Prevalencia y factores de riesgo asociados a la depresión posparto en puérperas de un Centro de Atención Primaria en el Sur de Chile / Prevalence and risk factors associated with postpartum depression in puerperal women consulting in primary care

Background: Mood disorders are common in Chile. Among these, post partum depression (PPD) deranges the maternal and family relationships. Aim: To determine the prevalence and risk factors associated with PPD in puerperal women in Temuco, Chile. Material and methods: The Edinburgh Postnatal Depression Scale was administered to 73 puerperal women aged 15 to 32 years, between 40 to 45 days after delivery. To detect risk factors, 20 women with and 20 women without post partum depression (PPD) were interviewed and their clinical records were reviewed to assess their perinatal care. Results: The prevalence of PPD in the whole sample was 50.7 percent. The individual psychological risk factors detected were a feeling of discomfort with their body after giving birth, a personal history of mental health problems and a high level of overload associated to child care. An individual physical risk factor was alcohol consumption during pregnancy. Family risk factors were a poor relationship with the father of the child during pregnancy, a history of mental health problems in close family members, a history of family violence and a poor realtionship with parents during puerpurium. Having more children was a sociodemographic risk factor. Conclusions: Pospartum depression is common. The characterization of risk factors should lead to the implementation of preventive strategies.

Identificación de factores de riesgo y factores protectores del embarazo en adolescentes de la novena región / Identification of risk factors and protective factors of pregnancy in adolescents of the ninth region

Objetivo: Comprender los factores relacionados con el embarazo no planificado en las adolescentes, desde la perspectiva de las escolares nuligestas.Método: Estudio cualitativo de casos, en mujeres entre 15 y 19 años, pertenecientes a dos establecimientos educacionales, con altos índices de embarazo, en la ciudad de Temuco, Chile. Se realizaron cuatro grupos focales, constituidos por 14 adolescentes no embarazadas,identificándose factores en las dimensiones individuales, familiares y sociales. Para el análisis se utilizó el programa ATLAS-ti 4,1. Se trianguló por investigador en la ejecución del estudio y análisis de los datos. Resultados: En la dimensión individual aparecen como relevantes factores de riesgo que favorecen el embarazo (FFE): "amor romántico", no uso de métodos anticonceptivos, baja autoestima, irresponsabilidad masculina y falta de conocimiento en sexualidad. En la dimensión familiar destacan los factores: límite estrecho familiar y negligencia paterna. Surgen factores percibidos por las adolescentes como protectoras del embarazo no planificado (FPE), en la dimensión individual destacan: capacidad reflexiva y proyecto de vida; en la dimensión familiar: "familia cuidadora" y límites claros; y en la dimensión social la categoría o factor con mayor peso es "sanción social". Conclusiones: Entre los hallazgos destacan como FFE relevantes el "amor romántico" y los límites polares familiares. Como FPE, la capacidad de reflexión y "familia cuidadora". Estos elementos debieran ser considerados en la prevención del embarazo no planificado en población adolescente.

Objective: To identify and understand factors associated to pregnancy in adolescents under the perspective of the never pregnant adolescent. Methods: Qualitative study undergone on women 15 to 19 years of age. School based sample of women were drawn from 2 schools chosen due to their high pregnancy rate. Four focus groups were created and each one was composed by 14 eligible women. Factors associated to individuals, to family, and to social environment were studied. Triangulation was performed during the study conduction and data analysis. Analysis was done by using ATLAS-ti 4.1. Results: Factors which appear to be favouring pregnancy at the individuals were: "romantic love", no use of contraceptives, low self esteem, male irresponsibility, lack of knowledge in sexuality. At the family level, the factors are: the permit's restriction and paternal negligence. Factors which help in avoiding pregnancy in adolescents at the individual level are: subject's reflexive capacity and project of life. At the family level, protective family and clearly defined limits are the ones which help preventing pregnancy. Social punishment is the main social factor associated. Conclusions: The view of the never pregnant adolescent and the multilevel model used in the focus group will allow decision makers to design strategies at the subject, family and social levels to help in reducing the unwanted pregnancy in adolescents. Main factors here identified are: "romantic love", permit`s restriction, paternal negligence as favouring pregnancy; reflexive capacity and protective family are the ones shown as preventives.