Tecnologías de la información y la comunicación como apoyo a la salud mental para mujeres en etapa perinatal / Information and communication technology as a support for mental health in perinatal women / Tecnologias de informação e comunicação como apoio à saúde mental de mulheres na fase perinatal

Durante el embarazo la mujer experimenta muchos cambios, no solo físicos, también mentales, por eso la salud mental perinatal es de gran importancia en esta etapa. La mayoría de las mujeres en embarazo que desarrollan alguna enfermedad mental durante la gestación, como depresión o ansiedad, no son diagnosticadas, lo que puede generar efectos adversos para la madre y el bebé. En ese sentido, es de gran importancia el tamizaje, diagnóstico, manejo y seguimiento de este grupo. Gracias a los avances tecnológicos podemos contar con las tecnologías de la Información y la comunicación (TIC) para buscar maneras cómo aproximarse a las mujeres en etapa perinatal para el tamizaje y hacer el seguimiento de su salud mental. Así que este artículo de revisión se enfoca en ver su aceptabilidad, la percepción, las barreras al acceso y nuevos desarrollos enfocados en mejorar la salud mental en las mujeres en etapa perinatal.

During pregnancy, a woman experiences many changes, not only physical, but also mental, which is why perinatal mental health is of great importance at this stage. The majority of pregnant women who develop a mental illness during pregnancy, such as depression or anxiety, are not diagnosed, which can cause adverse effects for the mother and baby. In this sense, the screening, diagnosis, management and follow-up of this group is of great importance. Thanks to technological advances, we can count on the Information and Communication Technologies (ICT) to find ways to approach women in the perinatal stage for screening and monitoring their mental health. So this review article focuses on seeing its acceptability, perception, barriers to access and new developments focused on improving mental health in perinatal women.

Durante el embarazo la mujer experimenta muchos cambios, no solo físicos, también mentales, por eso la salud mental perinatal es de gran importancia en esta etapa. La mayoría de las mujeres en embarazo que desarrollan alguna enfermedad mental durante la gestación, como depresión o ansiedad, no son diagnosticadas, lo que puede generar efectos adversos para la madre y el bebé. En ese sentido, es de gran importancia el tamizaje, diagnóstico, manejo y seguimiento de este grupo. Gracias a los avances tecnológicos podemos contar con las tecnologías de la Información y la comunicación (TIC) para buscar maneras cómo aproximarse a las mujeres en etapa perinatal para el tamizaje y hacer el seguimiento de su salud mental. Así que este artículo de revisión se enfoca en ver su aceptabilidad, la percepción, las barreras al acceso y nuevos desarrollos enfocados en mejorar la salud mental en las mujeres en etapa perinatal.

Design of a regression model to predict the presence of depression during pregnancy based on emotional intelligence, parental care, anxiety and stress / Diseño de un modelo de regresión para predecir la presencia de la depresión durante el embarazo a partir de la inteligencia emocional, el cuidado parental, la ansiedad y el estrés

Background: Emotion regulation involves the modulation of emotional experiences to facilitate goal attainment. Conversely, emotional difficulties are a pattern of emotional experiences and expressions that interfere with goal-directed behavior. Objectives: Design a new model to predict the presence of depression in women during pregnancy. Methods: Non-experimental, cross-sectional, explanatory study of depression in women during pregnancy (logistic regression) considering the variables emotional intelligence, parental care, anxiety and stress. The sample consisted of 273 pregnant women-mothers between 14 and 38 weeks pregnant, aged between 18 and 38 years, for a mean of 25.67 years (SD= 5.8). Results: The regression model is valid and significant in predicting the probability of occurrence of depression, explaining 82.4% of the variance of DV (Presence of depression) by the variables age, clarity and repair of depression dimensions. emotional intelligence, the maternal and paternal overprotection dimensions, and paternal care of the parental style variables; stress, work and single marital status. There is a 95.2% probability of success in the depression result when each of the model variables is incorporated. Conclusions: The best predictors of depression in pregnancy would be, on the one hand, higher levels or values of the variables and indicators age, reparation, maternal overprotection, paternal care, and stress, and on the other hand, low scores in the dimensions and values of clarity variables, and paternal overprotection; added to whether the woman works and is single. This combination of variables would be the individual and contextual conditions that influence said appearance.

