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Experiences of mothers who disclose symptoms of postnatal depressionAbraham-Smith, Kelly Michelle January 2016 (has links)
Whilst previous research has explored women's experiences of disclosing symptoms of postnatal depression (PND) to health professionals, very little qualitative research exists on women's experiences of disclosing to people in their personal support networks. Research has shown that some mothers with PND find it difficult to disclose to professionals and prefer to seek support from partners, family and friends. Aim: The current study aimed to explore the overall process mothers go through to disclose PND - to people with whom they have personal relationships, as well as health professionals. Method: Five women who experienced and disclosed PND participated in semi-structured interviews. Verbatim transcripts were analysed using Interpretative Phenomenological Analysis. Results: The analysis produced four super-ordinate themes: 'Trying to cope whilst making sense of experiences', 'Deciding whether to disclose: Facilitative and inhibiting factors', 'The two-way interpersonal nature of disclosure', 'Disclosure as part of a transformative process'. Conclusions: This study highlighted the influence of internalised expectations of motherhood and stigma surrounding PND on how mothers try to cope with their initial symptoms and on their decisions about whether or not to disclose. The participants described a cautious approach to disclosure in which they had to deal with setbacks. Consequences of disclosing were considered alongside how the disclosure process was influenced by recovery from PND.
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Adverse Life Events and Perinatal Depression Among Young Pregnant and Postpartum WomenFriesen, Kira January 2016 (has links)
Background: Young childbearing women have an increased risk of experiencing perinatal depression when compared to adult childbearing women. Perinatal depression has been associated with adverse life events in the literature and conceptually, in frameworks such as the Lifecycle Approach to Risk Factors for Mental Disorders Model. Purpose: The purpose of this manuscript-based thesis was to (1) determine the prevalence of: (i) adverse life events that have been associated with depression and (ii) depressive symptoms among the young pregnant and parenting women who access specialized services in an urban centre in Ontario, Canada; (2) determine which adverse life events are predictive of depression during the perinatal period, in this population; and (3) examine the psychometric properties of the Edinburgh Postnatal Depression Scale (EPDS) for use in a population of young childbearing women who access specialized services in an urban centre in Ontario, Canada. Methods: A survey was conducted with 102 young women from two agencies that provide specialized services to young parents. The interviewer-administered questionnaire included demographic questions, the Edinburgh Postnatal Depression Scale, the Antenatal Psychosocial Health Assessment, the Centers for Epidemologic Studies Depression Scale, Brown’s Support Behaviour Inventory. Results: 31.4% of the sample screened positive for perinatal depression. The only adverse life events found to predict perinatal depression were satisfaction with support from ‘others’ and intimate partner violence. Another predictor was very young maternal age (14 – 17 years). The EPDS was found to be psychometrically sound when used in this population of young childbearing women.
Conclusion: In this study of young childbearing women in Ontario, Canada, we found a high prevalence rate of perinatal depression and adverse life events. Furthermore, we identified specific factors that predict the development of perinatal depression in this group. Nurses can use these findings to help prioritize perinatal screening efforts to identify this condition early on in order to lessen the adversities related to perinatal depression.
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Early environments and neurobehavioural programming: Therapeutic actions of antidepressants. Neurobehavioural programming during development.Alrumaih, Ali M.S. January 2013 (has links)
Following decades of research on stress and its impact on behaviour, it is now widely accepted that selective psycho-pathologies, in particular clinical depression are more prevalent in humans with prior history of life-stress events. Interest in stress has led to questions about how it might affect the physiology and behaviour of animals exposed indirectly during gestational development. Not unexpectedly gestational stress has been shown to affect the offspring in several ways: endocrine responses to stress are elevated, fear, arousal and affective disturbances are all subject to vary if the pregnant animal is subjected to periods of aversive stimulation.
