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1.
J Pediatr (Rio J) ; 101(1): 54-60, 2025.
Artículo en Inglés | MEDLINE | ID: mdl-39128828

RESUMEN

OBJECTIVE: When the expectant mother is faced with an unforeseen event during pregnancy, she may experience emotional fragility and depression. This study was carried out to test the association between the time of diagnosis of critical congenital heart disease (CCHD) and depressive symptoms in puerperal women. METHOD: A case-control study. All mothers answered a semi-structured questionnaire and the Edinburgh Postnatal Depression Scale (EPDS). Pearson's correlation and multiple linear regression analysis were used to determine factors associated with depression. RESULTS: 50 puerperal women, 23 cases and 27 controls. The proportion of puerperal depressive symptoms was 26.1 % among mothers of infants prenatally diagnosed with CCHD and 77.8 % among mothers of infants postnatally diagnosed (p = 0.001 [OR] 9.917; 95 % CI 2.703-36.379). Multiple linear regression analysis showed that the use of psychotropic drugs and time of diagnosis were significantly associated with puerperal depressive symptoms. CONCLUSION: Prenatal diagnosis of CCHD was associated with significantly lower levels of depressive symptoms.


Asunto(s)
Depresión Posparto , Cardiopatías Congénitas , Diagnóstico Prenatal , Humanos , Femenino , Cardiopatías Congénitas/psicología , Depresión Posparto/diagnóstico , Depresión Posparto/psicología , Adulto , Embarazo , Diagnóstico Prenatal/métodos , Estudios de Casos y Controles , Adulto Joven , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Encuestas y Cuestionarios
2.
Rev. Ciênc. Plur ; 10(3): 37077, 23 dez. 2024. ilus, tab
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1584972

RESUMEN

Introdução: O puerpério constitui um momento de fragilidade na saúde da mulher e, quando associado com a menor assistência nos cuidados pós parto do que na gestação, contribuem para um período com morbimortalidade materna significativa, exigindo dessa forma a necessidade de atendimentos no cuidado pós-parto para atender às preocupações da paciente.Objetivo: Reunir a luz da literatura os fatores envolvidos na depressão pós-parto e discutir de que modo o estado lida com essa situação.Metodologia: Trata-se de um estudo do tipo revisão integrativa de literatura. A busca foi realizada a partir dos descritores e o operador booleano "AND": "Transtornos Puerperais" AND "Fatores Sociais" AND "Ajuste Emocional" e seus correspondentes em inglês nas bases de dados da BVS e Pubmed.Resultados e discussão: O estudo contou com 19 artigos, sendo 100% encontrados na base de dados BVS. Dentre as causas mencionadas nos estudos estão aquelas com etiologia relacionada a idade da mãe onde observa-se a diminuição da prevalência conforme o aumento da idade da mãe. Ademais, afalta de apoio, multiparidade, história pregressa de distúrbios psicológicos, desemprego, menor nível de escolaridade também constituifatores de risco para desenvolvimento da depressão pós parto. Conclusões: Considera-se o perfil de risco para o desenvolvimento de depressão pós-parto mulheres jovens, desamparadas, multíparas, com histórico de distúrbios psicológicos, desempregada e com baixa escolaridade constituindo dessa forma como fatores de risco para desenvolvimento da depressão pós-parto. Intensifica-se a necessidade do desenvolvimento de estratégias que permitam o rastreio precoce desses fatores (AU).


Introduction:The puerperium is a time of fragility in women's healthand, when combined with less assistance in postpartum care than during pregnancy, it contributes to a period of significant maternal morbidity and mortality, requiring postpartum care to address the patient's concerns. Objective:To compile the literatureabout the factors involved in postpartum depression and discuss how the state deals with this situation. Methodology:This is an integrative literature review. The search was carried out using the descriptors and the boolean operator "AND": "Puerperal Disorders" AND "Social Factors" AND "Emotional Adjustment" and their corresponding terms in English counterparts in the BVS and Pubmed databases. Results and discussion:The study included 19 articles, 100% of which were found in the BVS database. Among the causes mentioned in the studies are those with an etiology related to the mother's age, where there is a decrease in prevalence as the mother's age increases. In addition, lack of support, multiparity, previous history of psychological disorders, unemployment and lower levels of education are also risk factors for developing postpartum depression. Conclusions:The risk profile for developing postpartum depression is considered to be young, helpless, multiparous women, with ahistory of psychological disorders, unemployed, and with low levels of education, thus constituting risk factors for developing postpartum depression. There is a growing need to develop strategies that allow early screening of these factors (AU).


Introducción: El período posparto constituye un momento de fragilidad en la salud de la mujer y, cuando se asocia con menos asistencia en la atención posparto que durante el embarazo, contribuye a un período con importante morbilidad y mortalidad materna, requiriendo así la necesidad de asistencia en la atención posparto para abordar el parto. las preocupaciones del paciente.Objetivo: Recoger en la literatura los factores involucrados en la depresión posparto y discutir cómo el Estado aborda esta situación.Metodología:Se trata de un estudio de revisión integradora de la literatura. La búsqueda se realizó utilizando los descriptores y el operador booleano "AND": "Puerperal Disorders" AND "Social Factors" AND "Emotional Adjustment" y sus homólogos en inglés en las bases de datos Biblioteca Virtual en Salud (BVS) y Pubmed.Resultados y discusión:El estudio incluyó 19 artículos, el 100% de los cuales fueron encontrados en la base de datos de la BVS. Entre las causas mencionadas en los estudios se encuentran aquellas con una etiología relacionada con la edad de la madre, donde se observa una disminución de la prevalencia a medida que aumenta la edad de la madre. Además, la falta de apoyo, la multiparidad, la historia previa de trastornos psicológicos, el desempleo y el menor nivel educativo también constituyen factores de riesgo para el desarrollo de depresión posparto. Conclusiones: Se considera que el perfil de riesgo para el desarrollo de depresiónesel de mujeres jóvenes, indefensas, multíparas, con antecedentes de trastornos psicológicos, desempleadas y con bajo nivel educativo, constituyendo así factores de riesgo para el desarrollo de depresión posparto. Se intensifica la necesidad de desarrollar estrategias que permitan el cribado precoz de estos factores (AU).


