Depressão durante a gestação: um estudo sobre a associação entre fatores de risco e de apoio social entre gestantes

Thiengo, Daianna Lima; Santos, Jacqueline Fernandes de Cintra; Fonseca, Diego Lima; Abelha, Lúcia; Lovisi, Giovanni Marcos

Resumos

A ausência de apoio social e outros fatores podem tornar gestantes mais suscetíveis à ocorrência de transtornos mentais como a depressão. O objetivo deste estudo foi investigar a associação entre apoio social percebido e prevalência de depressão em gestantes atendidas em uma unidade básica de saúde de Nova Iguaçu, Rio de Janeiro. Participaram dele 100 gestantes, das quais foram verificadas as características sociodemográficas, condições médicas/obstétricas, eventos estressantes e apoio social. A depressão foi avaliada pela Composite International Diagnostic Interview. A prevalência da depressão na gravidez foi 18% (IC95% 12,2-23,8), sendo os fatores associados na análise final: estar solteira, desempregada, possuir história anterior de depressão e tabagismo. Houve relação entre a falta de apoio social e a depressão na análise inicial (p<0,05). A ausência de apoio de informação e interação durante o período pré-natal, e sua associação inicial com a depressão, evidencia a fragilidade do serviço de saúde no atendimento integral às gestantes. Nossos resultados demonstram que intervenções psicossociais e políticas sociais deveriam ser implementadas para esta população.

gravidez; apoio social; fatores de risco; depressão

Lack of social support and other factors can cause pregnant more susceptible to mental disorders such as depression. The aim of this study was to investigate the association between perceived social support and prevalence of depression in pregnant attended in a primary care unit of Nova Iguaçu, Rio de Janeiro. The study included 100 women and verified the sociodemographic characteristics, obstetric and medical complications, stressful life events and social support. Depression was evaluated using the Composite International Diagnostic Interview. The prevalence of depression during pregnancy was 18% (95%CI 12.2-23.8), and the associated factors in the final analysis were: being single, unemployed, with a prior history of depression and smoking. In the initial analysis, there was significant association (p<0.05) between lack of social support and depression. The absence of information and social interaction during the prenatal period, and its initial association with depression, shows the failings of the full health care services for pregnant. Our findings show that psychosocial interactions and social policies should be implemented for this population.

pregnancy; social support; risk factors; depression

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²
Barrón A. Apoyo social. Aspectos teóricos y aplicaciones. Madrid: Siglo Veinteuno, 1996.
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Mitsuhiro SS, Chalem E, Barros MM, Guinsburg R, Laranjeira R. Teenage pregnancy: use of drugs in the third trimester and prevalence of psychiatric disorders. Rev Bras Psiquiatr. 2006:28(2):122-5.
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Matsukura TS, Marturano EM, Oishi J. O questionário de suporte social (SSQ): estudos de adaptação para o português. Rev Latino-Am Enfermagem. 2002;10(5):675-81.
¹⁰
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¹¹
Camacho RS, Cantinelli FS, Ribeiro CS, Cantilino A, Gonsales BK, Braguittoni E,Rennó Jr J. Transtornos psiquiátricos na gestação e no puerpério: classificação, diagnóstico e tratamento. Rev Psiquiatr Clín. 2006;33(2):92-102.
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²⁸
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³¹
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Datas de Publicação

Publicação nesta coleção
15 Ago 2013
Data do Fascículo
2012

This work is licensed under a Creative Commons Attribution 4.0 International License.

[1] ¹
Langford CP, Bowsher J, Maloney JP, Lillis PP. Social support: a conceptual analysis. J Adv Nurs. 1997;25(1):95-100.

[2] ²
Barrón A. Apoyo social. Aspectos teóricos y aplicaciones. Madrid: Siglo Veinteuno, 1996.

[3] ³
Galanter M. Research on social supports and mental illness. Am J Psychiatry. 1988;145(10):1270-2

[4] ⁴
Olstad R, Sexton H, Sogaard AJ. The Finnmark Study. A prospective population study of the social support buffer hypothesis, specific stressors and mental distress. Soc Psychiatry Psychiatr Epidemiol. 2001;36(12):582-9.

[5] ⁵
Mitsuhiro SS, Chalem E, Barros MM, Guinsburg R, Laranjeira R. Teenage pregnancy: use of drugs in the third trimester and prevalence of psychiatric disorders. Rev Bras Psiquiatr. 2006:28(2):122-5.

[6] ⁶
Pierce GR, Sarason IG, Sarason BR, Joseph HJ, Henderson CA. Conceptualizing and assessing social support in the context of the family. In: Pierce GR, Sarason BR, Sarason IG, editors. Handbook of social support and the family. New York: Plenum Press; 1996. p. 3-23.

[7] ⁷
Wallston BS, Alagna SW, Devellis BM, Devellis RF. Social support and health. Health Psychology. 1983;2:367-91.

[8] ⁸
Geller PA. Pregnancy as a stressful life event. CNS Spectr. 2004;9(3):188-97.

[9] ⁹
Matsukura TS, Marturano EM, Oishi J. O questionário de suporte social (SSQ): estudos de adaptação para o português. Rev Latino-Am Enfermagem. 2002;10(5):675-81.

[10] ¹⁰
Dalgard OS, Haheim LL. Psychosocial risk factors and mortality: a prospective study with special focus on social support, social participation, and locus of control in Norway. J Epidemiol Community Health. 1998;52(8):476-81.

[11] ¹¹
Camacho RS, Cantinelli FS, Ribeiro CS, Cantilino A, Gonsales BK, Braguittoni E,Rennó Jr J. Transtornos psiquiátricos na gestação e no puerpério: classificação, diagnóstico e tratamento. Rev Psiquiatr Clín. 2006;33(2):92-102.