Beginning in 1997, Michael Meaney of McGill University produced a series of publications suggesting that peri-natal events influence offspring and infant development, not via physical discomfort or physiological disturbance, but does so through modifications of maternal behaviour. Highly nurturant mothers (those who engage in active arched-back nursing (ABN), and spend more time licking and grooming (L/G) their pups), programme their offspring with improved cognitive abilities, decreased anxiety and fear, and reduced HPA axis hormone secretion. Low-nurturant mothers, who engage in less ABN and less L/G, tend to programme the opposite responses in their offspring. Our initial foray into this field was to investigate if gestational stress might also produce responses in the offspring via changes in maternal behaviour, and indeed ABN and L/G were reduced in dams which were subjected to gestational stress. We queried why stressed Dams would be less maternal towards their infants, and tested gestationally-stressed Dams in the Porsolt test for depressive-like behaviour. Our results suggested that these stressed Dams were actually depressed and this resulted in less maternal behaviour. Human mothers with depression are also less maternal and have been shown to divest themselves of infant care much like our prenatally-stressed Dams. On this basis we have proposed that gestational stress induced decrements in maternal behaviour represent a novel rat model for postnatal depression with face and construct validities.
In the present work we have attempted to replicate the findings of Smythe¿s group (Smith et al., 2004), and have investigated the potential for antidepressants to alter the influence of gestational stress on maternal behaviours and depressive-like response, and whether or not the offspring¿ are modified by maternal treatment with ant-depressants. Approximately 140 time-mated, lister hooded rats were generated in house, and subjected to gestational stress on days 10-20 (1hr restraint/day) or remained undisturbed in their home cages. Following birth, cohorts of control and stressed Dams were administered vehicle or an antidepressant (imipramine 15mg/kg; or sertraline 10mg/kg) once daily until postnatal day 10.
We assessed maternal Porsolt activity, nurturance (ABN, L/G, nest building) and anxiety-like behaviour in the elevated plus maze (EPM). Representative offspring of each Dam¿s treatment conditions were maintained post weaning and assessed in the Porsolt and EPM to determine if any changes in maternal behaviour elicited by the antidepressants altered their behavioural programming. Our findings confirm that Dams show depressive-like symptoms following gestational stress, and that administration of antidepressants to the Dams reduces depressive-like behaviour and increased maternal care.
We propose that rat gestational stress is a putative model for human postnatal depression. Prenatal stress effects on maternal behaviour in the rat Dam represent a novel, and innovative model for human postnatal depression. / Ministry of Defence, Prince Sultan Military College of Health Sciences and the Saudi Culture Bureau
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Fysisk aktivitet och upplevd stress hos kvinnor 3-6 månader efter vaginal förlossning / Physical activity and perceived stress among women 3-6 months after vaginal birthNilsson, Minda January 2023 (has links)
Bakgrund: Graviditet och förlossning innebär en fysisk och mental påfrestning. Efter förlossning kan det vara svårt att återgå till den nivå av fysisk aktivitet som innan en graviditet. Med fluktuerande hormoner visar att vissa kvinnor kan vara mer utsatt för upplevd stress och ångest vilket kan leda till depression. Det finns ej några nationella riktlinjer för fysisk aktivitet och träning postpartum. Det finns endast ett fåtal studier som studerar sambandet mellan fysisk aktivitetsnivå och stress hos kvinnor postpartum. Syfte: Syftet är att undersöka fysisk aktivitet och upplevd stress, samt sambandet mellan fysisk aktivitet och upplevd stress hos kvinnor i Sverige 3 – 6 månader efter vaginal förlossning. Metod: En korrelerande och deskriptiv kvantitativ icke experimentell design användes i denna tvärsnittsstudie. Urvalet skedde via riktade svenska Facebookgrupper och självskattningsenkäter rörande fysisk aktivitetsnivå (Socialstyrelsens indikatorfrågor om fysisk aktivitet) och upplevd stress (The Perceived stress scale - 10) samlades in vid ett tillfälle från 26 kvinnor. Totalt 19 enkäter användes i undersökningen. Resultat: Studiedeltagarna skattade sin vardagsmotion till 225 minuter/vecka (IQR = 180), sin fysiska träning till 15 min/vecka (IQR = 75), samt totala aktivitetsminuter till 300 minuter/vecka (IQR = 225). Den upplevda stressnivån skattades till 16 (IQR = 10). En svag, icke signifikant negativ korrelation förelåg mellan totala aktivitetsminuter och upplevd stress (r = -0,25). Slutsats: Denna studie är den enda studien som studerat samband mellan fysisk aktivitetsnivå och stress hos kvinnor 3–6 månader postpartum. Ingen korrelation förelåg men kvinnorna hade en relativt hög fysisk aktivitetsnivå totalt. Undersökningen har gjorts på en liten grupp individer på 19 personer och därför är slutsatser svåra att dra. / Background: Pregnancy and childbirth involve physical and mental strain. After giving birth, it can be difficult to return to the level of physical activity within a pregnancy. Having fluctuating hormones shows that some women may be more vulnerable to perceived stress and anxiety which can lead to depression. There are no national guidelines for physical activity and exercise postpartum. Only few studies study the relationship between physical activity level and stress in postpartum women. Objective: The aim is to investigate physical activity and perceived stress, as well as the relationship between physical activity and perceived stress in women in Sweden 3 – 6 months after giving vaginal birth. Method: A correlational and descriptive quantitative non-experimental design was used in this cross-sectional study. The selection took place via targeted Swedish Facebook groups and self-assessment questionnaires regarding physical activity level (The National Board of Health and Welfare's indicator questions on physical activity) and perceived stress (The Perceived stress scale-10) were collected on one occasion from 26 women. A total of 19 questionnaires were used in the survey. Results: The study participants estimated their daily exercise to be 225 minutes/week (IQR = 180), their physical training to be 15 minutes/week (IQR = 75), and a total activity level to 300 minutes/week (IQR = 225). The perceived stress level was estimated at 16 (IQR = 10). A weak, non-significant negative correlation existed between total activity minutes and perceived stress (r = -0.25). Conclusion: This study is the only study that studied the relationship between physical activity level and stress in women 3–6 months postpartum. There was no correlation, but the women had a relatively high level of physical activity overall. The study has been done on a small group of individuals of 19 people, which is why conclusions are difficult to draw.
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Postnatal depression (PND) and neighborhood effects for women enrolled in a home visitation programJones, David 03 June 2016 (has links)
No description available.
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En nybliven mor kan vara en deprimerad mor : Om förväntningar, självanklagelser och hjälpbehov / A new mother can be a depressed mother : A study about expectations, self-accusations and the need for helpSjöström, Elin, Törnell, Malin January 2016 (has links)
The aim of this study was to examine how expectations may affect a new mother during postnatal depression, both her own expectations and he expectations she feels from her surroundings. The result is based on seven interviews with mothers who have had postnatal depression. It is not uncommon for women to suffer from postpartum depression after childbirth, studies show that approximately ten percent of all new mothers are affected. Symptoms of postpartum depression are, besides the symptoms for regular depression also feelings of worthlessness and hopelessness or she might difficulties feeling happy about the situation and the baby. Qualitative content analysis was used to analyse the material. The study shows that those feelings does not go well together with the so called mother myth, that the new mother is supposed to feel instant love towards the baby and be the more responsible parent. This leads to the mother feeling guilty and ashamed. Because of this, several mothers feel reluctant to seek help. This is due to emotions of guilt and shame. The study also showed that the women felt a lack of professional care and the need for development in the professional field. Three important factors in the care were presented: Information, knowledge and understanding.
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Qualidade de vida relacionada à saúde de mulheres grávidas com sintomas depressivos / Health related quality of life of pregnant women with depressive symptomsLima, Marlise de Oliveira Pimentel 11 February 2011 (has links)
Os objetivos do estudo foram: analisar a influência dos sintomas depressivos na qualidade de vida relacionada à saúde percebida por mulheres na gestação de baixo risco e pós-parto e verificar os fatores socioeconômicos e obstétricos associados à qualidade de vida e aos sintomas depressivos. Trata-se de um estudo longitudinal, com inclusão de 313 gestantes matriculadas em 11 Unidades Básicas de Saúde da zona sul do Município de São Paulo, SP. As participantes foram seguidas em quatro etapas: 20ª, 28ª, 36ª semanas de gestação e 45 dias após o parto, com ± 2 semanas em cada etapa. A coleta dos dados foi de julho de 2008 a março de 2010. A amostra final das quatro etapas constou de 132 mulheres. Os dados sociodemográficos e obstétricos foram obtidos por meio de entrevista na primeira etapa, com exceção dos do pós-parto, que foram coletados na quarta etapa. Para avaliação dos sintomas depressivos, foi utilizada a Edinburgh Postnatal Depression Scale (EPDS) e para avaliação da qualidade de vida relacionada à saúde, o questionário Medical Outcomes Study 36-Item Short Form Health Survey (MOS-SF36), que foram autoaplicados nas quatro etapas. O estudo foi aprovado pelo Comitê de Ética em Pesquisa - Parecer nº 154/08-CEP/SMS. Os escores médios dos domínios do MOS-SF36 apresentaram declínio ao longo da gestação com recuperação no pós-parto, exceto Estado Geral de Saúde e Saúde Mental, com diferença significativa para Capacidade Funcional (p<0,000), Aspectos Físicos (p=0,001), Dor (p<0,001) e Vitalidade (p=0,002). A proporção de gestantes com sintomas depressivos variou nas quatro etapas, sendo de 29,5% na 20ª, 24,2% na 28ª, 24,5% na 36ª semanas de gestação e 33,6% com 45 dias de pós-parto. Houve correlação inversa significativa em todos os domínios do MOS-SF36 e a EPDS, com variação no coeficiente de Spearman de 0,234 a 0,785. Nas quatro etapas, os escores médios dos domínios mostraram diferenças significantes, na comparação entre gestantes sem e com sintomas depressivos, exceto Dor, na segunda etapa e Aspectos Físicos na quarta. Na regressão logística da qualidade de vida relacionada à saúde, os sintomas depressivos foram um fator de risco em todos os domínios, exceto Aspectos Físicos. Para os sintomas depressivos, as variáveis associadas foram situação conjugal, anos de estudo e número de consultas de pré-natal, como fatores de proteção e queixas como fator de risco. A presença dos sintomas depressivos na gestação e puerpério altera a percepção subjetiva da qualidade de vida relacionada à saúde em gestantes de baixo risco. / The aims of the present study were to analyze the influence of depressive symptoms on the health related quality of life (HRQOL) perceived by low risk pregnant women and at postpartum and verify the socioeconomic and obstetric factors associated with the quality of life and depressive symptoms. This is a longitudinal study and it was conducted with 313 pregnant women enrolled in 11 Basic Health Units of the southern area of São Paulo City, SP. The participants were followed up at their 20th, 28th, 36th weeks of gestation and 45 days postpartum, with ± 2 weeks in each periods. Data was collected from July 2008 to March 2010. The final sample of four periods consisted of 132 women. Sociodemographic and obstetric data was obtained by interviewing subjects in the first period and postpartum data in the fourth period. For the assessment of depressive symptoms, Edinburgh Postnatal Depression Scale (EPDS) was used and to assess the health related quality of life (HRQOL), the questionnaire Medical Outcomes Study 36-Item Short Form Health Survey (MOS-SF36), which were self-administered in four stages. The study was approved by the Ethics in Research Committee nº 154/08-CEP/SMS. The mean scores of the domains of MOS-SF36 presented decline over the gestation with postpartum recovery, except in General (Health) and Mental Health, with a significant difference in Physical Functioning (p<0,000), Role Limitation due to Physical Problems (p=0,001), Bodily Pain (p<0,001) and Vitality (p=0,002). The proportion of pregnant women with depressive symptoms was 29.5% at 20th, 24.2% at 28th, 24.5% at 36th weeks of gestation and 33.6% at 45 days postpartum. There was a significant inverse correlation among all domains of the MOS-SF36 and the EPDS, with Spearman coefficients range of 0.234 to 0.785. At the four periods, the mean scores of the domains showed significant differences between pregnant subjects with or without depressive symptoms except Bodily Pain in the second period and Role Limitation due to Physical Problems in the fourth one. At HRQOL logistic regression the depressive symptoms were a risk factor in all domains, except Role Limitation due to Physical Problems. To depressive symptoms, the associated factors were marital status, years of education and the number of prenatal consultations as protective factors and complaints as a risk factor. The presence of depressive symptoms at pregnancy and postpartum changes the subjective perception of Health related quality of life in low risk pregnant women.