Asunto(s)
Humanos , Femenino , Trastornos Puerperales/psicología , Depresión Posparto , Ajuste Emocional , Factores Sociales , Atención Posnatal , Política Pública , Factores de Riesgo , Salud de la Mujer
3.
Rev. méd. Maule ; 39(3): 21-28, dic. 2024. tab
Artículo en Español | LILACS | ID: biblio-1586512

RESUMEN

OBJECTIVE: To know the level of compliance with early attachment during the immediate postpartum period in mothers and newborns treated in the Prepartum Service of the Regional Hospital of Talca, during the period between January 2021 and December 2023. MATERIALS AND METHOD: An observational, descriptive and analytical, retrospective study was carried out. The population studied was the mother-newborn dyad; Clinical data of the mothers and newborns were collected from the digital database of the Hospital Prepartum Unit and the Electronic Clinical Record of the Maule Health System. The data were processed using the IBM SPSS Statistics v27 program. RESULTS: A total of 10,552 mother-child days were analyzed; cases of abortion (48), stillbirth (54) and lack of maternal information (22) were excluded. Maternal age varies between 13 and 58 years, with an average age of 29.1 years. There are "Attachment" and "Non-attachment" groups; the latter includes cases that had attachment for less than 30 minutes. 93.53% of the days engaged in attachment for more than 30 minutes and 6.46% did not engage in attachment; Among the main reasons is the hospitalization of the newborn in the neonatology service and serious maternal pathology. CONCLUSIONS: The percentage of early attachment in the immediate postpartum period was 93.52%, according to ministerial guidelines and close to the international figure. This good behavior should be promoted and the attachment period prolonged in cases where possible.


OBJETIVO: Conocer el nivel de cumplimiento de apego precoz durante el puerperio inmediato en madres y recién nacidos atendidos en el Servicio de Prepartos del Hospital Regional de Talca, durante el período entre enero de 2021 y diciembre de 2023. MATERIALES Y MÉTODOS: Se realizó un estudio observacional, descriptivo y analítico, retrospectivo. La población estudiada fue la diada madre-recién nacido; se recogieron datos clínicos de las madres y recién nacidos de la base de datos digital de la Unidad de Preparto del Hospital y la Ficha Clínica Electrónica del Sistema de Salud del Maule. Los datos fueron procesados con la utilización del programa IBM SPSS Statistics v27. RESULTADOS: Se analizaron un total de 10.552 diadas madre-hijo, se excluyeron los casos de aborto (48), mortinato (54) y falta de información materna (22). La edad materna varía entre los 13 y 58 años, con una edad media de 29.1 años. Se encuentran los grupos de "Apego" y "No apego", en este último incluye los casos que realizaron un apego menor a 30 minutos. Un 93.53% de las diadas realizó un apego mayor a 30 minutos y un 6.46% no realizó apego; entre las principales razones se encuentra la hospitalización del recién nacido en servicio de neonatología y patología materna grave. CONCLUSIONES: El porcentaje de apego precoz en puerperio inmediato fue de un 93.52%, de acuerdo con los lineamientos ministeriales y cercano a la cifra internacional. Se debe promover esta buena conducta y prolongar el período de apego en casos donde sea possible.


Asunto(s)
Humanos , Femenino , Embarazo , Adolescente , Adulto , Persona de Mediana Edad , Relaciones Materno-Fetales/psicología , Periodo Posparto , Patología , Atención Posnatal , Chile , Epidemiología Descriptiva , Hospitales Públicos
4.
Lima; Perú. Ministerio de Salud. Dirección General de Intervenciones Estratégicas en Salud Pública. Dirección de Salud Mental; 1 ed; Dic. 2024. 35 p. ilus.
Monografía en Español | MINSAPERÚ, LILACS, LIPECS | ID: biblio-1584418

RESUMEN

La presente publicación describe una propuesta de intervención grupal centrada en la adquisición de conocimientos y entrenamiento de habilidades bajo una metodología activa, reflexiva y transformadora para fortalecer las habilidades de crianza de madres, padres y/o cuidadores. Ser madre, padre o cuidador/a constituye una de las tareas más importantes en la vida de una persona, dado que, de su desempeño depende en gran medida el futuro que afectan el desarrollo psicosocial de las niñas, niños y adolescentes


Asunto(s)
Humanos , Embarazo , Niño , Adolescente , Niño , Responsabilidad Parental , Cuidadores , Atención Integral de Salud , Impacto Psicosocial , Poblaciones Vulnerables , Mujeres Embarazadas , Madres , Salud Mental
5.
PLoS One ; 19(11): e0313498, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39514618

RESUMEN

INTRODUCTION: Congenital transmission is one of the most significant forms of Trypanosoma cruzi transmission worldwide. Migrant women, in particular, often face barriers to accessing the healthcare system; one such barrier being that their health rights are not recognised. The situation in Chile is a reality that can be extrapolated to historical territories affected by Chagas disease and that is characterized by migrant populations. This article explores the healthcare experiences of pregnant and women living with Chagas disease, both nationals and migrants, and residents of three regions of Chile. METHODOLOGY: The qualitative research study analyzed the experiences and meanings around the problem of Chagas based on 54 in-depth interviews with women in pregnancy and women who were diagnosed with the disease. The information was processed following the Grounded Theory tenets through the constant encoding feedback procedure, which allowed us to describe and comprehensively understand the phenomenon. RESULTS: The findings indicate that managing information is a sensitive aspect in evaluating healthcare experiences, with the potential to either positively or negatively impact the acceptance of diagnosis and treatment planning. The negative impact is determined by the communicative dimension and how healthcare teams deliver information. Poor attention, poor treatment, and lack of empathy lead patients to reject or distance themseves from the healthcare system. The positive aspects are related to a sensitive, personalized, and highly empathetic treatment. In historically endemic areas, these factors are essential for ensuring continuity in healthcare processes. There is an evident need to understand and value the settings, means, and contents within Chagas´s healthcare contexts. CONCLUSION: Communication is crucial during diagnostic processes as it determines the assessment, credibility, and trust in the health system, thereby influencing the continuity of treatment, especially in highly sensitive moments such as pregnancy. Therefore, it is necessary to articulate strategies considering information magement with greater empathy and emotional support.