[12] ¹²
Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: sistematic review. Obstet Gynecol. 2004;103(4):698-709.

[13] ¹³
Faisal-Cury A, Menezes PR. Prevalence of anxiety and depression during pregnancy in a private setting sample. Arch Womens Ment Health. 2007;10(1):25-32.

[14] ¹⁴
Kitamura T, Yoshida K, Okano T, Kinoshita K, Hayashi M, Toyoda N, Ito M, Kudo N, Tada K, Kanazawa K, Sakumoto K, Satoh S, Furukawa T, Nakano H. Multicentre prospective study of perinatal depression in Japan: incidence and correlates of antenatal and postnatal depression. Arch Womens Ment Health. 2006;9(3):121-30.

[15] ¹⁵
Rubertsson C, Wickberg B, Gustavsson P, Radestad I. Depressive symptoms in early pregnancy, two months and one year portpartum-prevalence and psychosocial risk factors in a national Swedish sample. Arch Womens Ment Health. 2005;8(2):97-104.

[16] ¹⁶
Lovisi GM, López JR, Coutinho ES, Patel V. Poverty, violence and depression during pregnancy: a survey of mothers attending a public hospital in Brazil. Psychol Med. 2005;35(10):1485-92.

[17] ¹⁷
Heron J, O'Connor TG, Evans J, Golding J, Glover V, ALSPAC Study Team. The course of anxiety and depression trough pregnancy and the postpartum in a community sample. J Affect Disord. 2004;80(1):65-73.

[18] ¹⁸
Felice E, Saliba J, Grech V, Cox J. Prevalence rates and psychosocial characteristics associated with depression in pregnancy and postpartum in Maltese women. J Affect Disord. 2004;82(2):297-301.

[19] ¹⁹
Patel V, Rodrigues M, DeSouza N. Gender, poverty, and pPostnatal depression: a study of mothers in Goa, India. Am J Psychiatry. 2002;159(1):43-7.

[20] ²⁰
Freitas GVS, Botega NJ. Gravidez na adolescência: prevalência de depressão, ansiedade e ideação suicida. Rev Assoc Med Bras. 2002;48(3):245-9.

[21] ²¹
Moreira MC, Sarriera JC. Satisfação e composição da rede de apoio social a gestantes adolescentes. Psicol Estud. 2008;13(4):781-9.

[22] ²²
Elsenbruch S, Benson S, Rücke M, Rose M, Dudenhausen J, Pincus-Knackstedt MK, Klapp BF, Arck PC. Social support during pregnancy: effects on maternal depressive symptoms, smoking and pregnancy outcome. Hum Reprod. 2007;22(3):869-77.

[23] ²³
Andersson L, Sundström-Poromaa I, Wulff M, Aström M, Bixo M. Depression and anxiety during pregnancy and six months postpartum: a follow-up study. Acta Obstet Gynecol Scand. 2006;85(8):937-44.

[24] ²⁴
Patel V, DeSouza N, Rodrigues M. Postnatal depression and infant growth and development in low income countries: a cohort study from Goa, India. Arch Dis Child. 2003;88(1):34-7.

[25] ²⁵
Josefsson A, Berg G, Nordin C, Sydsjö G. Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand. 2001;80(3):251-5.

[26] ²⁶
Caputo VG, Bordin IA. Problemas de saúde mental entre jovens grávidas e não-grávidas. Rev Saúde Pública. 2007;41(4):573-81.

[27] ²⁷
Mitsuhiro SS, Chalem E, Barros MM, Guinsburg R, Laranjeira R. Teenage pregnancy: use of drugs in the third trimester and prevalence of psychiatric disorders. Rev Bras Psiquiatr. 2006;28(2):122-5.

[28] ²⁸
Da-Silva VA, Moraes-Santos AR, Carvalho MS, Martins ML, Teixeira NA. Prenatal and postnatal depression among low income Brazilian women. Braz J Med Biol Res. 1998;31(6):799-804.

[29] ²⁹
Falcone VM, Mäder CVN, Nascimento CFL, Santos JMM, Nóbrega FJ. Atuação multiprofissional e a saúde mental de gestantes. Rev Saúde Pública. 2005;39(4):612-8.

[30] ³⁰
Pinheiro SN, Laprega MR, Furtado EF. Morbidade psiquiátrica e uso de álcool em gestantes usuárias do Sistema Único de Saúde. Rev Saúde Pública. 2005;39(4):593-8.

[31] ³¹
Luis MAV, Oliveira ER. Transtornos mentais na gravidez, parto e puerpério, na região de Ribeirão Preto-SP-Brasil. Rev Esc Enf USP. 1998,32(4):314-24.

[32] ³²
Organização Mundial de Saúde. Classificação de transtornos mentais e de comportamento da CID-10. Porto Alegre: Artes Médicas, 1993.

[33] ³³
American Psychiatric Association. Manual diagnóstico e estatístico de transtornos mentais. 4. ed. Porto Alegre: Artmed, 2002.

[34] ³⁴
Quintana MI, Gastal FL, Jorge MR, Miranda CT, Anderoli SB. Validity and limitations of the Brazilian version of the Composite International Diagnostic Interview (CIDI 2.1). Rev Bras Psiquiatr. 2007;29(1):18-22.

[35] ³⁵
Sherbourne CD, Stewart AL. The MOS social support survey. Social Science and Medicine. 1991;32:705-14.

[36] ³⁶
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Depressão durante a gestação: um estudo sobre a associação entre fatores de risco e de apoio social entre gestantes

Depression during pregnancy: a study about the association between risk factors and social support among pregnant

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