Introducción: La depresión perinatal se ha definido como la presencia de episodios depresivos mayores o menores durante el período gestacional y/o durante el primer año posparto. La depresión durante el embarazo afecta alrededor de un 13% de las mujeres embarazadas a nivel mundial y en un 10% en la población chilena con consecuencias significativas para la mujer, su hijo y su familia. Objetivo: Diseñar un nuevo modelo para predecir la presencia de depresión en mujeres durante el embarazo. Método: Estudio no experimental, transversal, de tipo explicativo de la depresión en mujeres durante el embarazo (regresión logística) considerando las variables inteligencia emocional, cuidado parental, ansiedad y estrés. La muestra estuvo conformada por 273 mujeres-madres gestantes entre 14 y 38 semanas de embarazo, con edades entre 18 y 38 años, para una media de 25.67 años (SD= 5.8). Resultados: El modelo de regresión es válido y significativo en la predicción de las probabilidades de ocurrencia de la depresión, explicando el 82,4% de la varianza de la VD (Presencia de la depresión) por las variables edad, las dimensiones claridad y reparación de la inteligencia emocional, las dimensiones sobreprotección materna y paterna, cuidado paterno de las variables estilo parental; estrés, trabajo y estado civil soltera. Hay un 95.2% de probabilidad de acierto en el resultado de la depresión cuando se incorpora cada una de las variables del modelo. Conclusiones: Los mejores predictores de la depresión en el embarazo serían por una parte mayores niveles o valores de las variables e indicadores edad, reparación, sobreprotección materna, cuidado paterno y estrés, y por otra parte puntajes bajos en las dimensiones y valores de variables claridad, y sobreprotección paterna; sumado a si la mujer trabaja y es soltera. Esta combinación de las variables serían las condiciones tanto individuales como contextuales que influyen en dicha aparición.

Diseño de un modelo de regresión para predecir la presencia de la depresión durante el embarazo a partir de la inteligencia emocional, el cuidado parental, la ansiedad y el estrés

Introducción: La depresión perinatal se ha definido como la presencia de episodios depresivos mayores o menores durante el período gestacional y/o durante el primer año posparto. La depresión durante el embarazo afecta alrededor de un 13% de las mujeres embarazadas a nivel mundial y en un 10% en la población chilena con consecuencias significativas para la mujer, su hijo y su familia. Objetivo: Diseñar un nuevo modelo para predecir la presencia de depresión en mujeres durante el embarazo. Método: Estudio no experimental, transversal, de tipo explicativo de la depresión en mujeres durante el embarazo (regresión logística) considerando las variables inteligencia emocional, cuidado parental, ansiedad y estrés. La muestra estuvo conformada por 273 mujeres-madres gestantes entre 14 y 38 semanas de embarazo, con edades entre 18 y 38 años, para una media de 25.67 años (SD= 5.8). Resultados: El modelo de regresión es válido y significativo en la predicción de las probabilidades de ocurrencia de la depresión, explicando el 82,4% de la varianza de la VD (Presencia de la depresión) por las variables edad, las dimensiones claridad y reparación de la inteligencia emocional, las dimensiones sobreprotección materna y paterna, cuidado paterno de las variables estilo parental; estrés, trabajo y estado civil soltera. Hay un 95.2% de probabilidad de acierto en el resultado de la depresión cuando se incorpora cada una de las variables del modelo. Conclusiones: Los mejores predictores de la depresión en el embarazo serían por una parte mayores niveles o valores de las variables e indicadores edad, reparación, sobreprotección materna, cuidado paterno y estrés, y por otra parte puntajes bajos en las dimensiones y valores de variables claridad, y sobreprotección paterna; sumado a si la mujer trabaja y es soltera. Esta combinación de las variables serían las condiciones tanto individuales como contextuales que influyen en dicha aparición.

Background: Emotion regulation involves the modulation of emotional experiences to facilitate goal attainment. Conversely, emotional difficulties are a pattern of emotional experiences and expressions that interfere with goal-directed behavior. Objectives: Design a new model to predict the presence of depression in women during pregnancy. Methods: Non-experimental, cross-sectional, explanatory study of depression in women during pregnancy (logistic regression) considering the variables emotional intelligence, parental care, anxiety and stress. The sample consisted of 273 pregnant women-mothers between 14 and 38 weeks pregnant, aged between 18 and 38 years, for a mean of 25.67 years (SD= 5.8). Results: The regression model is valid and significant in predicting the probability of occurrence of depression, explaining 82.4% of the variance of DV (Presence of depression) by the variables age, clarity and repair of depression dimensions. emotional intelligence, the maternal and paternal overprotection dimensions, and paternal care of the parental style variables; stress, work and single marital status. There is a 95.2% probability of success in the depression result when each of the model variables is incorporated. Conclusions: The best predictors of depression in pregnancy would be, on the one hand, higher levels or values of the variables and indicators age, reparation, maternal overprotection, paternal care, and stress, and on the other hand, low scores in the dimensions and values of clarity variables, and paternal overprotection; added to whether the woman works and is single. This combination of variables would be the individual and contextual conditions that influence said appearance.