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Improving Emotional Care For Childbearing Women: An Intervention StudyGamble, Jennifer Anne, n/a January 2003 (has links)
Childbirth can be associated with short and long-term psychological morbidity including depression, anxiety and trauma symptoms. Some previous studies have used psychological interventions to reduce postpartum distress but have primarily focussed on attempting to relieve symptoms of depression with little recognition of trauma symptoms. Furthermore, the intervention used in these studies has generally been poorly documented. The first aim of the present study was to develop a counselling framework, suitable for use by midwives, to address psychological trauma following childbirth. Multiple methods were used to develop the intervention including focus groups with women and midwives. Both the women and midwives gave unequivocal support for postpartum debriefing. Themes that emerged from the focus groups with women included the need for opportunities to talk about their birth experience, an explanation of events, an exploration of alternative courses of action that may have resulted in a different birth experience, talking about their feelings such as loss, fear, anger and self-blame, discussing social support, and discussing possible future childbearing. There was a high level of agreement between the women's and midwives' views. These themes were synthesized with contemporary literature describing counselling interventions to assist in reconciling a distressing birth experience and a model for understanding women's distressing birth experiences to develop a counselling framework. The counselling intervention was then tested using a randomised controlled study involving 400 women recruited from antenatal clinics of three public hospitals. When interviewed within seventy-two hours of birth, 103 women reported a distressing birth experience and were then randomised into either the treatment or control group. Women in the intervention group had the opportunity to debrief at the initial postpartum interview (< 72 hours postpartum) and at four to six weeks postpartum. The prevalence of posttraumatic stress disorder was quite high; 9.6% of participants meeting the diagnostic criteria for acute PTSD at four to six weeks postpartum. Fewer participants (3.5%) met the diagnostic criteria for chronic PTSD at three months postpartum. As with previous research relating to childbearing women, few demographic factors or antenatal psychological factors were associated with the development of a PTSD symptom profile following childbirth. The development of PTSD symptom profile was strongly associated with obstetric intervention and a perception of poor care in labour. This finding is also consistent with previous research. Emotional distress was reduced for women in the intervention group in relation to the number of PTSD symptoms [t (101) = 2.144, p = .035], depression [c2 (1) = 9.188, p = .002], stress [c2 (1) = 4.478, p = .029] and feelings of self-blame [t (101) = -12.424, p <.001]. Confidence about a future pregnancy was higher for these women [t (101) = -9.096, p <.001]. Although there was not a statistically significant difference in the number of women with a PTSD symptom profile at three months postpartum, fewer women in the intervention group (n=3) than in the control group (n=9) met PTSD criteria. Likewise, there were fewer women in the intervention group (n=1) with anxiety levels above mild than in the control group (n=6). Importantly, this study found that offering women who have had a traumatic birth the opportunity for counselling using the framework documented in this dissertation was not harmful. This finding is in contrast to previous findings of other studies. The intervention was well received by participants. All the women in the intervention group found the counselling sessions helped them come to terms with their birth experience. Maternity service providers need to be cognizant of the prevalence of this debilitating condition and be able to identify women at risk for early intervention and referral to a mental health practitioner if appropriate. This research offers further support for the compelling need to implement changes to the provision of maternity services that reduce rates of obstetric intervention and humanise service delivery as a means of primary prevention of birth-related PTSD.
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Kvinner med fødselsdepresjon – finner vi dem? : En intervjustudie av helsesøstres opplevelser på helsestasjoner i Oslo. / Women with postnatal depression – do we trace them? : Interviews with public health nurses about their experiences in primary health care in OsloAnker-Rasch, Celina January 2005 (has links)
Hensikten med studien var å forstå hvordan helsesøstre jobber for å finne og hjelpe kvinnermed fødselsdepresjon, hvor effektivt dette arbeidet oppleves og deres holdning til ny kunnskap og til å ta nye metoder i bruk i arbeidet. Fødselsdepresjon er hyppig i barselperioden og flere studier viser at tilstanden ofte oversees. Fødselsdepresjon kan føre til forstyrrelser i ”bonding” mellom mor og barn som kan hanegativ innflytelse på barnets utvikling og helse. Hjelp og støtte til kvinnene vil ha betydning for mors- og barns fremtidige helse. I en kvalitativ studie ble 14 helsesøstre påhelsestasjoner i Oslo intervjuet om hvordan de finner frem til disse kvinnene og om de finner alle, samt deres holdning til å ta i bruk Edinburgh Postnatal Depression Scale (EPDS), som er et spørreskjema utviklet til bruk i primærhelsetjenesten for å oppdage kvinner med fødselsdepresjon. Det er benyttet en hermeneutisk/fenomenologisk tilnærming. Resultatet viser at helsesøstrene mangler en klar metode for å finne kvinner med fødselsdepresjon. De baserer seg på egen erfaring, personlighet og intuisjon og innser at de ikke finner alle. De er gjennomgående positive til å få mere kunnskap og ta i bruk EPDS . Denne studien bør følgesopp med en bred debatt om hvorvidt man ønsker en screening for fødselsdepresjon og hvordan man ser for seg organisering av oppfølging for kvinnene / The aim of this study was to understand how public health nurses work to trace women with postnatal depression, how effective they find their work and their attitude towards new knowledge and methods. Postnatal depression is common in the postnatal period and studies show that the conditionoften is not detected. Postnatal depression may lead to disturbances in the bonding between mother and child which can have a negative influence on the child’s development and health. Help and support given to these women will have a positive impact on both the mothers’ and the children’s future health. In a qualitative study 14 public health nurses wereinterviewed and asked how they trace these women, whether they miss some and their attitude towards using Edinburgh Postnatal Depression Scale (EPDS), which is aquestionnaire validated for use in primary health care to detect women with postnataldepression. The design had a hermeneutical/phenomenological approach. The results showed that the public health nurses do not have a method to trace women with postnatal depression. They rely on their experience, personality and intuition and are aware that they do not trace all.They are positive towards getting more knowledge about postnatal depression and to start using EPDS. Further research should include discussions about whether screening for postnatal depression is desired and how the follow-up for the women should be organized / <p>ISBN 91-7997-116-4</p>
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Qualidade de vida relacionada à saúde de mulheres grávidas com sintomas depressivos / Health related quality of life of pregnant women with depressive symptomsMarlise de Oliveira Pimentel Lima 11 February 2011 (has links)
Os objetivos do estudo foram: analisar a influência dos sintomas depressivos na qualidade de vida relacionada à saúde percebida por mulheres na gestação de baixo risco e pós-parto e verificar os fatores socioeconômicos e obstétricos associados à qualidade de vida e aos sintomas depressivos. Trata-se de um estudo longitudinal, com inclusão de 313 gestantes matriculadas em 11 Unidades Básicas de Saúde da zona sul do Município de São Paulo, SP. As participantes foram seguidas em quatro etapas: 20ª, 28ª, 36ª semanas de gestação e 45 dias após o parto, com ± 2 semanas em cada etapa. A coleta dos dados foi de julho de 2008 a março de 2010. A amostra final das quatro etapas constou de 132 mulheres. Os dados sociodemográficos e obstétricos foram obtidos por meio de entrevista na primeira etapa, com exceção dos do pós-parto, que foram