Anxiety and depression in mothers of newborns in intensive care units

Authorship contribution:

Larissa Gouveia de Souza: Conceptualization, data curation, research, writing of the original draft. Viviane Cordeiro de Queiroz: Formal analysis, visualization and writing of the original draft, revision and editing. Smalyanna Sgren da Costa Andrade: Conceptualization, data curation, formal analysis, methodology, supervision, visualization and writing of the original draft, revision and editing. Simone Helena dos Santos Oliveira: Conceptualization, data curation, formal analysis, methodology, supervision, visualization and writing of the original draft, revision and editing. Edna Samara Ribeiro César: Conceptualization, methodology, formal analysis, visualization and writing of the original draft, revision and editing. Vilma Felipe Costa de Melo: Conceptualization, methodology, formal analysis, visualization and writing of the original draft, revision and editing.

The authors declare that there is no conflict of interest.

Variable	ANXIETY					OR (CI) †
	Moderate		Severe		p*
	f	%	f	%	p*
Occupation
Paid	6	6.6	50	54.9	0.780	0.893
Not Paid	0	-	35	38.5		(0.815-0.978)
Religion
Catholic	3	3.3	42	46.2	1.000	1.024
Non-Catholic	3	3.3	43	47.2		(0.195-5.362)
Education
Up to Primary School	0	-	10	11	1.000	1.080
From High School	6	6.6	75	82.4		(1.015-1.149)
Age Group
18-25 years	2	2.2	62	68.1	0.061	0.185
≥ 26 years	4	4.4	23	25.3		(0.032-1.082)
Color
White	4	4.4	32	35.2	0.209	3.313
Not White	2	2.2	53	58.2		(0.547-19.123)
Income^*
Up to 1 MW	6	6.6	79	86.8	1.000	0.929
Over 2 MW	0	-	6	6.6		(0.877-0.985)
Smoker
Yes	1	1.1	15	16.5	1.000	0.933
No	5	5.5	70	76.9		(0.102-8.579)
Acohol Consumer
Yes	2	2.2	37	40.7	0.697	0.649
No	4	4.4	48	52.7		(0.113-3.735)
Leasure
0-1 time in a month	5	5.5	65	71.4	1.000	1.538
2-3 times in a month	1	1.1	20	22		(0.170-13.951)
Marital Status
With partner	5	5.5	55	60.4	0.429	2.727
Without partner	1	1.1	30	33		(0.304-24.433)
Planned Pregnancy
No	5	5.5	28	30.8	0.022‡	10.179
Yes	1	1.1	57	62.6		(1.134-91.327)
Parity
Primiparous	2	2.2	34	37.4	1.000	0.450
Multiparous	4	4.4	51	56		(0.130-4.324)
Abortion
Yes	0	-	12	13.2	1.000	1.082
No	6	6.6	73	80.2		(1.016-1.153)
Delivery Route
Cesarean Section	6	6.6	42	46.2	0.028‡	0.875
Vaginal	0	-	43	47.2		(0.786-0.974)
Number of children
Only 1	1	1.1	35	38.5	0.397	0.286
≥2	5	5.5	50	54.9		(0.032-2.553)
Prenatal consultations
1-5 consultations	2	2.2	53	58.2	0.209	0.302
≥ 6 consultations	4	4.4	32	35.2		(0.052-1.743)
Baby’s weight
<2.500g	0	-	27	29.7	0.174	1.103
>2.500g	6	6.6	58	63.7		(1.020-1.194)
Kangaroo Method
Yes	6	6.6	63	69.2	0.329	0.913
No	0	-	22	24.2		(0.849-0.982)
Supplementation
Yes	6	6.6	51	56	0.080	0.895
No	0	-	34	37.4		(0.819-0.978)
Milk Bank
Yes	5	5.5	60	65.9	0.670	2.083
No	1	1.1	25	27.5		(0.232-18.748)
Mechanical ventilation
Yes	1	1.1	32	35.2	0.411	0.331
No	5	5.5	53	58.2		(0.037-2.964)
Gestational age
≤ 36 weeks	0	-	28	30.8	0.172	1.105
≥ 37 weeks	6	6.6	57	62.6		(1.020-1.197)