Application of "Internet +" hospital-community-family trinity linkage management model in maternal perinatal depression / 四川精神卫生

BackgroundPerinatal depression seriously affects the physical and mental health of pregnant women， such as affecting their role transition， identity， and family relationships， etc. In severe case， it can even lead to suicidal behavior， causing a heavy burden on pregnant women and their families. A hierarchical management model centered on pregnant women， involving collaboration of families， communities， and hospitals， facilitates comprehensive and dynamic management of perinatal depression. ObjectiveTo evaluate the application effect of "Internet +" hospital-community-family trinity linkage management model on perinatal depression in pregnant women， in order to provide a reference for the clinical intervention. Methods80 pregnant women who established medical records from the Department of Obstetrics and Gynecology of Mianyang Third People's Hospital from January to December 2022， with Edinburgh Postnatal Depression Scale （EPDS） score>9， were selected as the research objects. According to the random number table method， they were divided into a study group and a control group， each group consisting of 40 cases. Both groups received routine nursing intervention in the pregnant women's school of obstetrics and gynecology outpatient department before delivery， and in the study room of the department of obstetrics and gynecology after being admitted to the hospital for delivery. After discharge， they received routine follow-up until 42 days postpartum. The study group received the "Internet +" hospital-community-family ternary linkage management on the basis. EPDS， Pittsburgh Sleep Quality Index （PSQI）， Generic Quality of Life Inventory （GQOLI-74） and Nursing Satisfaction questionnaire were assessed before intervention and 42 days postpartum. ResultsAfter intervention， the EPDS score and PSQI score of the study group were lower than those of the control group （F=42.823， 60.453， P<0.05）， GQOLI-74 score and nursing satisfaction were higher than those of the control group （F=198.902， χ2=5.165， P<0.05） . Conclusion"Internet +" hospital-community-family trinity linkage management model may help to improve the severity of perinatal depression symptoms， improve the quality of sleep and life， and increase the satisfaction of pregnant women.［Funded by Mianyang Health Scientific Research Commission Project （number， 202134）］

Antecedente de depresión, síntomas de estrés postraumático, apoyo social percibido: prediciendo la depresión posparto / History of depression, post-traumatic stress symptoms, perceived social support: predicting postpartum depression

Objetivo: Describir y analizar si el apoyo social percibido modera la relación entre antecedente de depresión (AD) o síntomas de trastorno de estrés postraumático (TEPT) y desarrollo de síntomas de depresión posparto (SDPP), evaluado prospectivamente. Método: Diseño longitudinal de tres tiempos: antes del parto (n = 458), primer mes posparto (n = 406) y tercer mes posparto (n = 426). Se utilizaron la Escala de Depresión Posparto de Edimburgo (EPDS), la Escala de Síntomas de Estrés Postraumático (PCL-C) y la Escala de Apoyo Social Percibido (MOS). Se realizó un análisis de ocho modelos jerárquicos de regresión lineal múltiple, por cada tiempo de evaluación en el estudio. Resultados: Se encontró una asociación significativa entre síntomas de TEPT y puntaje de SDPP en los tres tiempos. El apoyo social percibido es un factor protector significativo para los SDPP en los tiempos 1 y 2, mientras que el AD es un factor de riesgo significativo en los tiempos 2 y 3. Los resultados no apoyan las hipótesis de interacción. Conclusiones: El apoyo social es un factor protector significativo, que puede disminuir los SDPP; sin embargo, disminuye con el tiempo. El apoyo social no logra revertir la asociación de los síntomas de TEPT con el puntaje en SDPP.

Objective: Describe and analyze if the perceived social support moderates the relationship between depression history or post-traumatic stress disorder symptoms and the development of symptoms of postpartum depression, prospectively evaluated. Method: Longitudinal design of three times: before partum (n = 458), one month (n = 458) and 3 months postpartum (n = 458). The version of the Edinburgh Postnatal Depression Scale (EPDS), the version of the PTSD Checklist-Civilian Version (PCL-C), and the version of the Medical Outcomes Study Social Support Survey (MOS) were used. Analysis of eight hierarchical multiple linear regression models. Results: A significant association was found between symptoms of post-traumatic stress and postpartum depression, in the three times measured. The perceived social support variable was found to be a significant protective factor for perinatal depression in times 1 and 2, and history of depression was significant in times 2 and 3. The results do not support the interaction hypothesis. Conclusions: Social support is a significant protective factor, which can reduce the symptoms of postpartum depression, nevertheless the significance decreases over time. However, social support fails to reverse the association of post-traumatic stress disorder symptoms with symptoms of postpartum depression score.

