Severe Maternal Morbidity: post-traumatic suffering and social support

To assess the relationship of post-traumatic stress symptoms and the perception of social support in women submitted to Severe Maternal Morbidity (SMM).

Method:

A prospective cohort study, with 549 women from public hospitals. The Impact of Events and Social Support scales were used.

Results:

Women with SMM were from the State countryside (p=0.046), with low schooling (p=0.039) and did not work (p<0.001). They presented higher consumption of alcoholic beverages (p<0.001), did not perform prenatal (p<0.001), and were older (28.15 ± 28 years). Women with SMM had higher mean values of avoidance behavior (24.32, SD: 4.16), intrusive thinking (18.28, SD: 3.80), lower social support (0.11, SD: 0.001) with large effect size and lower social support satisfaction (0.69; SD: 0.19), with small effect size.

Conclusion:

SMM is a differential and negative factor for women’s mental health, and social support can favor their coping.

Descriptors:
Morbidity; Maternal Health; Post-Traumatic Stress Disorders; Social Support; Obstetric Nursing

Variables	Groups		X² (p value)	OR (IC95)	Adjusted OR (IC95)	p value
	With SMM (n=277)	Without SMM (n=272)
	n (%)	n (%)
Origin
Capital	95 (34)	200 (74)	3.971 (0.046)	1.45 (1.01-2.09)
Countryside	182 (66)	72 (26)		1
Average Age (SD)	28.15 (7.75)	26.77 (7.75)	0.038^* * Mann-Whitney’ Test; SD = Standard Deviation; OR = Odds Ratio; CI = Confidence Interval = 95%.
≥35	70 (25)	53 (20)	2.64 (0.104)	1.40 (0.93-2.09)	1.72 (1.11-2.65)	0.104
<35	207 (75)	219 (80)		1	1
Schooling
< 8 years	198 (53.5)	172 (46.5)	4.246 (0.039)	1.46 (1.02-2.09)
≥ 8 years	79(44.1)	100 (55.9)		1
Marital Status
Single	59 (21)	75 (28)	2.928 (0.087)	0.71 (0.48-1.05)
Married	218 (79)	197 (72)		1
Work
No	222 (80)	185 (68)	10.530 (<0.001)	1.90 (1.28-2.80)	2.36 (1.53-3.62)	<0.001
Yes	55 (20)	87 (32)		1	1
Prenatal
No	26 (9)	3 (1)	18.820 (<0.001)	9.29 (2.78-31.1)	10.9 (3.28-36.1)	<0.001
Yes	251 (91)	269 (99)		1	1
Parity
Primipara	43 (16)	32 (12)	1.644 (0.200)	1.34 (0.82-2.20)
1 or more births	234 (84)	240 (88)		1
Alcoholic beverages
No	192(69)	243 (89)	33.445 (<0.001)	1	1
Yes	85(31)	29 (11)		3.65 (2.30-5.79)	4.35 (2.66-7.11)	<0.001
Smoking
No	261 (94)	263 (97)	1.922 (0.166)	1
Yes	16(6)	9 (3)		1.79 (0.78-4.13)

Variables	Groups		Mann-Whitney	Eta ²
	With SMM	Without SMM
	Mean (SD)	Mean (SD)
Impact of events
Avoidance behavior	24.32 (4.16)	5.10 (2.08)	<0.001	0.895
Intrusive memory	18.28 (3.80)	7.47 (1.91)	<0.001	0.763
SSQ-6
SSQ-N	0.11 (0.001)	0.13 (0.04)	<0.001	0.151
SSQ-S	0.69 (0.19)	0.73 (0.17)	0.01	0.014

Variables	SSQ-N	SSQ-S
Variables	R (p value)	R (p value)
Impact of events Avoidance behavior
With SMM	-0,034 (0,577)	0,088 (0,144)
Without SMM	-0,031 (0,613)	0,125 (0,040)
F (p value)	0,48 (0,488)	0,058 (0,810)
Intrusive memory
With SMM	-0,084 (0,164)	0,024 (0,687)
Without SMM	-0,084 (0,167)	0,070 (0,251)
F (p value)	2,99 (0,084)	0,04 (0,832)

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] CORRESPONDING AUTHOR: Mônica Silva Silveira E-mail: mssdoutora@gmail.com