Factors associated with depression during pregnancy in women receiving high- and low-risk prenatal care: a predictive model.

Introduction: Depression during pregnancy can put strain on pregnant women's interpersonal relationships, the formation of emotional bonds with the fetus, and the adaptation to the new routine and social role post-pregnancy. Some studies have associated socioeconomic factors, emotional factors, interpersonal relationships, perceived social support, gestational risk, and the occurrence of certain diseases during pregnancy with higher risk of depression. Objectives: This study aimed to investigate the prevalence of depression during pregnancy and associated factors in low- and high-risk prenatal patients at a Brazilian university hospital. Methods: This study presents a retrospective and prospective cross-sectional design. A total of 684 prenatal psychological analysis records from a Brazilian tertiary university service were retrospectively evaluated to assess depression through the PRIME-MD questionnaire between 2002-2017. Between 2017 and 2018, 76 patients treated at the same service were prospectively evaluated with the aforementioned instrument. Medical records were accessed to obtain labor and birth data. Multivariate analyses assessed the association between sociodemographic, gestational or obstetric, and health variables and the presence of depression during pregnancy. Results: A total of 760 pregnant women were included in the study, with a depression prevalence of 20.66% (n = 157). At the time of assessment, 48 (21.05%) women from the low-risk pregnancy group and 109 (20.49%) from the high-risk pregnancy group were depressed. The mean age was 30.01 ± 6.55 years in the group with depression and 29.81 ± 6.50 years in the group without depression. In the univariate analysis, there was an association of risk for depression with absence of paid work, absence of a partner, low family income and diagnosis of epilepsy, being a protective factor the presence of diabetes during pregnancy. However, in the multivariate analysis, a lower family income, not having a partner at the time of the assessment, and the prevalence of epilepsy were independently associated with an increased risk of depression during pregnancy. Conclusion: This study showed that 1 in 5 women had depression during pregnancy, with no association with obstetric risk, but those women living in unfavorable economic conditions, without a partner, and having epilepsy were at increased risk of depression.

Post-Traumatic Stress Disorder in Brazilian Pregnant Women at the Beginning of the Coronavirus Disease Pandemic.

OBJECTIVE: Analyze the presence of PTSD symptoms and their risk among the pregnant women during the COVID-19 pandemic. METHODS: This is a cross-sectional study of pregnant women that received receiving prenatal care at two university hospitals in São Paulo, Brazil, during the COVID-19 pandemic, from April to June 2020. The sociodemographic and health data of the participants and their exposure to individuals suspected or confirmed to have COVID-19 were evaluated. The Impact of Event Scale-Revised and the State-Trait Anxiety Inventory were used to assess PTSD and anxiety symptoms, respectively. RESULTS: A total of 149 pregnant women were included in this study. The risk of PTSD among the participants was 55.1%. The independent risk factors for PTSD were state anxiety (ORadj = 2.6), trait anxiety (ORadj = 10.7), changes in routine due to the pandemic (ORadj = 4.7) and contact with a confirmed case of COVID-19 person (ORadj = 7.1). CONCLUSIONS: The COVID-19 pandemic had a significant negative impact on the mental health of pregnant women, more than half of the participants of the present study showed a risk of PTSD, exacerbated by anxiety symptoms and exposure to individuals with a confirmed case of COVID-19.

Postpartum depressive symptoms of Brazilian women during the COVID-19 pandemic measured by the Edinburgh Postnatal Depression Scale.

BACKGROUND: The COVID-19 pandemic gave rise to concerns about its potential impact on the mental health of pregnant and postpartum women as the general postpartum depression rates increased. METHODS: Three postpartum questionnaires (Edinburgh Postnatal Depression Scale - EPDS; Anxiety and Depression Scale - HAD; and a demographic questionnaire about isolation and information acquisition) were used to evaluate the mental health of women with and without COVID-19 and determine the factors associated with depressive symptoms (EPDS ≥ 12). RESULTS: Data from 184 participants with a mean of 56 postpartum days were analyzed. The rate of symptoms compatible with postpartum depression (PPD) was 38.8%, with a 14.3% positive response to item 10 on the EPDS (suicidal ideation - SI). Listening to the news about COVID-19 averaged 4.45 hours a day. Factors related to PPD were concerns about lack of hospital beds (OR = 2.45), absence of a partner (OR = 2.70), and anxiety symptoms (OR = 10). Factors related to SI were anxiety symptoms (OR = 1.56) and friends as a source of information (OR = 5.60). LIMITATIONS: Considering the rapidly changing epidemiological conditions of this pandemic, this study may only be the photograph of an instant. CONCLUSIONS: Higher rates of PPD in the Brazilian population are related not only to anxiety but also to an inadequate family environment, kind of information acquisition and concerns about the lack of hospital beds.