A review of progress in research of relationship between air pollution and perinatal depression / 环境与职业医学

In recent years, the increasing incidence of perinatal depression has become an important public health problem. In addition to the traditional social demographic factors, biological factors, obstetric factors, etc., the association between air pollution and perinatal depression (PND) has also attracted more and more attention. In this paper, studies on the association between air pollution and PND were reviewed, especially the associations of PND with ambient air pollutants such as PM2.5, PM10, NO2, and O3 as well as indoor air pollutants such as tobacco smoke, and the characteristics and possible biological mechanisms of the influence of different pollutants on PND were summarized. Based on the available studies, various outdoor air pollutants are associated with PND, and some pollutants may exhibit a dose-response relationship with it. As for indoor air pollution, studies only have focused on the impact of tobacco exposure on PND, and as yet, no study has explored the association between other indoor pollutants (e.g. cooking oil smoke and solid fuel) and PND. Current studies indicate that air pollution may act on PND through oxidative stress and neuroendocrine mechanisms, but the exact biological mechanism remains to be further studied. In the future, further studies should be encouraged on the epidemiological associations of other indoor air pollutants with PND and the interactions between other factors and air pollution on PND, and the underlying biological mechanisms, to provide new insights for the prevention of PND from the perspective of environmental health.

Research progress in biological markers of perinatal depression / 中国药科大学学报

@#Perinatal depression, one of the most common complications in the perinatal period, has a significant impact on the physical and mental health of mothers and children.At present, it is difficult to diagnose perinatal depression at an early stage, so objective and effective biomarkers are of great significance for the early detection and treatment of perinatal depression. In recent years, the exploration of biomarkers for early diagnosis of perinatal depression has become a hot research topic, mainly in sex hormones, neuroendocrine-related hormones, immuno-inflammatory molecules, genetics, and epigenetics.This article reviews the research progress of the biomarkers of perinatal depression in recent years.

Partner relationship quality predicts later postpartum depression independently of the chronicity of depressive symptoms

Objective: Given the lifelong implications of extended postpartum depression (PPD), research is needed to examine the social factors implicated in its development (such as relationship quality) and associated predictors. This study sought to examine the association of partner relationship quality (PRQ) and decline of sexual life (DSL) with maternal PPD at 12-15 months after childbirth. Methods: Prospective study of 294 low-income postpartum women. A structured questionnaire and the Patient Health Questionnaire-9 (PHQ-9) captured responses for the main outcome variable and covariates. Results: The prevalence of the main outcome (PPD at 12-15 months) was 19.1%. Using logistic regression models, low PRQ (risk ratio [RR] = 1.58, 95%CI 1.01-2.49) and DSL (RR = 1.97, 95%CI 1.23-3.15) were associated with PPD at 12-15 months even after controlling for perinatal depression. Conclusions: Late PPD (12 to 15 months after giving birth) is very common among low-income women, and is independently associated with different aspects of the couple's relationship. Improving PRQ may prevent late PPD. Future investigations are warranted.

Depresión perinatal: detección, diagnóstico y estrategias de tratamiento / Perinatal depression: a review on diagnosis and treatment strategies

Para las mujeres, experimentar cambios emocionales durante el embarazo y hasta un año posterior al parto puede ser parte del proceso de adaptación a los cambios fisiológicos y emocionales de esta nueva etapa, siendo por lo general manejable por ellas mismas. Diferente es el desarrollo de síntomas depresivos durante este período perinatal que comprende el embarazo y hasta doce meses posterior al parto. La depresión perinatal constituye un trastorno de alta prevalencia que puede tener efectos negativos tanto para la salud de la madre, del hijo y de otros miembros de la familia.

For women it is natural to experience changes in mood and feelings during pregnancy and after twelve months after childbirth, these shifting moods are often manageable by themselves, it differs with depressive symptoms that appear during these period. Perinatal depression constitutes a high prevalence disorder that might have a negative effect not only in the mother, but the child and other familiy members.

Depresión en el embarazo / Depression in Pregnancy

RESUMEN Introducción: La depresión es la morbilidad psiquiátrica más común en el embarazo, y llega a afectar a más del 13% de las gestantes. Su diagnóstico se basa en los criterios establecidos por el DSM-V y la aplicación de escalas validadas como la Escala de Depresión Posnatal de Edimburgo; sin embargo, entre los profesionales de la salud aún existen errores y falencias en el reconocimiento, el diagnóstico y el tratamiento de la depresión durante el embarazo, lo que propicia las diferentes consecuencias y repercusiones para la gestación misma o el feto. Objetivo: Presentar una revisión de tema acerca de la depresión en el embarazo, sus factores de riesgo, las características clínicas, las complicaciones y el tratamiento. Métodos: Se utilizaron las bases de datos PubMed y LILACS para la búsqueda de manuscritos; de 223 artículos, 55 cumplían los criterios de inclusión. Resultados: En Sudamérica se registra una prevalencia de aproximadamente el 29%. Los factores de riesgo con mayor significación son el abuso sexual, la edad temprana al embarazo y la violencia intrafamiliar. Por ello, el diagnóstico temprano favorece la disminución en las conductas de riesgo, los trastornos del neurodesarrollo fetal y los resultados obstétricos. Conclusiones: La depresión en el embarazo es una afección frecuente; no obstante, se presenta subregistro por la atribución de los síntomas a la gestación misma. Se recomienda el uso de antidepresivos como los inhibidores de la recaptación de serotonina, especialmente la fluoxetina, que no sea ha relacionado con teratogenicidad, además de la implementación de tratamiento no farmacológico como psicoterapia, mindfulness y ejercicio aeróbico. La sensibilización del personal de salud permitirá el diagnóstico y el tratamiento adecuados de esta enfermedad.

ABSTRACT Introduction: Depression is the most common psychiatric morbidity in pregnancy, affecting more than 13% of pregnant women. Its diagnosis is based on the criteria established by the DSM-5 and the application of validated scales such as the Edinburgh Postnatal Depression Scale. However, there are still errors and shortcomings among healthcare professionals in the recognition, diagnosis and treatment of depression during pregnancy, with the resulting consequences and repercussions on the gestation itself or the foetus. Objective: To present a review of depression in pregnancy, its risk factors, clinical characteristics, complications and treatment. Methods: The PubMed and LILACS databases were used to search for manuscripts. Of the 223 articles found, 55 fulfilled the inclusion criteria. Results: The prevalence of depression in pregnancy in South America is approximately 29% and the most significant risk factors are sexual abuse, pregnancy at an early age and intrafamily violence. Therefore, early diagnosis favours a reduction in risk behaviour, foetal neurodevelopmental disorders and obstetric outcomes. Conclusions: Depression in pregnancy is common condition but is underreported as its symptoms are often attributed to the pregnancy itself. The use of selective serotonin reuptake inhibitor antidepressants, particularly fluoxetine, which has not been associated with teratogenicity, is recommended, in addition to the implementation of non-pharmacological treatment such as psychotherapy, mindfulness and aerobic exercise. Educating healthcare professionals will facilitate the correct diagnosis and treatment of this condition.

Study on the influencing factors of perinatal depression and its alleviating effect / 中国实用护理杂志

Objective@#The influencing factors of perinatal depression and the study of social support and anti-stress ability.@*Methods@#A total of 712 women were enrolled in the Obstetrics and Gynecology Department of Rizhao City Maternal and Child Health Hospital from January 2014 to January 2016. From the second trimester (after 12 weeks of pregnancy)-pregnant women within 1 month after delivery, each pregnancy was recorded. The maternal population was scored at the first visit, and the depression score was scored at each visit. Stress resistance scores and social support scores, stratified binary Logistic regression analysis of variables, stress resistance, social support on depression and mitigation effects.@*Results@#Of the 712 maternal women, 615 were included in the standard. The enrollment rate was 86.3% (615/712). The average score of 615 maternal uncomfortable symptoms was 2.2±0.8, and the average score of the compressive capacity scale was 115.3 ±32.1, the average score of the social support scale was: 48.2 ± 9.4. The degree of education, monthly income, and physical discomfort scores significantly affected the perinatal depression score (b=-0.023, -0.013, 0.625, P<0.05). Self-compression ability can alleviate the impact of physical discomfort on perinatal depression, and social support can not be significantly relieved.@*Conclusions@#Education level and monthly income level are independent factors of perinatal depression, self-resistance can relieve depression.

Study on the influencing factors of perinatal depression and its alleviating effect / 中国实用护理杂志

Objective The influencing factors of perinatal depression and the study of social support and anti-stress ability. Methods A total of 712 women were enrolled in the Obstetrics and Gynecology Department of Rizhao City Maternal and Child Health Hospital from January 2014 to January 2016. From the second trimester (after 12 weeks of pregnancy)- pregnant women within 1 month after delivery, each pregnancy was recorded. The maternal population was scored at the first visit, and the depression score was scored at each visit. Stress resistance scores and social support scores, stratified binary Logistic regression analysis of variables, stress resistance, social support on depression and mitigation effects. Results Of the 712 maternal women, 615 were included in the standard. The enrollment rate was 86.3% (615/712). The average score of 615 maternal uncomfortable symptoms was 2.2±0.8, and the average score of the compressive capacity scale was 115.3 ±32.1, the average score of the social support scale was: 48.2 ± 9.4. The degree of education, monthly income, and physical discomfort scores significantly affected the perinatal depression score (b=-0.023,-0.013, 0.625, P<0.05). Self-compression ability can alleviate the impact of physical discomfort on perinatal depression, and social support can not be significantly relieved. Conclusions Education level and monthly income level are independent factors of perinatal depression, self-resistance can relieve depression.

Screening and diagnosing postpartum depression: when and how? / Triagem e diagnóstico de depressão pós-parto: quando e como?