Variables	DEPRESSION					OR (CI) †
	Moderate		Severe		p*
	F	%	f	%	p*
Occupation
Paid	31	34	25	27.5	0.246	1.653
Not Paid	15	16.5	20	22		(0.705-3.876)
Religion
Catholic	26	28.6	19	20.9	0.173	1.779
Non-Catholic	20	22	26	28.5		(0.775-4.082)
Education
Up to Primary School	5	5.5	5	5.5	1.000	0.976
From High School	41	45.1	40	44.1		(0.262-3.630)
Age Group
18-25 years	33	36.3	31	34.1	0.821	1.146
≥ 26 years	13	14.3	14	15.3		(0.466-2.820)
Color
White	50	54.9	10	12.1	0.749	1.163
Not White	23	25.3	7	7.7		(0.460-2.939)
Income^*
Up to 1 MW	41	45.1	44	48.4	0.203	0.186
Over 2 MW	5	5.5	1	1		(0.021-1.663)
Smoker
Yes	9	9.9	7	7.6	0.784	1.320
No	37	40.7	38	41.8		(0.446-3.914)
Acohol Consumer
Yes	19	20.8	20	22	0.834	0.880
No	27	29.7	25	27.5		(0.383-2.019)
Leasure
0-1 time in a month	38	41.8	32	35.2	0.221	1.930
2-3 times in a month	8	8.8	13	14.2		(0.711-5.237)
Marital Status
With partner	25	27.5	35	38.4	0.383	0.340
Without partner	21	23.1	10	11		(0.137-0.846)
Planned Pregnancy
No	14	15.3	19	21	0.280	0.599
Yes	32	35.1	26	28.5		(0.253-1.419)
Parity
Primiparous	15	15.4	21	20.9	0.170	0.553
Multiparous	31	35.2	24	28.5		(0.236-1.294)
Abortion
Yes	10	11	2	2.2	0.027‡	5.972
No	36	39.6	43	47.2		(1.228-29.036)
Delivery Route
Cesarean Section	26	28.6	22	24.2	0.531	1.359
Vaginal	20	22	23	25.3		(0.595-3.103)
Number of children
Only 1	16	17.6	20	22	0.395	0.667
≥2	30	33	25	27.4		(0.286-1.522)
Prenatal consultations
1-5 consultations	28	30.8	27	29.6	1.000	1.037
≥ 6 consultations	18	19.8	18	19.8		(0.448-2.403)
Baby’s weight
<2.500g	14	15.4	13	14.3	1.000	1.077
>2.500g	32	35.2	32	35.1		(0.375-2.685)
Kangaroo Method
Yes	39	42.9	30	33	0.053‡	2.786
No	7	7.7	15	16.4		(1.009-7.691)
Supplementation
Yes	28	30.8	29	31.9	0.829	0.858
No	18	19.7	16	17.6		(0.367-2.009)
Milk Bank
Yes	29	31.9	36	39.6	0.104	0.426
No	17	18.8	9	9.9		(0.166-1.097)
Mechanical ventilation
Yes	11	12.1	22	24.2	0.017‡	0.329
No	35	38.4	23	25.3		(0.134-0.804)
Gestational age
≤ 36 weeks	14	15.4	14	15.4	1.000	0.969
≥ 37 weeks	32	35.2	31	34		(0.398-2.360)

Manifestations of Beck Anxiety Inventory
Variables	Mild	Moderate	Severe
Tremors in the legs	14 (15.3%)	37 (40.7%)	40 (44.0%)
Unable to relax	40 (44.0%)	30 (33.0%)	21 (23.0%)
Heart palpitation or acceleration	45 (49.5%)	36 (39.5%)	10 (11.0%)
Difficulty to breath	49 (53.8%)	30 (33.0%)	12 (13.2%)
Scared	18 (19.8%)	46 (50.5%)	27 (29.7%)
Manifestations of Beck Anxiety Inventory
Variables	Mild	Moderate	Severe
Sadness	49 (53.8%)	35 (38.5%)	7 (7.7%)
Discouragement	-	62 (68.1%)	29 (31.9%)
Failure	44 (48.4%)	33 (36.2%)	14 (15.4%)
Dissatisfaction	36 (39.6%)	33 (36.3%)	22 (24.1%)
Appetite	45 (49.4%)	37 (40.7%)	9 (9.9%)

Defining Characteristic	Nursing Diagnosis		Planning	Intervention
Manifestations	Focus	Judgement	Planning	Intervention
Tremors in the legs	Risk for body movement	Increased	Reduced negative consequences of tremors	* Guide to the possibility of trauma. * Assist in the care activities of the newborn. * Instruct on risk reduction posture. * Provide calm environment with minimal stressors.
Unable to relax	Sleep pattern	Altered	Relaxation Promotion	* Demonstrate relaxation techniques * Assist in creating a schedule of daily activities
Heart palpitation or acceleration	Risk of blood pressure	Altered	Maintenance of sensitive pressure and emotional state	* Help the patient recognize signs of increased or decreased blood pressure and anxiety. * Support the mother by listening to her needs. * Encourage to express her concerns.
Difficulty to breath	Risk of respiratory pattern	Altered	Improvement of respiratory pattern	* Guide on the technique for breathing exercises. * Monitor respiratory pattern. * Check for signs of agitation.
Scared	Risk of disorganized behavior	Increased	Reduction of fear	* Provide correct information using simple terms. * Encourage patients to verbalize any fear and concern. * Speak calmly and slowly * Provide tranquility and comfort. *Indicate psychotherapy.
Sadness	Risk for Depression	Increased	Reduction of sadness	* Stimulate dialogue * Encourage family visit * Provide distraction methods * Guide engagement in support groups.
Discouragement	Risk of hopelessness	Increased	Improvement of the mood	* Help women prioritize activities. * Identify and control factors that lead the woman to discouragement. * Keep the atmosphere receptive and welcoming.
Failure	Risk of frustration	Increased	Improvement of self-esteem	* Identify negative self-critical discourses * Score the evolution of the development of the newborn. * Praise the care and attention aimed at the child * Ask the woman to point out the best achievements of her life.
Dissatisfaction	Risk of negation capacity to manage life	Increased	Increased level of satisfaction for life	* Stimulate positive thinking. * Ensure psychological support by the health team. * Indicate support group of mothers of newborn inpatients as a strategy to promote acceptance of the situation.
Appetite	Food intake	Decreased	Improvement of food pattern	Request nutritional guidance from the health service team. Inform the patient about the importance of food intake for the breastfeeding of the newborn.

[1] Corresponding author:
Smalyanna Sgren da Costa Andrade E-mail: smalyanna@facene.com.br

Brasil

Brasil

Anxiety and depression in mothers of newborns in intensive care units

Ansiedad y depresión en madres de recién nacidos en unidades de cuidados intensivos

ABSTRACT

Objective:

Method:

Results:

Conclusion: