inquéritos e Questionários , Fatores de Tempo
5.
Medicine (Baltimore) ; 99(50): e23603, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327328

RESUMO

BACKGROUND: Postpartum depression (PPD) is one of the most common postpartum psychiatric disorders. The prevalence of PPD ranges from approximately 10% to 30%. In recent years, iron supplementation has emerged as potential means to treat PPD, and an increasing number of studies have been published to support the effectiveness of iron supplementation for PPD. we will conduct a comprehensive systematic review and meta-analysis to evaluate the evidence of randomized controlled trials for iron supplementation treatment of PPD. METHODS: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, China Science, and Technology Journal Database, and Chinese Biomedical Literature Database will be searched from their inception of databases to December 31, 2020. Two reviewers will select articles, extract data and assess the risk of bias independently. Any disagreement will be resolved by discussion with the third reviewer. Review Manager 5.3 software will be used for data synthesis. The Cochrane risk of bias assessment tool will be used to assess the risk of bias. RESULTS: This study will conduct a comprehensive literature search and provide a systematic synthesis of current published data to explore the effectiveness of iron supplementation for PPD. CONCLUSIONS: This systematic review and meta-analysis will provide clinical evidence for the effectiveness of iron supplementation for PPD, inform our understanding of the value of iron supplementation in improving PPD symptoms, and help clinicians to make better decisions regarding the appropriate role of iron supplementation as a part of prevention and treatment routines. STUDY REGISTRATION NUMBER: INPLASY2020110007.


Assuntos
Depressão Pós-Parto/tratamento farmacológico , Ferro/administração & dosagem , Suplementos Nutricionais , Feminino , Humanos , Gravidez
6.
Sci Rep ; 10(1): 22380, 2020 12 24.
Artigo em Inglês | MEDLINE | ID: mdl-33361797

RESUMO

The mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Coronavirus Disease 2019 (COVID-19) pandemic on postpartum women are of increasing concern among mental health practitioners. To date, only a handful of studies have explored the emotional impact of the pandemic surrounding pregnancy and none have investigated the consequence of pandemic-related social restrictions on the postpartum mood of those living among different socioeconomic status (SES). All postpartum patients appearing to the Mount Sinai Health System for their postpartum appointment between January 2, 2020 and June 30, 2020, corresponding to before and during pandemic imposed social restrictions, were screened for mood symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Each patient's socioeconomic status (high/low) was determined by their location of clinical service. A total of 516 postpartum patients were screened. While no differences in EPDS scores were observed by SES prior to social restrictions (U = 7956.0, z = - 1.05, p = .293), a significant change in mood symptomatology was observed following COVID-19 restrictions (U = 4895.0, z = - 3.48, p < .001), with patients living in lower SES reporting significantly less depression symptomatology (U = 9209.0, z = - 4.56, p < .001). There was no change in symptomatology among patients of higher SES (U = 4045.5, z = - 1.06, p = .288). Postpartum depression, the most common complication of childbearing, is a prevalent, cross-cultural disorder with significant morbidity. The observed differences in postpartum mood between patients of different SES in the context of temporarily imposed COVID-19-related social restrictions present a unique opportunity to better understand the specific health and social support needs of postpartum patients living in urban economic poverty. Given that maternal mental illness has negative long-term developmental implications for the offspring and that poor mental health reinforces the poverty cycle, future health policy specifically directed towards supporting postpartum women living in low SES by ameliorating some of the early maternal burdens associated with balancing employment-family-childcare demands may assist in interrupting this cycle while simultaneously improving the long-term outcomes of their offspring.


Assuntos
Afeto , /prevenção & controle , Depressão Pós-Parto/epidemiologia , Pandemias/prevenção & controle , Período Pós-Parto/psicologia , Quarentena/psicologia , Classe Social , Adolescente , Adulto , Estudos de Coortes , Depressão Pós-Parto/diagnóstico , Feminino , Humanos , Saúde Mental , Cidade de Nova Iorque/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Adulto Jovem
7.
BMJ ; 371: m4022, 2020 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-33177069

