Depresión posparto: prevalencia y factores de riesgo asociados en una muestra de población mexicana / Postpartum depression: prevalence and associated risk factors in a sample of the Mexican population

Resumen OBJETIVO: Determinar la prevalencia de depresión posparto en una muestra de población mexicana por medio de la Escala de Edimburgo y los factores de riesgo asociados con su inicio MATERIALES Y MÉTODOS: Estudio observacional, transversal, relacional y analítico efectuado en una muestra de población mexicana atendida entre los meses de marzo a julio del 2022 en cuatro hospitales de segundo y tercer nivel de cuatro entidades de la República Mexicana. Se aplicó la escala de Edimburgo a pacientes en el puerperio. Los datos obtenidos se procesaron con una técnica de regresión logística binaria ajustada para identificar los factores de riesgo más importantes de depresión posparto. RESULTADOS: De una muestra de 717 pacientes a quienes se aplicó la Escala de Edimburgo, 106 resultaron positivas a depresión posparto, lo que da una prevalencia del 14.9%. La edad promedio de las pacientes fue de 26 años (límites de 12 y 46). El estado civil soltera resultó un factor protector de depresión posparto y, en su contraparte, quienes estaban casadas tuvieron cierta predisposición a la depresión posparto. A mayor grado de escolaridad menor predisposición a la depresión posparto. CONCLUSIONES: Los principales factores de riesgo de depresión posparto fueron: el antecedente de trastornos psiquiátricos en la familia, depresión previa, dificultades económicas y ser soltera. Las pacientes pueden cursar con diversos factores de riesgo simultáneos, circunstancia que potencia el riesgo de depresión. Es primordial que el obstetra identifique los factores de riesgo desde el control prenatal, a fin de prevenir que el estado depresivo se agudice durante el puerperio.

Abstract OBJECTIVE: To determine the prevalence of postpartum depression in a Mexican population sample by means of the Edinburgh Scale and the risk factors associated with its onset. MATERIALS AND METHODS: Observational, cross-sectional, relational and analytical study carried out in a sample of Mexican population attended from March to July 2022 in four second and third level hospitals in four Mexican states. The Edinburgh scale was applied to postpartum patients. The data obtained were processed with a binary logistic regression technique adjusted to identify the most important risk factors for postpartum depression. RESULTS: From a sample of 717 patients to whom the Edinburgh Scale was applied, 106 were positive for postpartum depression, giving a prevalence of 14.9%. The average age of the patients was 26 years (range 12 and 46). Unmarried marital status was a protective factor for postpartum depression and, on the other hand, those who were married had a certain predisposition to postpartum depression. The higher the level of schooling the lower the predisposition to postpartum depression. CONCLUSIONS: The main risk factors for postpartum depression were: history of psychiatric disorders in the family, previous depression, economic difficulties and being single. Patients may have several simultaneous risk factors, a circumstance that increases the risk of depression. It is essential for the obstetrician to identify the risk factors from the prenatal check-up, to prevent the depressive state from worsening during the puerperium.

Incidencia de depresión en mujeres embarazadas y puérperas mediante la aplicacion de la escala de edimburgo en el hospital de la mujer de la ciudad de la paz, entre los meses de noviembre y diciembre de 2020 en el contexto de la pandemia de la enfermedad por sars cov 2 / Incidence of depression in pregnant and puerperal women through the application of the Edinburgh scale in the women's hospital of the city of La Paz, between the months of November and December 2020 in the context of the pandemic of the disease by sars cov 2

Introducción: El objetivo del presente estudio es determinar la incidencia de depresión en mujeres embarazadas y puérperas mediante la escala de Edimburgo en el Hospital de la Mujer de la ciudad de La Paz entre noviembre y diciembre de 2020, en el contexto de la pandemia de la enfermedad por SARS COV 2. Material y Métodos: Se aplicó un estudio descriptivo, observacional de corte transversal. Conclusiones: La incidencia de depresión en mujeres embarazadas y puérperas de consulta externa e internadas en el Hospital de la Mujer de la ciudad de La Paz mediante la aplicación de la escala de Edimburgo con puntuación igual o mayor a 13, es de 37% que corresponde a 44 pacientes. Los factores sociodemográficos asociados son: 21 pacientes se encontraban en etapa de puerperio mediato. 17 pacientes entre los 16 a 25 años, 24 pacientes tenían como estado civil unión libre, 34 pacientes eran de la ciudad de área urbana, 15 pacientes tenían como nivel de formación bachillerato, la ocupación más frecuente era labores de casa en 36 pacientes, 5 eran primíparas, 4 tuvieron hijos fallecidos, 8 pacientes tuvieron hijo con enfermedad grave, 3 paciente tuvieron un embarazo no deseado, 8 tuvieron antecedente de aborto, 38 pacientes pertenecen a familias nucleares, 6 pacientes viven violencia intrafamiliar, 3 presentan abuso de bebidas alcohólicas, 5 pacientes tenían enfermedad crónica, 10 tuvieron antecedente de depresión. Los síntomas más frecuentes son: ansiedad en 42 pacientes, llanto en 41, pánico en 39 y desesperanza en 36.

Introduction: The objective of this study is to determine the incidence of depression in pregnant and postpartum women using the Edinburgh scale at the Women's Hospital in the city of La Paz between November and December 2020, in the context of the pandemic of the disease due to SARS COV 2. Material and methods: A descriptive, observational cross-sectional study was applied. Conclusions: The incidence of depression in pregnant and postpartum women in out patient clinics and in patients at the Women's Hospital in the city of La Paz through the application of the Edinburgh scale with a score equal to or greater than 13, is 37%, which corresponds to 44 patients. The associated sociodemographic factors are: 21 patients were in the immediate puerperium stage. 17 patients between 16 and 25 years old, 24 patients marital status free union, 34 patients were from the city of urban area, 15 patients had a high school education level, the most frequent occupation was housework in 36 patients, 5 were primiparous, 4 had deceased children, 8 patients had children with serious illness, 3 patients had an unwanted pregnancy, 8 had a history of abortion, 38 patients belong to nuclear families, 6 patients experience domestic violence, 3 have alcohol abuse, 5 patients had a chronic disease, 10 had a history of depression. The most frequent symptoms are: anxiety in 42 patients, crying in 41, panic in 39 and hopelessness in 36.

Depresión posparto valorada mediante la escala de Edimburgo / Postpartum depression assessed by the scale Edinburgh

Objetivo: Determinar la prevalencia de depresión posparto en puérperas atendidas en el Servicio de Obstetricia del Hospital General del Oeste “Dr. José Gregorio Hernández” de Caracas, durante el período comprendido entre junio y septiembre de 2013. Métodos: Se realizó una investigación de tipo descriptiva y prospectiva, con una muestra de 249 puérperas, aplicando la escala de depresión posparto de Edimburgo para detectar depresión posparto. Resultados: En el puerperio mediato hubo una prevalencia de depresión posparto de 84,2% en las adolescentes y de 81,5% en las adultas sin diferencia significativa entre ambos grupos. Conclusión: La prevalencia de depresión posparto fue elevada en adolescentes y en adultas, predominando la depresión posparto de grado moderada.

Objective: To determinate prevalence of depression in postpartum women attended in the Obstetric Service of General Hospital of the West “Dr. Jose Gregorio Hernandez” in Caracas, during June to September 2013. Methods: By means of a descriptive and prospective study, postpartum depression was investigated in a sample of 249 patients, applying the Edinburgh Postpartum Depression Scale. Results: In mediate puerperium there was postpartum depression prevalence of 84.2 % in adolescents and of 81.5 % in adults, without significant difference between both groups. Conclusion: The prevalence of postpartum depression was high in adolescents and adults, predominating postpartum depression of moderate grade.

Factores de riesgo de depresión posparto en puérperas venezolanas valoradas por medio de la escala de Edimburgo / Risk factors of postpartum depression in Venezuelan women measured by Edinburgh postnatal depression scale

Antecedentes: La depresión posparto (DPP) es un importante trastorno de la salud mental en la mujer, al cual se le han atribuido variados factores de riesgo para su presentación. Objetivo: Se propuso determinar los factores de riesgos para DPP en puérperas atendidas en la Maternidad "Dr. Armando Castillo Plaza" del Hospital Universitario de Maracaibo, Venezuela. Método: Se realizó una investigación descriptiva con diseño no experimental, mediante una muestra de 100 puérperas, evaluadas por la Escala de Depresión Postparto de Edimburgo (EDPS). Resultados: Hubo una prevalencia del test positivo del 91 por ciento, con una prevalência de DPP confirmada mediante el DSM-IV del 22 por ciento. De las características evaluadas solo los trastornos médicos durante el embarazo, la enfermedad del neonato, no contar con el apoyo de su pareja, presentar antecedentes de depresión o melancolía o tener un nivel educativo primario o inferior, mostraron una asociación significativa con el desarrollo de DPP. El nacimiento mediante cesárea y no contar con el apoyo familiar presentaron una asociación significativa con el riesgo de DPP; mientras que el parto vaginal o haber alcanzado un nivel educativo superior a la primaria mostraron tener un efecto protector. Conclusión: Existe una alta prevalencia de DPP, con diversos factores de riesgo que permitirían tomar acciones para un diagnóstico oportuno de esta enfermedad.

Background: Postpartum depression (PPD) is a major mental health disorder in women, which have been attributed to various risk factors for it presentation. Objective: To determine the PPD's risk factors present in the postpartum patients taken care of Maternity "Dr Armando Castillo Plaza" at the University Hospital of Maracaibo, Venezuela. Method: A descriptive study was conducted with non-experimental design, which included a sample of 100 postpartum women, as measured by the scale of the Edinburgh Postpartum Depression (EDPS). Results: The results demonstrated a prevalence of the positive test in 91 percent of the sample, with a confirmed prevalence of postpartum depression by the DSM-IV of 22 percent, determined that the characteristics assessed only medical disorders during pregnancy, the disease of the newborn, not having the support from your partner, have a history of depression or melancholy, or have a primary or lower education level, showed a significant association with the development of PPD. For its part, the birth by caesarean section and not having family support showed a significant association with the risk of PPD, while vaginal delivery or have reached a level higher than primary education showed a protective effect with this condition. Conclusion: There is a high prevalence of postpartum depression, with several risk factors that would take action for a timely diagnosis of disease.