coletados na quarta etapa. Para avaliação dos sintomas depressivos, foi utilizada a Edinburgh Postnatal Depression Scale (EPDS) e para avaliação da qualidade de vida relacionada à saúde, o questionário Medical Outcomes Study 36-Item Short Form Health Survey (MOS-SF36), que foram autoaplicados nas quatro etapas. O estudo foi aprovado pelo Comitê de Ética em Pesquisa - Parecer nº 154/08-CEP/SMS. Os escores médios dos domínios do MOS-SF36 apresentaram declínio ao longo da gestação com recuperação no pós-parto, exceto Estado Geral de Saúde e Saúde Mental, com diferença significativa para Capacidade Funcional (p<0,000), Aspectos Físicos (p=0,001), Dor (p<0,001) e Vitalidade (p=0,002). A proporção de gestantes com sintomas depressivos variou nas quatro etapas, sendo de 29,5% na 20ª, 24,2% na 28ª, 24,5% na 36ª semanas de gestação e 33,6% com 45 dias de pós-parto. Houve correlação inversa significativa em todos os domínios do MOS-SF36 e a EPDS, com variação no coeficiente de Spearman de 0,234 a 0,785. Nas quatro etapas, os escores médios dos domínios mostraram diferenças significantes, na comparação entre gestantes sem e com sintomas depressivos, exceto Dor, na segunda etapa e Aspectos Físicos na quarta. Na regressão logística da qualidade de vida relacionada à saúde, os sintomas depressivos foram um fator de risco em todos os domínios, exceto Aspectos Físicos. Para os sintomas depressivos, as variáveis associadas foram situação conjugal, anos de estudo e número de consultas de pré-natal, como fatores de proteção e queixas como fator de risco. A presença dos sintomas depressivos na gestação e puerpério altera a percepção subjetiva da qualidade de vida relacionada à saúde em gestantes de baixo risco. / The aims of the present study were to analyze the influence of depressive symptoms on the health related quality of life (HRQOL) perceived by low risk pregnant women and at postpartum and verify the socioeconomic and obstetric factors associated with the quality of life and depressive symptoms. This is a longitudinal study and it was conducted with 313 pregnant women enrolled in 11 Basic Health Units of the southern area of São Paulo City, SP. The participants were followed up at their 20th, 28th, 36th weeks of gestation and 45 days postpartum, with ± 2 weeks in each periods. Data was collected from July 2008 to March 2010. The final sample of four periods consisted of 132 women. Sociodemographic and obstetric data was obtained by interviewing subjects in the first period and postpartum data in the fourth period. For the assessment of depressive symptoms, Edinburgh Postnatal Depression Scale (EPDS) was used and to assess the health related quality of life (HRQOL), the questionnaire Medical Outcomes Study 36-Item Short Form Health Survey (MOS-SF36), which were self-administered in four stages. The study was approved by the Ethics in Research Committee nº 154/08-CEP/SMS. The mean scores of the domains of MOS-SF36 presented decline over the gestation with postpartum recovery, except in General (Health) and Mental Health, with a significant difference in Physical Functioning (p<0,000), Role Limitation due to Physical Problems (p=0,001), Bodily Pain (p<0,001) and Vitality (p=0,002). The proportion of pregnant women with depressive symptoms was 29.5% at 20th, 24.2% at 28th, 24.5% at 36th weeks of gestation and 33.6% at 45 days postpartum. There was a significant inverse correlation among all domains of the MOS-SF36 and the EPDS, with Spearman coefficients range of 0.234 to 0.785. At the four periods, the mean scores of the domains showed significant differences between pregnant subjects with or without depressive symptoms except Bodily Pain in the second period and Role Limitation due to Physical Problems in the fourth one. At HRQOL logistic regression the depressive symptoms were a risk factor in all domains, except Role Limitation due to Physical Problems. To depressive symptoms, the associated factors were marital status, years of education and the number of prenatal consultations as protective factors and complaints as a risk factor. The presence of depressive symptoms at pregnancy and postpartum changes the subjective perception of Health related quality of life in low risk pregnant women.
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