Abstract Introduction: Prevalence rates of postpartum depression (PPD) vary widely, depending on the methodological parameters used in studies: differences in study populations, diagnostic methods, and postpartum time frame. There is also no consensus on the ideal time to perform screening, on whether PPD can only be diagnosed in the early postnatal period, or on how soon after a delivery depression may be related to it. Objective: To review which instruments have been used over recent years to screen and diagnose PPD and the prevailing periods of diagnosis. Methods: Only articles published within 5 years and related exclusively to screening and diagnosis were selected. The sample comprised 22 articles. Results: The Edinburgh Posnatal Depression Scale (EPDS) was the most common screening tool, used in 68% of the sample (15 articles), followed by the Beck Depression Inventory (BDI-II) (27%, 6 articles), and the Patient Health Questionnaire-9 (PHQ-9) (18%, 4 articles). Screening time frame was reported in 21/22 articles: 0 to 3 months postpartum in 9 (43%), up to 6 months in 4 (19%), and up to 12 months or more in 8 (38%). In short, 13 articles screened during the first 6 months (59%) while only 8 (36%) screened up to 1 year. Conclusion: The most frequent PPD diagnosis tool was the EPDS, but other scales were also used. The most common period for diagnosis was up to 3 months postpartum. However, some researchers diagnosed PPD 12 months or more postpartum. Greater standardization of parameters for investigation of this disease is needed.

Resumo Introdução: A prevalência de depressão pós-parto (DPP) varia consideravelmente dependendo dos parâmetros metodológicos utilizados: diferentes populações, métodos de diagnóstico e o tempo pós-parto considerado. Também não há consenso sobre o momento ideal para a triagem, se a DPP pode ser diagnosticada apenas no período puerperal, e por quanto tempo após o parto a depressão pode ser relacionada a ele. Objetivo: Revisar os instrumentos mais usados recentemente para rastreamento e diagnóstico de DPP e os períodos predominantes de diagnóstico. Métodos: Foram selecionados apenas artigos relacionados exclusivamente ao rastreio e diagnóstico publicados num período de 5 anos. A amostra incluiu 22 artigos. Resultados: A Escala de Depressão Pós-Parto de Edimburgo (EPDS) foi a ferramenta mais frequente, utilizada em 68% da amostra (15 artigos), seguida pelo Inventário de Depressão de Beck (27%, 6 artigos) e o Patient Health Questionnaire-9 (PHQ-9) (18%, 4 artigos). O tempo de rastreio foi definido em 21/22 artigos: 0-3 meses pós-parto em 9 (43%), < 6 meses em 4 (19%), e ≤ 12 meses em 8 (38%). Treze artigos selecionaram as mulheres durante os primeiros 6 meses (59%), enquanto apenas 8 (36%) o fizeram até 1 ano. Conclusão: A EPDS foi o instrumento mais utilizado para o diagnóstico de DPP, mas outras escalas também foram aplicadas. O período mais comum para o diagnóstico foi de < 3 meses pós-parto. No entanto, alguns pesquisadores consideraram o diagnóstico de PPD em ≤ 12 meses após o parto. Há necessidade de maior padronização de parâmetros em relação à investigação desta doença.

Provider report of the existence of detection and care of perinatal depression: quantitative evidence from public obstetric units in Mexico / Existencia de la detección y atención para depresión perinatal según lo reportado por prestadores: evidencia cuantitativa de unidades obstétricas públicas en México

Abstract: Objective: To provide evidence on perinatal mental healthcare in Mexico. Materials and methods: Descriptive and bivariate analyses of data from a cross-sectional probabilistic survey of 211 public obstetric units. Results: Over half (64.0%) of units offer mental healthcare; fewer offer perinatal depression (PND) detection (37.1%) and care (40.3%). More units had protocols/guidelines for PND detection and for care, respectively, in Mexico City-Mexico state (76.7%; 78.1%) than in Southern (26.5%; 36.4%), Northern (27.3%; 28.1%) and Central Mexico (50.0%; 52.7%). Conclusion: Protocols and provider training in PND, implementation of brief screening tools and psychosocial interventions delivered by non-clinical personnel are needed.

Resumen: Objetivo: Producir evidencia sobre atención para salud mental perinatal en México. Materials y métodos: Encuesta transversal probabilística de 211 unidades obstétricas públicas con análisis descriptivo y bivariado. Resultados: Más de la mitad (64.0%) de las unidades ofrece atención de salud mental; menos de la mitad ofrece detección (37.1%) o atención (40.3%) para depresión perinatal (DPN). En el DF/ Estado de México más unidades tienen protocolos/lineamientos para detección y atención para DPN (76.7%;78.1%) que en el sur (26.5%;36.4%), norte (27.3%; 28.1%) o centro (50.0%;52.7%) del país. Conclusión: Se requieren protocolos y capacitación en PND, implementación de herramientas breves de tamizaje e intervenciones psicosociales impartidas por personal no-clínico.