Asunto(s)
Enfermedad de Chagas , Accesibilidad a los Servicios de Salud , Humanos , Enfermedad de Chagas/epidemiología , Enfermedad de Chagas/psicología , Enfermedad de Chagas/transmisión , Femenino , Embarazo , Chile , Adulto , Investigación Cualitativa , Adulto Joven , Migrantes/psicología , Complicaciones Parasitarias del Embarazo/epidemiología , Complicaciones Parasitarias del Embarazo/psicología
6.
BMC Pregnancy Childbirth ; 24(1): 779, 2024 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-39587543

RESUMEN

INTRODUCTION: There are grounds for the hypothesis that poor sleep quality, regardless of the pre-gestational nutritional status, is a risk factor for inadequate gestational weight gain. OBJECTIVE: To investigate the association between sleep quality and insufficient or excessive gestational weight gain in Brazilian pregnant women without gestational complications and monitored in public prenatal care units. METHODS: This is a cross-sectional study nested within a cohort study that reviewed pregnant women's mental health, sleep, and nutritional outcome. Data collection was carried out from May 2018 to June 2019 through face-to-face and telephone interviews and consultation of pregnant women's medical records. Sleep quality was assessed using the Mini-sleep Questionnaire. The pregnancy weight gain was measured based on the Institute of Medicine's recommendations. Univariate and multivariate Poisson regression analysis was used for the two outcomes: insufficient or excessive weight gain, using pregnant women with adequate weight gain as the reference category. Associations were considered significant when p < 0.05. RESULTS: The prevalence of severe sleep disorders was high: 63.4% of pregnant women experienced this condition. Severe sleep disorders enhanced independently the risk of insufficient gestational weight gain (PR = 2.40; 95% CI = 1.06-5.42, p = 0.035). There was no association between sleep disorders and excessive gestational weight gain. CONCLUSION: The hypothesis that poor sleep quality influences gestational weight gain was confirmed. Severe sleep disorders, a highly prevalent condition, significantly increased the prevalence of insufficient gestational weight gain, yet it was not associated with excessive weight gain. Thus, educational actions should be included in the preconception and prenatal periods, in order to encourage the adoption of habits that favor sleep quality, an intervention that may have positive effects in reducing insufficient gestational weight gain.


Asunto(s)
Ganancia de Peso Gestacional , Complicaciones del Embarazo , Calidad del Sueño , Trastornos del Sueño-Vigilia , Humanos , Femenino , Embarazo , Estudios Transversales , Adulto , Brasil/epidemiología , Trastornos del Sueño-Vigilia/epidemiología , Complicaciones del Embarazo/epidemiología , Adulto Joven , Factores de Riesgo , Prevalencia , Estudios de Cohortes , Encuestas y Cuestionarios
7.
Lima; Perú. Ministerio de Salud. Dirección General de Intervenciones Estratégicas en Salud Pública. Dirección de Salud Mental; 1 ed; Nov. 2024. 57 p. ilus.
Monografía en Español | MINSAPERÚ, LILACS, LIPECS | ID: biblio-1579022

RESUMEN

La presente publicación describe las disposiciones técnicas y procedimientos para el cuidado y el autocuidado de la salud mental de gestantes y madres de niñas y niños menores de 5 años, con la finalidad de contribuir a la respuesta del sistema de salud de atención integral de la salud mental de la población, pacientes y sus familiares, así como de la población en situación de vulnerabilidad y mejora de su calidad de vida.


Asunto(s)
Humanos , Femenino , Embarazo , Niño , Niveles de Atención de Salud , Niño , Tamizaje Neonatal , Atención Integral de Salud , Técnicas y Procedimientos Diagnósticos , Poblaciones Vulnerables , Mujeres Embarazadas , Intervención Psicosocial , Madres , Salud Mental
8.
Br J Nutr ; 132(8): 1052-1064, 2024 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-39417343

RESUMEN

The present study investigated the relationships between maternal characteristics and subjective well-being (life satisfaction and optimism) among overweight Brazilian adult pregnant women. A cross-sectional study utilising baseline data from a randomised controlled clinical trial was conducted. A total of 330 women were investigated. Maternal characteristics (sociodemographic, obstetric and lifestyle) were obtained through a structured questionnaire. Data on dietary intake were collected through two 24-h dietary recalls, and the usual diet was estimated using the Multiple Source Method. Life satisfaction and optimism were assessed using validated instruments. Both unadjusted and adjusted linear regression models were employed to investigate the relationship between maternal characteristics and subjective well-being. Sleep quality was found to be positively associated with life satisfaction. Miscarriage and smoking during pregnancy were negatively associated with this sentiment. Additionally, a positive association was observed between optimism and maternal characteristics such as sleep quality, desired pregnancy and alcohol consumption in the previous 30 d. Furthermore, it was found that the consumption of sugary drinks, dietary fibre and Ca were positively associated with this same feeling. The present study showed that some maternal and food consumption characteristics were associated with subjective well-being among overweight pregnant women. It is, therefore, essential to recognise predictors of maternal mental health given their relevance to the field of public health.