RESUMO

OBJECTIVE: To evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression in pregnant and postpartum women. DESIGN: Individual participant data meta-analysis. DATA SOURCES: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (from inception to 3 October 2018). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Eligible datasets included EPDS scores and major depression classification based on validated diagnostic interviews. Bivariate random effects meta-analysis was used to estimate EPDS sensitivity and specificity compared with semi-structured, fully structured (Mini International Neuropsychiatric Interview (MINI) excluded), and MINI diagnostic interviews separately using individual participant data. One stage meta-regression was used to examine accuracy by reference standard categories and participant characteristics. RESULTS: Individual participant data were obtained from 58 of 83 eligible studies (70%; 15 557 of 22 788 eligible participants (68%), 2069 with major depression). Combined sensitivity and specificity was maximised at a cut-off value of 11 or higher across reference standards. Among studies with a semi-structured interview (36 studies, 9066 participants, 1330 with major depression), sensitivity and specificity were 0.85 (95% confidence interval 0.79 to 0.90) and 0.84 (0.79 to 0.88) for a cut-off value of 10 or higher, 0.81 (0.75 to 0.87) and 0.88 (0.85 to 0.91) for a cut-off value of 11 or higher, and 0.66 (0.58 to 0.74) and 0.95 (0.92 to 0.96) for a cut-off value of 13 or higher, respectively. Accuracy was similar across reference standards and subgroups, including for pregnant and postpartum women. CONCLUSIONS: An EPDS cut-off value of 11 or higher maximised combined sensitivity and specificity; a cut-off value of 13 or higher was less sensitive but more specific. To identify pregnant and postpartum women with higher symptom levels, a cut-off of 13 or higher could be used. Lower cut-off values could be used if the intention is to avoid false negatives and identify most patients who meet diagnostic criteria. REGISTRATION: PROSPERO (CRD42015024785).


Assuntos
Depressão Pós-Parto/psicologia , Transtorno Depressivo Maior/psicologia , Complicações na Gravidez/psicologia , Psicometria , Feminino , Humanos , Gravidez , Cuidado Pré-Natal , Sensibilidade e Especificidade
8.
BMC Psychiatry ; 20(1): 557, 2020 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-33238927

RESUMO

BACKGROUND: The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. To date, there are limited studies that have investigated the impact of COVID-19 pandemic on mental health among female population. Therefore, the study aims to investigate the prevalence of postpartum depression (PPD) and it's related factors among women in Guangzhou, China, during the COVID-19 pandemic. METHODS: A cross-sectional study was performed from 30th March 2020 to 13th April 2020 using anonymous online questionnaire among 864 women at 6-12 weeks postpartum. The Chinese version of Edinburgh Postnatal Depression Scale and a questionnaire regarding associated factors were administered to all participants. Multivariate logistic regression was used to determine factors that were significantly associated with PPD. RESULTS: The prevalence of PPD among women at 6-12 weeks postpartum was 30.0%. A multivariate logistic regression model identified significant factors as: immigrant women, persistent fever, poor social support, concerns about contracting COVID-19 and certain precautionary measures. CONCLUSIONS: The findings suggest the need for policies and interventions to not only mitigate the psychological impacts but also target disadvantaged sub-groups of women following childbirth during the COVID-19 pandemic.


Assuntos
/epidemiologia , Depressão Pós-Parto/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Pandemias , Gravidez , Prevalência , Adulto Jovem
9.
BMJ Open ; 10(11): e041133, 2020 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-33247023

RESUMO

INTRODUCTION: Mental health disorders are common during pregnancy and the postnatal period and can have serious adverse effects on women and their children. The consequences for global mental health due to COVID-19 are likely to be significant and may have a long-term impact on the global burden of disease. Besides physical vulnerability, pregnant women are at increased risk of mental health problems such as anxiety, depression and post-traumatic stress disorder due to the consequences of social distancing. It can result in altered healthcare routines, less support from the family and friends, and in some cases, partners not being allowed to be present during prenatal visits, labour and delivery. Higher than expected, rates of perinatal anxiety and depression have been already reported during the pandemic. Pregnant women may also feel insecure and worried about the effects of COVID-19 on their unborn child if they get infected during pregnancy. Today, young urban women are used to using internet services frequently and efficiently. Therefore, providing mental health support to pregnant women via internet may be effective in ameliorating their anxiety/depression, reducing the risk of serious mental health disorders, and lead to improved maternal and perinatal outcomes. OVERARCHING AIM: Our aim is to explore the effectiveness of a web-based psychosocial peer-to-peer support intervention in reducing the risk and severity of perinatal mental health disorders and preventing adverse pregnancy outcomes among pregnant women living in metropolitan urban settings. METHODS AND ANALYSIS: We plan to conduct a multicentre prospective randomised controlled trial, Mental health of Urban Mothers trial. Pregnant women living in large metropolitan cities will be recruited using internet-based application through non-profit organisations' websites. The women who consent will be randomised to receive a web-based peer-to-peer support intervention or usual care. Data will be analysed to identify the effects of intervention on Edinburgh Postnatal Depression Score and Generalised Anxiety Disorder 7 scores as well as pregnancy outcomes. The impact of COVID-19 pandemic on maternal stress will be assesed using Impact Event Scale-R. Any differences in outcomes between cities will be addressed in subgroup analyses. ETHICS AND DISSEMINATION: The study will be conducted according to the principles of Good Clinical Practice and will follow the ethical principles of the Declaration of Helsinki. The study protocol has been approved by the ethical review board of Chinese University of Hong Kong (IRB number 2019-8170) and Shanghai Center for Women's and Children's Health (international review board (IRB) number 2020-F001-12). The results will be disseminated at national and international scientific conferences, published in peer-reviewed medical journals and spread to the public through social media, news outlets and podcasts. TRIAL REGISTRATION NUMBER: NCT04363177; Trial sponsor Karolinska Institute, CLINTEC, Stockholm, Sweden.