Terapia de interacción guiada en díadas madre-bebé con sintomatología depresiva materna en el embarazo: un estudio piloto / Guided interaction therapy in mother-infant dyads with maternal depressive symptoms in pregnancy: a pilot study

La depresión perinatal constituye un trastorno del ánimo de alta frecuencia, que afecta negativamente a la madre y al bebé, y requiere una intervención dirigida a ambos miembros de esta díada. Esta investigación evalúa la aplicabilidad y resultados de una intervención piloto dirigida a fortalecer el vínculo y a reducir la depresión en díadas con esta problemática. Se estudian tres díadas madre-hijo/a, con sintomatología depresiva materna y se desarrolla una intervención psicoterapéutica breve utilizando el modelo de Interacciones Guiadas. Los resultados muestran una reducción en la sintomatología depresiva y un aumento en sensibilidad materna, cooperatividad infantil y calidad vincular. La intervención realizada resulta eficaz en las variables estudiadas, requiriéndose nuevas aplicaciones en muestras de mayor tamaño para confirmar estos hallazgos.

Perinatal depression is a high frequency mood disorder which negatively affects mother and baby, and requires an intervention addressing both members of the dyad. This paper evaluates the applicability and results of a pilot intervention to strengthen this bond and reduce depression in dyads with this problem. Three mother-child dyads, with maternal depressive symptoms and a brief psychotherapeutic intervention using the model of Guided Interactions were studied. The results showed a reduction in depressive symptoms and an increase in maternal sensitivity, child cooperativeness and relationship quality. The intervention turned out to be effective in the variables under study. Nevertheless, new applications over larger sample sizes are required to confirm these findings.

Depresión postparto y ejercicio / Postpartum depression and exercise

La depresión postparto es una entidad conocida y tratada en nuestro medio. Actualmente, existen diversos métodos con entrevistas e incluso intervenciones farmacológicas efectivas para su corrección. Se conoce que afecta de forma severa al binomio madre-hijo en distintas maneras. Este artículo recopila los aspectos importantes de la depresión postparto y las diversas formas de tratarla. Se hace referencia al efecto del ejercicio y la actividad física durante el embarazo, sus complicaciones y formas de aplicarlos, ya que se han propuesto intervenciones usándolos con el fin de modificar el curso de esta entidad. También se aborda cómo la actividad física puede igualmente influir en la etapa perinatal.

Postpartum depression is a well-known entity. Currently, there are several methods of intervention that include interviews and even pharmacological treatments. It is known that postpartum depression severely affects the mother-child binomial in different ways. The objective of the article is to enlist the most important aspects of postpartum depression and its forms of treatment. The article also refers to the effects of exercise and physical activity during pregnancy, possible complications, and ways to perform them. It has been proposed that this intervention may modify the course of postpartum depression. We also analize how physical activity can influence the perinatal stage.

The effect of Sopfrology childbirth method training, Kegel training and Lamaze respiratory training on depression and sexual life of perinatal pregnant woman / 中华行为医学与脑科学杂志

Objective To study the effect of Sopfrology childbirth method training,Kegel training and Lamaze respiratory training (SLK training) on depression and sexual life of perinatal pregnant woman..Methods The women in 24 weeks of pregnancy who came to the clinic to receive the pregancy test were divided into study group(n=232) and control group(n=126) according whether they voluntered to participate the study.All the women in two group were subjected to regular prenatal care and the women in study group received SLK training additionally.The depression,pelvic floor muscle tension and female sexual function index were evaluated by Self Rating Depression Scale(SDS),the Pelvic Floor Muscle Examination Grading Standards and the Female Sexual Function Inventory (FSFI) respectively.Results 6 months after delivery,the incidence of depression,SDS score,pelvic floor muscle tension score and live index standard rate in study group and the control group respectivelywere(10.3％ vs 18.3％),((43.6±5.1) vs(45.3±6.3)),((3.36±0.33) vs(2.46±0 89)),(81.5％ vs 65.9％),and the differences were statistically significant(P＜0.05).Conclusion SLK training program for perinatal women has the effects of preventing,treating prenatal depression and postpartum depression,improves pregnancy index and the quality of sexual life,worthy of further study.

Perinatal depression in Asian women: prevalence, associated factors, and cultural aspects.