Asunto(s)
Dieta , Estilo de Vida , Sobrepeso , Satisfacción Personal , Humanos , Femenino , Embarazo , Adulto , Sobrepeso/psicología , Estudios Transversales , Brasil , Optimismo/psicología , Adulto Joven , Factores Socioeconómicos , Calidad del Sueño , Encuestas y Cuestionarios , Fibras de la Dieta/administración & dosificación , Complicaciones del Embarazo/psicología , Conducta Alimentaria/psicología
9.
BMC Pregnancy Childbirth ; 24(1): 578, 2024 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-39227798

RESUMEN

BACKGROUND: Risk perception varies greatly among individuals, affecting their behavior and decision-making in risky situations. The COVID-19 pandemic affected worldwide, but the role of risk perception related to COVID-19 in ethnic minorities in Mexico is unclear. This study quantifies the impact of COVID-related risk perception (susceptibility and severity) and perceived fear on the utilization of antenatal care services among indigenous women in San Cristobal de las Casas, Chiapas, Mexico. METHODS: We conducted a retrospective crossover study between June and December 2021, interviewing 98 women from San Cristóbal de las Casas, Chiapas. In a crossover design, each subject acts as their own control, so we required the participants to have a previous pregnancy experience. A logistic model was used to calculate the odds ratio for the outcome of having an adequate number of antenatal care visits. The analysis considered the period (during or before the pandemic) as well as perceived severity and susceptibility levels as independent variables. RESULTS: COVID-19 reduced antenatal care utilization by 50%. During the pandemic, the adjusted odds ratio for attending health antenatal care services was 0.83 (95% CI: 4.8, 14.5) compared to pre pandemics. Adjusted for fear of contagion, the mother's perception of severity was associated with an increased likelihood of an insufficient number of antenatal visits. OR = 0.25 (95% CI: 0.10, 0.65). CONCLUSION: The risk perception for COVID-19 decreased the likelihood of receiving an adequate number of antenatal care visits.


Asunto(s)
COVID-19 , Aceptación de la Atención de Salud , Atención Prenatal , SARS-CoV-2 , Humanos , Femenino , COVID-19/psicología , COVID-19/epidemiología , Atención Prenatal/estadística & datos numéricos , Atención Prenatal/psicología , Embarazo , Adulto , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/psicología , México/etnología , Estudios Retrospectivos , Pueblos Indígenas/psicología , Pueblos Indígenas/estadística & datos numéricos , Estudios Cruzados , Adulto Joven , Percepción , Miedo/psicología , Medición de Riesgo
10.
Nutrients ; 16(17)2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39275305

RESUMEN

Food insecurity (FI) is a critical issue in developing countries, particularly in low-resource settings, where it can worsen women's mental health. Psychosocial factors such as low household income, limited education, multiparity, and vulnerability are linked to depressive symptoms during pregnancy. Additionally, the family environment influences parental practices, which may impact mental health. This study evaluates the association of socioeconomic factors, parental practices, FI risk, and home visit frequency with depressive symptoms in pregnant women enrolled in the Happy Child Program (Programa Criança Feliz-PCF) in the Federal District, Brazil. In this cross-sectional study, 132 pregnant women monitored by PCF from May to July 2023 were assessed using a self-administered questionnaire for socioeconomic data, the two-item Triage for Food Insecurity (TRIA) instrument for FI risk, the Scale of Parental Beliefs and Early Childhood Care Practices, and the Beck Depression Inventory-II for depressive symptoms. Most participants were multiparous (87.9%), had low income (under 200 USD/month; 80.8%), presented depressive symptoms (67.4%) and were at risk of FI (81.8%). About half demonstrated adequate parental practices (50.8%) and received four home visits per month during pregnancy (54.5%). Women who received four PCF home visits had a lower prevalence of depressive symptoms compared to those with fewer visits (PR 0.76, 95% CI 0.59-0.98). No significant association was found between FI or parental practices and depressive symptoms. These findings suggest that the PCF home-visiting program may strengthen vulnerable families, support social networks, and improve mental health during pregnancy. Additionally, the results of this study highlight the need for targeted interventions aimed at reducing food insecurity and promoting mental health during pregnancy, particularly among socially vulnerable populations. Furthermore, they reinforce the importance of expanding access to home-visiting programs as an effective strategy to improve maternal mental health and well-being, while fostering healthier prenatal environments for both mothers and their children.


Asunto(s)
Depresión , Inseguridad Alimentaria , Visita Domiciliaria , Humanos , Femenino , Embarazo , Depresión/epidemiología , Brasil/epidemiología , Adulto , Estudios Transversales , Factores Socioeconómicos , Atención Prenatal , Adulto Joven , Encuestas y Cuestionarios , Responsabilidad Parental/psicología
11.
P R Health Sci J ; 43(3): 151-155, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39269767

RESUMEN

The recent COVID-19 global emergency may have ripple effects on mental health of many people worldwide. This is especially true for populations like birthing and postpartum women where many changes to daily routines, access to medical care, work-related routines and socialization were experienced. This brief report presents data from an ongoing cohort study aiming to describe maternal mental health during the pandemic T12 (March 2020 to April 2021) with post-pandemic T2 (May 2022 to May 2023) of mothers followed in Puerto Rico. 47 out of 100 mothers have been recalled and assessed with psychosocial interviews (COPE-IUS) and assessments of anxiety (GAD-7) and depression (PHQ-9). Paired t-test revealed mean scores of depressions (PHQ-9) were significantly higher for T2 with a mean of 6.35 and a range of 4.4+/- than for T1 where mean was 5.15 (+/- 2.9), t=-1.954, df=45, p < .05. Similarly, anxiety scores (GAD-7) were significantly higher in T2 6.67 (4.2) than for T1 5.35 (3.7), t=-1.8, df=45, p < .05. Also, COPE-IUS Post-pandemic psychosocial interview results evidence that 80% of mothers do not feel the COVID-19 pandemic is a significant stressor at T2 and are able to maintain routine activities with no social distancing measures. However, reports of loneliness, sadness, worry, and fear continue to be present. Our findings point to the need to further identify other contributing factors to the deterioration of maternal mental health during the perinatal/peripartum period (pregnancy, birth, and postpartum) in Puerto Rico. Possibly the effects of repeated adversity that has been present in the island (multiple environmental stressors, history of traumatic experiences, and constant hardships) may all have cumulative impact over maternal mental health during the perinatal/peripartum period.


Asunto(s)
Ansiedad , COVID-19 , Hispánicos o Latinos , Salud Mental , Humanos , Femenino , COVID-19/psicología , COVID-19/epidemiología , Puerto Rico , Hispánicos o Latinos/psicología , Adulto , Estudios de Cohortes , Ansiedad/epidemiología , Madres/psicología , Adulto Joven , Depresión/epidemiología , Embarazo , Salud Materna , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Periodo Posparto/psicología
12.
Clinics (Sao Paulo) ; 79: 100501, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39277982

RESUMEN

INTRODUCTION: Considering the relationship between Gestational Diabetes Mellitus and maternal and perinatal adverse outcomes, it's pertinent to investigate whether this diagnosis is a predictor of fear of childbirth. As there is little data about the fear of childbirth in Brazil, it´s necessary to understand better the population, and this way the authors can identify factors that influence this fear as well as propose public health policies to treat it. OBJECTIVE: The main goal was to compare the prevalence of fear of childbirth between the groups of low-risk pregnancy and gestational diabetes mellitus. MATERIAL AND METHODS: In this cohort study, the sample consisted of 319 patients divided into low-risk pregnancy group (n = 152) and gestational diabetes mellitus group (n = 167). Patients have undergone a semi-structured interview with epidemiological, obstetric, and anthropometric data and the main cause of fear of childbirth. In addition, the patients have marked an "X" on the scale into the Fear of Birth Scale to describe their fear. After delivery, data have been collected through electronic medical records. RESULTS: The prevalence of fear of childbirth found was higher for the gestational diabetes mellitus group (46.05%) compared to the low-risk pregnancy group (34.73%) with a cutoff score ≥ 54. In the whole sample, the main cause of fear of childbirth (score ≥ 60) was the pain of labor and delivery (31.58%). CONCLUSIONS: The prevalence of fear of childbirth in the present study was greater than 30%, highlighting the relevance of implementing this assessment during prenatal care.


Asunto(s)
Diabetes Gestacional , Miedo , Parto , Humanos , Diabetes Gestacional/psicología , Embarazo , Femenino , Miedo/psicología , Adulto , Parto/psicología , Brasil/epidemiología , Adulto Joven , Factores de Riesgo , Estudios de Cohortes , Prevalencia , Factores Socioeconómicos , Encuestas y Cuestionarios
13.
Soc Sci Med ; 360: 117351, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39303534

RESUMEN

Increasing epidemiological evidence demonstrates the correlation between toxic contamination and miscarriages, and the disproportionate exposure of marginalised and racialised groups to environmental burdens. Yet, the debate on environmental reproductive health is still largely underpinned by a reductionist biomedical understanding of the health-place relationship that overlooks the interplay between social identities and places. In this article, I argue that understanding the role that places play in shaping reproductive inequalities, beyond the simplistic recognition of the environment as a factor of risk, is important to design a more inclusive reproductive health agenda that addresses the multiple scales across which reproductive inequalities unfold. These scales span from everyday experiences of reproduction to state-level models of reproductive governance. Drawing on 13 months of fieldwork in coca-farming territories in the Bajo Cauca region (Colombia), the aim of this paper is to conceptualise the reproductive geographies of miscarriages related to toxic contamination. This article contributes to debates on reproductive inequalities by discussing the complex and dynamic relationship between social identities and places, and theorising the spatiality of miscarriages.


Asunto(s)
Aborto Espontáneo , Identificación Social , Humanos , Femenino , Aborto Espontáneo/epidemiología , Aborto Espontáneo/psicología , Embarazo , Colombia/epidemiología , Disparidades en el Estado de Salud , Factores Socioeconómicos
14.
Rev Bras Enferm ; 77Suppl 2(Suppl 2): e20240090, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-39230097

RESUMEN

OBJECTIVES: to understand nurse perspectives regarding homeless pregnant women's accessibility to prenatal care. METHODS: a qualitative study, with analysis based on the concept of accessibility. Semi-structured interviews were carried out with 11 nurses who work at the Street Outreach Office in northern Brazil. RESULTS: nurses are faced with geographic barriers and dangerous situations in border regions, recognizing that there is a context of physical, sexual and psychological violence that involves homeless pregnant women who seek care at the Street Outreach Office. Street Outreach Office nurses' work occurs in conjunction with other services in the Health Care Network. The implementation of educational measures is a powerful strategy, as is establishing links with women. FINAL CONSIDERATIONS: the Street Outreach Office's work provides meetings with pregnant women on site in the territory, which can provide geographic and socio-organizational accessibility to prenatal care.