Aspectos epidemiológicos da depressão pós-parto em amostra brasileira / Postpartum depression epidemiology in a Brazilian sample

INTRODUÇÃO: Sintomas psiquiátricos são freqüentes após o parto, momento marcado por alterações hormonais e mudanças no caráter social, na organização familiar e na identidade feminina. A Escala de Depressão Pós-Parto de Edimburgo (EPDS) é instrumento de auto-avaliação para rastrear depressão após a gestação, nem sempre adequadamente reconhecida pelos profissionais de saúde. O objetivo deste estudo foi avaliar prevalência de depressão pós-parto em mulheres atendidas em unidades básicas de saúde. MÉTODOS: Estudo transversal com aplicação da EPDS em 292 mulheres que se encontravam entre 31 e 180 dias após o parto. Adotamos o ponto de corte < 12 na EPDS como depressão. RESULTADOS: Do total, 115 (39,4 por cento) apresentaram escores < 12, na EPDS, foram consideradas deprimidas; 177 (60,6 por cento), com escores < 12, foram consideradas não-deprimidas. Mulheres com menor escolaridade, maior número de gestações, maior paridade, maior número de filhos vivos e menor tempo de relacionamento apresentaram mais depressão. CONCLUSÃO: A elevada freqüência de depressão pós-parto está relacionada com fatores sociais, demonstrando a importância dos profissionais de atenção básica na detecção precoce da depressão, tendo como auxílio instrumentos como a EPDS, pela sua eficácia e praticidade.

INTRODUCTION: Psychiatric symptoms are frequent in the postpartum period, a moment marked by hormonal alterations and changes in social character, family organization and women's identity. The Edinburgh Postnatal Depression Scale (EPDS) is a self-reporting instrument to track depression after pregnancy, unfortunately not always properly supported by health care professionals. This study aimed at verifying the prevalence of postpartum depression in women receiving care at basic health units. METHODS: Cross-sectional study including 292 women in the postpartum period (from day 31 to 180) who answered the EPDS questionnaire. Cut-off point < 12 for EPDS depression was used. RESULTS: A total of 115 women (39.4 percent) had scores < 12 in EPDS, classified as depressive; 177 (60.6 percent) had scores < 12 and were not considered depressive. Women with lower education, higher number of pregnancies, higher parity, higher number of live children and shortest relationship time had more depression. CONCLUSION: High frequency of postpartum depression is associated with social factors, which shows the importance of health care professionals in early detection of depression, with the aid of instruments such as EPDS, due to its efficacy and practicability.

Variables posiblemente asociadas a depresión posparto, según escala Edimburgo / Variables probably associated to postpartum depression, according to the Edimburg scale

Analizar algunas variables sociodemográficas, obstétricas y perinatales asociadas al riesgo de depresión posparto, según escala de Edimburgo. Departamento de Obstetricia y Puericultura. Facultad de Medicina, Universidad de Concepción y Hospital de Coronel, Chile. Estudio analítico, observacional en 50 puérperas que asistieron a control a la 6° semanas posparto en el 2006. Se les aplicó la escala de Edimburgo, escala de Graffar y un instrumento de variables obstétricas y perinatales. Para el análisis estadístico se aplicó las pruebas Fisher y Chicuadrado. La frecuencia de test positivo según escala de Edimburgo, fue de 22 por ciento. La edad, escolaridad, estado civil, nivel socioeconómico, paridad, patologías del embarazo, tipo de parto, hospitalización del recién nacido, no resultaron estadísticamente diferentes para riesgo de depresión posparto. Es necesario realizar un tamizaje universal para la pesquisa precoz de depresión posparto y realizar nuevos estudios considerando otros factores asociados.

To analyze some socio-demographic, obstetrical and perinatal factors associated to postpartum depression risk in women, according to the Edinburgh Postnatal Depression Scale. Setting: Department of Obstetrics and Puericulture. Faculty of Medicine, University of Concepcion and Hospital of Coronel, Chile. Analytical and observational study in 50 postnatal women that attended control to six weeks pospartum in 2006. It was applied the Edinburgh Postnatal Depression Scale, Graffar scale and an instrument of obstetrical and perinatal variables. For the statistical analysis, the Fisher and Chisquare tests were applied. The frequency of positive test accordong to the Edinburg scale was 22 percent. The age, marital status, socioeconomic level, parity, pregnancy pathologies, type of delivery, and hospitalization of newborn, were not statistically different for postpartum depression risk. It is necessary to make a universal screening for the precocious detection of postpartum depression and to performe studies considering other associated factors.