Assuntos
/psicologia , Transtornos Mentais/prevenção & controle , Saúde Mental , Complicações na Gravidez/psicologia , Psicoterapia/métodos , Estresse Psicológico/prevenção & controle , População Urbana , Ansiedade/etiologia , Ansiedade/prevenção & controle , Criança , Depressão/etiologia , Depressão/prevenção & controle , Depressão Pós-Parto/prevenção & controle , Feminino , Humanos , Internet , Transtornos Mentais/etiologia , Mães/psicologia , Pandemias , Grupo Associado , Gravidez , Resultado da Gravidez , Gestantes/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Estresse Psicológico/etiologia
11.
Anesth Analg ; 131(6): e248-e249, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33196469
13.
Anesth Analg ; 131(6): e250-e251, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33196471
15.
Anesth Analg ; 131(6): e253-e254, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33196473
16.
Pan Afr Med J ; 37: 89, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33244352

RESUMO

Introduction: postpartum depression (PPD) continues to become one of the major maternal health challenges across the globe but there is a paucity of recent data on its magnitude in Africa. This study was motivated by the need to update the current magnitude of PPD in Africa based on various assessment tools. Methods: a total of 21 articles met the study criteria. Fifteen articles used the EPDS and six used other assessment tools. Postpartum depression among studies that used EPDS tool ranged from 6.9% in Morocco to 43% in Uganda and 6.1% in Uganda to 44% in Burkina Faso among studies that used other depression assessment tools. Sensitivity and specificity results of the EPDS ranged from 75%-100% and 87%-98% respectively. Results: a total of 21 articles met the study criteria. Fifteen articles used the EPDS and six used other assessment tools. Postpartum depression among studies that used EPDS tool ranged from 6.9% in Morocco to 43% in Uganda and 6.1% in Uganda to 44% in Burkina Faso among studies that used other depression assessment tools. Sensitivity and specificity results of the EPDS ranged from 75%-100% and 87%-98% respectively. Conclusion: despite the limited dearth of literature, the magnitude of PPD in Africa remains high which suggests that PPD is still a neglected illness and calls for immediate interventions. EPDS is an effective tool with high sensitivity and specify in varying study contexts.


Assuntos
Depressão Pós-Parto/epidemiologia , Mães/psicologia , África/epidemiologia , Depressão Pós-Parto/diagnóstico , Feminino , Humanos , Escalas de Graduação Psiquiátrica , Sensibilidade e Especificidade
17.
PLoS One ; 15(11): e0242333, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33201903

RESUMO

BACKGROUND: Due to the multiple health benefits of breastfeeding, it is essential to identify factors that may negatively interfere with this healthy practice. Among such factors are postpartum depression (PPD) and maternal satisfaction with breastfeeding. The objective of this study was to evaluate the association between maternal satisfaction with breastfeeding and symptoms of PPD in the first month after childbirth. METHODS: This cross-sectional study nested in a cohort study was conducted in Porto Alegre, Brazil, with 287 puerperal women selected at two maternity hospitals, one public and one private. Women were interviewed at their homes the week after the infant completed 30 days of life. A structured questionnaire was applied, as well as instruments to evaluate maternal satisfaction with breastfeeding (Maternal Breastfeeding Evaluation Scale) and to screen for PPD (Edinburgh Postnatal Depression Scale). The association between higher satisfaction with breastfeeding (outcome) and negative PPD screening test was assessed using Poisson regression with robust variance, adjusting for specific covariables. Adjusted prevalence ratios (aPR) and respective 95% confidence intervals (95%CI) were estimated. RESULTS: The prevalence of increased satisfaction with breastfeeding (defined as women with scores above the median) was 47% higher among women who screened negative for PPD when compared to those with a positive result (aPR 1.47; 95%CI 1.01-2.16). This result was adjusted for maternal age and skin color, cohabitation with the infant's father, planned pregnancy, type of delivery, exclusive breastfeeding, and occurrence of breastfeeding problems. CONCLUSIONS: The findings of this study showed an association between higher maternal satisfaction with breastfeeding and absence of PPD symptoms, reinforcing the importance of caring for the mental health of pregnant and puerperal women and paying attention to their satisfaction with breastfeeding.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Depressão Pós-Parto/diagnóstico , Satisfação Pessoal , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Mães/psicologia , Prevalência , Fatores de Risco , Adulto Jovem
18.
BMC Pregnancy Childbirth ; 20(1): 703, 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33208115