Asunto(s)
Accesibilidad a los Servicios de Salud , Enfermeras y Enfermeros , Atención Prenatal , Investigación Cualitativa , Humanos , Brasil , Atención Prenatal/métodos , Atención Prenatal/normas , Femenino , Accesibilidad a los Servicios de Salud/normas , Embarazo , Adulto , Enfermeras y Enfermeros/psicología , Enfermeras y Enfermeros/estadística & datos numéricos , Percepción , Personas con Mala Vivienda/psicología , Personas con Mala Vivienda/estadística & datos numéricos , Entrevistas como Asunto/métodos
15.
Cad Saude Publica ; 40(8): e00008024, 2024.
Artículo en Portugués | MEDLINE | ID: mdl-39292131

RESUMEN

This study aimed to analyze the relationship between disrespect and abuse during labor and the risk of postpartum depression. This is a cross-sectional study carried out with women from the rural and urban areas of Caxias, Maranhão State, Brazil. Postpartum depression was considered the dependent variable, assessed using the Edinburgh Postnatal Depression Scale. The independent variables were sociodemographic characteristics, mental health history, behavioral aspects, obstetric characteristics and self-perception of disrespect and abuse during labor. Pearson's chi-square test and multiple logistic regression were used to assess the association between postpartum depression and disrespect and abuse during labor. A total of 190 women were interviewed. The prevalence of postpartum depression was 16.3%. The occurrence of at least one type of disrespect and abuse during labor was 97.4%, with health system conditions and restrictions predominating (94.7%). More than half of the women (66.3%) suffered two forms of disrespect and abuse during labor, while three or more forms were reported by 22.6%. Suffering two (adjustedOR = 3.01; 95%CI 1.08-8.33) and three or more forms of disrespect and abuse during labor (adjustedOR = 3.41; 95%CI: 1.68-24.40) increased the chance of postpartum depression. There was a significant association between disrespect and abuse during labor and postpartum depression, and dignified and respectful care for women during childbirth were found to reduce the risk of postpartum depression symptoms.


O objetivo deste estudo é analisar a relação entre desrespeito e abuso durante o parto e o risco de depressão pós-parto. Trata-se de estudo transversal, realizado com mulheres das zonas rural e urbana de Caxias, Maranhão, Brasil. Considerou-se a depressão pós-parto como variável dependente, avaliada pela Escala de Depressão Pós-Natal de Edimburgo. As variáveis independentes foram características sociodemográficas, antecedentes de saúde mental, aspectos comportamentais, características obstétricas e autopercepção do desrespeito e abuso durante o parto. Empregou-se o teste do qui-quadrado de Pearson e a regressão logística múltipla para avaliar a associação entre depressão pós-parto e desrespeito e abuso durante o parto. Foram entrevistadas 190 mulheres. A depressão pós-parto apresentou prevalência de 16,3%. A ocorrência de pelo menos um tipo de desrespeito e abuso durante o parto foi de 97,4%, com predomínio das condições do sistema de saúde e restrições (94,7%). Mais da metade das mulheres (66,3%) foram submetidas a dois tipos de desrespeito e abuso durante o parto, enquanto três ou mais formas foram relatadas por 22,6%. Sofrer duas (ORajustada = 3,01; IC95%: 1,08-8,33) e três ou mais formas de desrespeito e abuso durante o parto (ORajustada = 3,41; IC95%: 1,68-24,40) aumentou a chance da ocorrência de depressão pós-parto. Houve associação significativa entre desrespeito e abuso durante o parto e depressão pós-parto, e o atendimento digno e respeitoso às mulheres durante o parto pode reduzir os riscos da sintomatologia de depressão pós-parto.


El objetivo de este estudio fue analizar la relación entre la falta de respeto y el abuso durante el parto y el riesgo de depresión posparto. Se trata de un estudio transversal, realizado con mujeres de la zona rural y urbana de Caxias, Maranhão, Brasil. La depresión posparto fue considerada como una variable dependiente, evaluada por la Escala de Depresión Posnatal de Edimburgo. Las variables independientes fueron características sociodemográficas, antecedentes de salud mental, aspectos comportamentales, características obstétricas y autopercepción de falta de respeto y el abuso durante el parto. Se empleó la prueba de chi-cuadrado de Pearson y la regresión logística múltiple para evaluar la asociación entre depresión posparto y falta de respeto y el abuso durante el parto. Se entrevistó a 190 mujeres. La depresión posparto tuvo una prevalencia del 16,3%. La ocurrencia de al menos un tipo de falta de respeto y el abuso durante el parto fue del 97,4%, con predominio de las condiciones del sistema de salud y restricciones (94,7%). Más de la mitad de las mujeres (66,3%) padecieron dos tipos de falta de respeto y el abuso durante el parto, mientras que tres o más formas fueron referidas por el 22,6%. Sufrir dos (ORajustado = 3,01; IC95%: 1,08-8,33) y tres o más formas de falta de respeto y el abuso durante el parto (ORajustado = 3,41; IC95%: 1,68-24,40) aumentó la posibilidad de que se produjera depresión posparto. Hubo una asociación significativa entre falta de respeto y el abuso durante el parto y depresión posparto, y una atención digna y respetuosa a las mujeres durante el parto puede reducir los riesgos de los síntomas de depresión posparto.


Asunto(s)
Depresión Posparto , Factores Socioeconómicos , Humanos , Femenino , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Depresión Posparto/etiología , Estudios Transversales , Adulto , Brasil/epidemiología , Embarazo , Adulto Joven , Factores de Riesgo , Relaciones Profesional-Paciente , Prevalencia , Adolescente , Trabajo de Parto/psicología , Población Urbana , Población Rural/estadística & datos numéricos
16.
Arq. ciências saúde UNIPAR ; 28(2): 48-62, 20240000.
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1572321

RESUMEN

Apesar de ser uma complicação recorrente em gestações, o abortamento pode gerar consequências bastante danosas à saúde física e mental da gestante, bem como de seu parceiro, especialmente em casos de abortamento recorrente. Este trabalho objetivou revisar as principais características epidemiológicas e fatores de risco descritos em relação ao abortamento recorrente. A respeito da metodologia, foi realizada uma revisão sistemática da bibliografia, tendo como foco os trabalhos que possuíssem os descritores "aborto", "recorrente" e "epidemiologia". Os artigos selecionados foram publicados entre os anos de 2016 e 2023, em português ou inglês. Em nossa pesquisa, observamos que a etiologia dos abortamentos é bastante diversa, incluindo fatores desconhecidos. É válido ressaltar que quanto maior o número de abortos espontâneos recorrentes antecedentes, maior parece ser a chance de nova perda de gestação. Não obstante, existem diferenças regionais determinantes para as etiologias e fatores de risco, sendo necessário compreender qual a causa do abortamento recorrente para que haja tratamento efetivo.