Background and Objective: Although perinatal depression is a worldwide problem, most of the studies related to this issue have been conducted in Western countries. This paper summarizes the literature on the prevalence as well as associated factors among Asian countries where the cultural attitudes, customs, and norms are considerably different from those in Western countries. Methods: We conducted a literature search using MEDLINE (PubMed) from 1968, PsychINFO from 1970, and SCOPUS database from 1982 using keywords “depression”, “antenatal”, “antepartum”, “pregnancy”, “postnatal”, “postpartum”, “perinatal”, “after childbirth” and “Asia”. Only the articles published in English were included. Results: The overall prevalence of depression during pregnancy and postnatal period are about 20% and 21.8%, respectively. The factors related to perinatal depression can be grouped into the following categories, individual characteristics, husband/marital relationship, pregnancy-related, infant-related, and other psychosocial issues. While there is considerable overlap between Asian and Western countries with respect to risk factors for perinatal depression, premarital pregnancy, conflict with mother in-law, and dissatisfaction with infant’s gender are more specific to Asian cultures. Conclusions: Studies conducted in Asian countries suggest that the prevalence of perinatal depression is slightly higher than in Western countries. There are several unique culturally related issues that clinicians treating pregnant and postpartum Asian women should be aware as they contribute to an increased risk of depression in these women.

Depressão pós-parto e alterações de sono aos 12 meses em bebês nascidos na zona urbana da cidade de Pelotas/RS / Postpartum depression and sleep disorders in 12 month-old babies born in the urban area of Pelotas city

OBJETIVO: Verificar se existe associação entre as alterações no sono dos bebês aos 12 meses de vida e a depressão pós-parto materna. MÉTODOS: Estudo do tipo transversal aninhado a uma coorte. A amostra foi constituída por mulheres que realizaram o acompanhamento pelo Sistema Único de Saúde (SUS), nas unidades básicas de saúde do município de Pelotas, e que tiveram seus partos a partir de junho/2006. Os bebês de 12 meses oriundos dessa gestação também fazem parte da amostra. Para avaliar a presença de sintomas depressivos nas mães, foi utilizada a Edinburgh Postnatal Depression Scale (EPDS) e foram investigados os seguintes comportamentos do sono dos bebês: horas de sono por dia, regularidade do horário para dormir e acordar, sono agitado e despertar noturno. Para análise, foi utilizada Regressão de Poisson. RESULTADOS: 35,7 por cento dos bebês possuem alteração no padrão de sono. Após o ajuste ao modelo hierárquico proposto, a alteração no sono infantil manteve associação com a sintomatologia depressiva da mãe (p < 0,01). CONCLUSÕES: Os profissionais de saúde devem investigar rotineiramente os comportamentos de sono dos bebês e dar atenção à saúde mental das mães, a fim de identificar os problemas precocemente e oferecer suporte no manejo do sono dos bebês.

OBJECTIVE: Verify whether there is association between sleep disorders in babies at 12 months of age and postpartum depression in motherhood. METHODS:Cross sectional study. The sample was made up of women who had done their prenatal medical care at the National Health System (SUS), at the health basic units in Pelotas and who had their deliveries from June, 2006. The 12 month old babies from these women are also part of the sample. In order to assess depressive symptoms in the mothers, Edinburgh Postnatal Depression Scale was used and the following sleeping behaviors of the babies were investigated: hours of sleep per day, regularity of sleep and wake up time, disturbed sleep and night awakening. Poisson Regression was used for the analysis. RESULTS: 35.7 percent of the babies showed alterations in their sleeping patterns. After adjusting for the proposed hierarchal model, sleep alteration of the babies was still associated with the depressive symptoms of the mothers (p < 0,01). CONCLUSIONS: Health professionals should regularly investigate sleeping behaviors of babies and pay attention to mothers' mental health in order to identify problems early and offer support in the management of babies' sleep.

A clinical study of depressive symptoms during pregnancy / 대한산부인과학회지

OBJECTIVE: To examine the incidence of the depressive symptoms during pregnancy and the socio-demographic and obstetric factors associated with depression. METHODS: Two hundred five women who had received antenatal care at Kangnam St. Mary's Hospital from March 2008 to May 2008 completed the questionnaire related to socio-demographic characteristics and Edinburgh Postnatal Depression Scale (EPDS). Statistics were performed using chi-square test and Fisher's extract test (SPSS 12.0). Results were considered statistically significant for P-values<0.05. RESULTS: Of 205 pregnant women, the mean score of EPDS was 7.3+/-4.2.54 of 205 women (26.5%) scored more than 10 point which is the cutoff value to define depressive symptoms. The incidences of depressive symptoms were not significantly different by the trimester (25.7% vs. 29.0% vs. 25.0%, P<0.844). There were no significant socio-geographic factors associated with depressive symptoms. In cases of unexpected pregnancies, the incidence of depressive symptoms was significantly high (34.6% vs. 21.0%, P=0.036), and the women who have problems of previous pregnancies scored significantly higher EPDS (56.3% vs. 23.8%, P=0.014). CONCLUSION: This study was the first report about the depression symptoms during pregnancy. Based on this study, we have to focus on and manage depression symptoms related to pregnancy.