RESUMO

BACKGROUND: Trauma, natural and man-made catastrophic events can be predictors of postpartum psychological distress. In a public health response due to coronavirus disease 2019 outbreak, the Italian government imposed a lockdown from March 9 to May 3. This extraordinary situation may have been challenging for maternal psychological health. The aim of this study was to investigate the prevalence of depressive and post-traumatic stress symptoms in women giving birth during the Covid-19 pandemic and its associations with quarantine measures, obstetrical factors, and relational attachment style. METHODS: Women who gave birth in a high-volume obstetric/gynaecological medical centre located in an epidemic area during the Covid-19 pandemic (March 8 to June 15) were asked to complete an online survey about their childbirth experience and the perceived effect of the pandemic. The Edinburgh Postnatal Depression Scale (EPDS), the Impact of Event Scale-Revised (IES-R), and the Relationship Questionnaire (RQ) were administered to assess levels of postpartum depressive and post-traumatic stress symptoms (PTSS) and relational style of attachment, respectively. Multivariate analysis was applied to identify associations between quarantine measures, childbirth experience, attachment style, and EPDS and IES-R scores. RESULTS: The survey was completed by 163 women (response rate 60.8%). The prevalence of depressive symptoms was 44.2% (EPDS cut-off score ≥ 11) and the PTSS rate was 42.9% (IES-R cut-off score ≥ 24). Dismissive and fearful avoidant attachment styles were significantly associated with the risk of depression and PTSS, respectively. Perceived pain during birth was a risk factor for postpartum depression. Perceived support provided by healthcare staff was a protective factor against depression and PTSS. Another protective factor against PTSS was quiet on the ward due to the absence of hospital visitors. CONCLUSION: This study reports a high prevalence of postpartum depressive and PTSS in women who gave birth during the Covid-19 pandemic. Postnatal psychological distress seemed to be associated more with the prenatal experience and other individual factors than with the pandemic hospital restrictions. Early detection during pregnancy of an insecure attachment style is fundamental to provide targeted preventive and therapeutic psychological interventions.


Assuntos
Infecções por Coronavirus/psicologia , Depressão Pós-Parto , Pneumonia Viral/psicologia , Período Pós-Parto/psicologia , Gestantes/psicologia , Angústia Psicológica , Quarentena/psicologia , Adulto , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/etiologia , Depressão Pós-Parto/prevenção & controle , Feminino , Humanos , Itália/epidemiologia , Pandemias/prevenção & controle , Parto/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Gravidez , Prevalência , Psicologia , Sistemas de Apoio Psicossocial , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle
19.
Ann Epidemiol ; 52: 26-34, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33010417

RESUMO

PURPOSE: The purpose of this study was to examine how combinations of adverse childhood events (ACEs) contribute to the risk of postpartum depression and the mediating role of prenatal social support. METHODS: The Adverse Childhood Experiences Scale Questionnaire and the Edinburgh Postnatal Depression Scale Questionnaire were used to measure the study's exposure and outcome. Among a cohort of 419 mothers enrolled in a home visiting (HV) program, latent class analyses were used to identify classes of ACEs exposure. General linear models assessed the risk of postpartum depression, and prenatal social support was examined as a mediator. RESULTS: Four distinct classes of ACE exposure were identified. On the Edinburgh Postnatal Depression scale, mothers who were classified in Classes 1-3 scored higher by 2.6-4.4 points compared with women in Class 0. ACE class was found to be indirectly associated with postpartum depression scores through prenatal social support. CONCLUSIONS: Identifying combinations of ACEs in an HV program has the potential to improve the characterization of ACEs among low-income perinatal women in the United States. Elucidating how these combinations contribute to the risk of postpartum depression has the potential to identify women at increased risk, which can help HV programs prioritize prevention efforts.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Experiências Adversas da Infância/psicologia , Maus-Tratos Infantis/psicologia , Depressão Pós-Parto/diagnóstico , Apoio Social , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Experiências Adversas da Infância/estatística & dados numéricos , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Estudos de Coortes , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Acontecimentos que Mudam a Vida , Período Pós-Parto , Cuidado Pré-Natal , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , Fatores Socioeconômicos , Inquéritos e Questionários
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