Despite being a recurrent complication in pregnancies, abortions can lead to harmful consequences for the physical and psychological health of the pregnant woman, as well as her partner's, especially in cases of recurrent miscarriage. This article aimed to review the main epidemiological characteristics and risk factors described in relation to recurrent miscarriage. About the methodology, it was developed a systematic review of pre-existing bibliography, focusing on papers that had the descriptors "abortion", "recurrent" and "epidemiology". The selected works were published between the years of 2016 and 2023, in Portuguese or English. In our research, we noticed that the etiology of miscarriages is quite diverse, including unknown factors. It is important to note that the higher the historical number of recurrent spontaneous miscarriages, the greater seems to be the chance of new pregnancy loss. However, there are regional differences that determine etiologies and risk factors. It is essential to understand what is causing the recurrent miscarriage in order to offer effective treatment.


A pesar de ser una complicación recurrente en los embarazos, el aborto puede tener consecuencias perjudiciales para la salud física y mental de la mujer embarazada, así como para su pareja, especialmente en casos de aborto recurrente. Este trabajo tuvo como objetivo revisar las principales características epidemiológicas y factores de riesgo descritos en relación con el aborto recurrente. En cuanto a la metodologia, se realizó una revisión sistemática de la bibliografía, centrándose en los trabajos que tenían los descriptores "aborto", "recurrente" y "epidemiología". Los artículos seleccionados se publicaron entre los años 2016 y 2023, en portugués o inglés. En nuestra investigación observamos que la etiología de los abortos es muy diversa, incluyendo factores desconocidos. Es válido destacar que a mayor número de abortos espontáneos recurrentes previos, parece aumentar la probabilidad de una nueva pérdida del embarazo. Sin embargo, existen diferencias regionales determinantes en las etiologías y factores de riesgo, siendo necesario comprender la causa del aborto recurrente para un tratamiento efectivo.

17.
Codas ; 36(5): e20230252, 2024.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-39109755

RESUMEN

PURPOSE: to verify the association between the perception of mothers of premature infants regarding the features that may interfere with breastfeeding and the mother's socioeconomic data, pregnancy and the baby's clinical data. METHODS: observational, descriptive and analytical quali-quantitative cross-sectional study. One hundred and fourteen mothers of premature infants were included and data were collected through questionnaires, applied at hospital discharge, and analysis of medical records. Maternal responses about the interference observed in the breastfeeding process were categorized by content analysis and associated with socioeconomic, pregnancy and baby data. RESULTS: the mothers' perceptions regarding the factors that interfere with the baby's feeding at the mother's breast were divided into four semantic categories: clinical and/or physical conditions of the baby; clinical, physical and/or psycho-emotional conditions of the mother; support network; and strategies for initiating and/or maintaining breastfeeding. Education, paternal presence, having other children and having breastfed them were associated with the maternal perception that their clinical, physical and/or psycho-emotional conditions interfere with breastfeeding. In addition, the support network was associated with exclusive breastfeeding at discharge. CONCLUSION: education, paternal presence, multiparity and having breastfed previous children influenced the maternal perception that their clinical, physical and/or psycho-emotional conditions interfere with breastfeeding. In addition, mention of the support network was associated with exclusive breastfeeding at discharge.


OBJETIVO: verificar a associação entre a percepção das mães de prematuros a respeito dos fatores que podem interferir no aleitamento e as características socioeconômicas da mãe, da gestação e clínicas do recém-nascido. MÉTODO: estudo qualiquantitativo observacional, descritivo e analítico do tipo transversal. Foram incluídas 114 mães de prematuros. Os dados foram coletados por meio de questionários, aplicados à alta hospitalar e análise dos prontuários. As respostas maternas sobre as interferências observadas no processo do aleitamento foram categorizadas por análise de conteúdo e associadas aos dados socioeconômicos, da gestação e do recém-nascido (RN). RESULTADOS: as percepções das mães quanto aos fatores que interferem na alimentação do RN ao seio materno foram divididas em quatro categorias semânticas: condições clínicas e/ou físicas do RN; condições clínicas, físicas e/ou psicoemocionais da mãe; rede de apoio; e estratégias para iniciar e/ou manter o aleitamento materno. Escolaridade, presença paterna, possuir outros filhos e tê-los amamentado apresentaram associação com a percepção materna de que suas condições clínicas, físicas e ou psicoemocionais interferem no aleitamento. Além disso, a rede de apoio esteve associada ao aleitamento materno exclusivo à alta. CONCLUSÃO: escolaridade, presença paterna, multiparidade e ter amamentado filhos anteriores influenciaram a percepção materna de que suas condições clínicas, físicas e ou psicoemocionais apresentam interferência no aleitamento. Além disso, a menção à rede de apoio esteve associada com o aleitamento materno exclusivo à alta.


Asunto(s)
Lactancia Materna , Recien Nacido Prematuro , Madres , Factores Socioeconómicos , Humanos , Lactancia Materna/psicología , Femenino , Estudios Transversales , Recién Nacido , Madres/psicología , Adulto , Encuestas y Cuestionarios , Percepción , Adulto Joven , Embarazo , Masculino
18.
Cien Saude Colet ; 29(8): e05502024, 2024 Aug.
Artículo en Español, Inglés | MEDLINE | ID: mdl-39140538

RESUMEN

This is a qualitative study that explores the perspectives and experiences of a group of Mexican women who experienced institutionalized childbirth care in the first and second waves of the COVID-19 pandemic. Through a semi-structured script, nine women who experienced childbirth care were interviewed between March and October 2020 in public and private hospitals in the city of San Luis Potosí, Mexico. Under the Grounded Theory analysis proposal, it was identified that the health strategies implemented during the pandemic brought with them a setback in the guarantee of humanized childbirth. Women described themselves as distrustful of the protocols that personnel followed to attend to their births in public sector hospitals and very confident in those implemented in the private sector. The intervention of cesarean sections without a clear justification emerged as a constant, as did early dyad separation. Healthcare personnel's and institutions' willingness and conviction to guarantee, protect and defend the right of women to experience childbirth free of violence remain fragile. Resistance persists to rethink childbirth care from a non-biomedicalizing paradigm.


Estudio de tipo cualitativo que explora las perspectivas y experiencias de un grupo de mujeres mexicanas que vivieron la atención institucionalizada del parto en la primera y segunda ola de la pandemia por COVID-19. A través de un guión semiestructurado se entrevistó a nueve mujeres que vivieron la experiencia de la atención del parto entre marzo y octubre de 2020, en hospitales públicos y privados de la ciudad de San Luis Potosí, en México. Bajo la propuesta de análisis de la teoría fundamentada, se identificó que las estrategias sanitarias implementadas en el marco de la pandemia, trajeron consigo un retroceso en la garantía del parto humanizado, las mujeres se narraron desconfiadas en los protocolos que siguió el personal para la atención de sus partos en los hospitales del sector público y muy confiadas en los que se implementaron en el sector privado. La realización de cesáreas sin una justificación clara emergió como una constante, igual que la separación temprana de los binomios. Continúa frágil la disposición y el convencimiento del personal sanitario y las instituciones para garantizar, proteger y defender el derecho de las mujeres a vivir el parto libre de violencia. Persisten resistencias para repensar la atención del parto desde un paradigma no biomédicalizante.


Asunto(s)
COVID-19 , Hospitales Públicos , Investigación Cualitativa , Humanos , México , Femenino , COVID-19/epidemiología , Embarazo , Adulto , Parto Obstétrico , Hospitales Privados , Entrevistas como Asunto , Cesárea/estadística & datos numéricos , Parto/psicología , Servicios de Salud Materna/normas , Servicios de Salud Materna/organización & administración , Teoría Fundamentada , Adulto Joven
19.
Nutrients ; 16(16)2024 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-39203870

RESUMEN

The aim of this study was to explore maternity care providers' knowledge, attitudes, and perceptions about the use of calcium supplements during pregnancy for the prevention of preeclampsia in three hospitals from Metropolitan Buenos Aires, Argentina. We conducted semi-structured interviews and followed a thematic analysis framework. Maternity care providers' knowledge, attitudes, and practices regarding calcium supplementation during pregnancy are linked to barriers to the potential implementation of calcium supplementation. Free provision of calcium supplements by the government, coupled with training that reinforces the scientific evidence supporting their use to prevent preeclampsia, along with documented recommendations from credible sources, would be crucial to ensure that health providers adopt the use of calcium supplements in antenatal care. Future studies should assess pregnant women and policymakers' perceptions about calcium supplementation during pregnancy, as well as local infrastructure to provide access to free-of-charge calcium supplements in antenatal care settings. Economic evaluation with local information could inform policymakers and advocate for the implementation of strategies to reduce preeclampsia.


Asunto(s)
Suplementos Dietéticos , Conocimientos, Actitudes y Práctica en Salud , Hospitales Públicos , Preeclampsia , Atención Prenatal , Investigación Cualitativa , Humanos , Embarazo , Femenino , Argentina , Atención Prenatal/métodos , Preeclampsia/prevención & control , Adulto , Actitud del Personal de Salud , Personal de Salud/psicología , Calcio de la Dieta/administración & dosificación , Calcio/administración & dosificación , Masculino
20.
Midwifery ; 138: 104130, 2024 11.
Artículo en Inglés | MEDLINE | ID: mdl-39137539

RESUMEN

OBJECTIVE: to identify the perception of professional empowerment among midwives in selected Latin American countries (LA). Specifically, this study aimed to compare i) the global level of empowerment among midwives in different LA countries, ii) the scores according to the different dimensions of the scale, and iii) scores according to area the of expertise. DESIGN: A quantitative, observational, analytical, cross-sectional and multisite study using an adaptation of the Perceptions Midwifery Empowerment Scale (PEMS). SETTINGS: Clinical, educational and managerial midwifery positions in 5 LA countries belonging to a Latin American Research Network in Midwifery. All the participating countries reported a similar profile regarding type of education, association and regulation procedures. PARTICIPANTS: A total of 1127 responses from midwives with different professional backgrounds were included in the study. FINDINGS: A total mean score of 73.28 (74.23-72.03) points was reported. Chile reported the lowest score of empowerment compared to the other countries, while Argentina reported the highest. Midwives' perceptions of empowerment within their area of expertise, primary health care (PHC) was the area of reference, and gynaecology reported a significantly lower score. Midwives working in management were significantly more empowered compared with those in other areas. Midwives who had continuous education and postgraduate studies were the most empowered. Regarding the provision of woman-centred Care, Chile and El Salvador differed significantly from Argentina (reference), while Uruguay reported a significantly higher score in this dimension. Midwives working in hospital wards reported significantly lower scores compared to those working in PHC. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This study suggests that midwifery programmes in the LA countries would benefit from prioritising professional empowerment, especially in the areas of hospital practice, where midwives' perceptions of empowerment were most limited.


Asunto(s)
Empoderamiento , Enfermeras Obstetrices , Humanos , Estudios Transversales , Adulto , Femenino , Enfermeras Obstetrices/psicología , Enfermeras Obstetrices/estadística & datos numéricos , Encuestas y Cuestionarios , Persona de Mediana Edad , América Latina , Partería/métodos , Partería/normas , Embarazo
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