Depressão, Ideação Suicida e Fatores Associados em Gestantes de Alto Risco
DOI:
https://doi.org/10.20435/pssa.v1i1.3021Palavras-chave:
depressão, Gravidez de alto risco, Ideação suicida, prevalênciaResumo
Este estudo objetiva identificar a prevalência de depressão e ideação suicida e seus fatores associados em gestantes de um ambulatório de pré-natal de alto risco. Foi realizado um estudo transversal censitário com 215 gestantes de alto risco atendidas por um ambulatório especializado, localizado em um hospital no extremo sul do Brasil. As pacientes responderam ao questionário sociodemográfico e a Escala de Depressão de Edimburgo. Foi encontrada uma prevalência de depressão de 40,5% e de ideação suicida foi de 20%. Foram identificadas associações entre o aumento de depressão e histórico de doença mental (RP: 1,18; IC95%: 1,07-1,36), suporte social considerado como bom e suporte social considerado mediano ou ruim (RP:1,34; IC95%: 1,20-1,51). Foram encontradas associações entre maior prevalência de ideação suicida e viver com HIV (RP 1,17; IC95%: 1,02-1,34), história de doença mental (RP: 1,15; IC95%: 1,06-1,23), suporte social bom (RP: 1,16; IC95%: 1,06-1,29) e suporte social percebido como mediano ou ruim (RP: 1,17; IC95%: 1,07-1,29). Os resultados apontam para necessidade de triagem psicológica nos serviços especializados, bem como estratégias para melhorar o planejamento familiar e o suporte social na gravidez de alto risco.
Referências
Abebe, W., Gebremariam, M., Molla, M., Teferra, S., Wissow, L., & Ruff, A. (2022, 20 Janreiro). Prevalence of depression among HIV-positive pregnant women and its association with adherence to antiretroviral therapy in Addis Ababa, Ethiopia. Plos One, p. 1–13. https://doi.org/10.1371/journal.pone.0262638 DOI: https://doi.org/10.1371/journal.pone.0262638
Acheanpong, K., Pan, X., Kaminga, A. C., & Liu, A. (2022). Prevalence and risk factors of prenatal depression among pregnant women attending antenatal clinic at Adventist Hospital, Bekwai Municipality, Ghana. Medicine (Baltimore), 101(10), 1–9. https://doi.org/10.1097/MD.0000000000028862 DOI: https://doi.org/10.1097/MD.0000000000028862
Arditi-Arbel, B., Hamdan, S., Winterman, M., & Gvion, Y. (2023). Suicidal ideation and behavior among perinatal women and their association with sleep disturbances, medical conditions, and known risk factors. Frontiers in psychiatry, 13, 987673. http://dx.doi.org/10.3389/fpsyt.2022.987673 DOI: https://doi.org/10.3389/fpsyt.2022.987673
Ayano, G., Tesfaw, G., & Shumet, S. (2019). Prevalence and determinants of antenatal depression in Ethiopia: A systematic review and meta-analysis. PLOS ONE, 14(2), e0211764. https://doi.org/10.1371/journal.pone.0211764 DOI: https://doi.org/10.1371/journal.pone.0211764
Barros, A. J. D., & Hirakata, V. N. (2003). Alternatives for logistic regression in cross‑sectional studies: An empirical comparison of models that directly estimate the prevalence ratio. BMC Medical Research Methodology, 3, Article 21. https://doi.org/10.1186/1471-2288-3-21 DOI: https://doi.org/10.1186/1471-2288-3-21
Belete, K., Kassew, T., Demilew, D., & Amare Zeleke, T. (2021). Prevalence and correlates of suicide ideation and attempt among pregnant women attending antenatal care services at public hospitals in southern Ethiopia. Neuropsychiatric Disease and Treatment, 18(17), 1517–1529. http://dx.doi.org/10.2147/NDT.S309702 DOI: https://doi.org/10.2147/NDT.S309702
Benute, G. R. G., Nomura, R. M. Y., Jorge, V. M. F., Nonnenmacher, D., Fráguas Junior, R., Lucia, M. C. S. D., & Zugaib, M. (2011). Risk of suicide in high risk pregnancy: An exploratory study. Revista da Associação Médica Brasileira, 57, 583–587. https://doi.org/10.1590/S0104-42302011000500019 DOI: https://doi.org/10.1590/S0104-42302011000500019
Borges, R. P., Reichelt, A. A. J., Brito, A., Molino, G. O. G., & Schaan, B. D. (2021). Impact of the COVID-19 pandemic on mental health of pregnant women with diabetes mellitus and hypertension. Revista da Associação Médica Brasileira (1992), 67(9), 1268–1273. https://doi.org/10.1590/1806-9282.20210504 DOI: https://doi.org/10.1590/1806-9282.20210504
Carvalho, L. L., Da Silva Fernandes, N., Da Silva Fernandes, N. M., & Dos Santos Grincenkov, F. R. (2021). Aspectos psicossociais da gestação de alto risco: Análise de mulheres grávidas hospitalizadas. Psico, 52(4), e36341. https://revistaseletronicas.pucrs.br/index.php/revistapsico/article/view/36341 DOI: https://doi.org/10.15448/1980-8623.2021.4.36341
Croxford, S., Kitching, A., Desai, S., Kall, M., Edelstein, M., Skingsley, A., Burns, F.,Copas, A., Brown, A. K., Sullivan, A. & Delpech, V. (2017). Mortality and causes of death in people diagnosed with HIV in the era of highly active antiretroviral therapy compared with the general population: an analysis of a national observational cohort. The Lancet Public Health, 2(1), e35–e46. https://doi.org/10.1016/S2468-2667(16)30020-2 DOI: https://doi.org/10.1016/S2468-2667(16)30020-2
Eid, K., Torkildsen, Ø. F., Aarseth, J., Flemmen, H. Ø., Holmøy, T., Lorentzen, Å. R., Myhr, K. M., Riise, T., Simonsen, C., Torkildsen, C. F., Wergeland, S., Willumsen, J. S., Øksendal, N., Gilhus, N. E., & Bjørk, M. H. (2021). Perinatal Depression and Anxiety in Women With Multiple Sclerosis: A Population-Based Cohort Study. Neurology, 96(23), e2789–e2800. https://doi.org/10.1212/WNL.0000000000012062 DOI: https://doi.org/10.1212/WNL.0000000000012062
Faisal-Cury, A., Rocha, A. C., Silotto, A. E. M. R., & de Oliveira Rodrigues, D. M. (2021). Prevalence and associated risk factors of antenatal depression among Brazilian pregnant women: A population-based study. Journal of Affective Disorders Reports, 5, 100166. https://doi.org/10.1016/j.jadr.2021.100166 DOI: https://doi.org/10.1016/j.jadr.2021.100166
Garman, E. C., Cois, A., Schneider, M., & Lund, C. (2019). Association between perinatal depressive symptoms and suicidal risk among low-income South African women: A longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 54, 1219–1230. http://dx.doi.org/10.1007/s00127-019-01730-w DOI: https://doi.org/10.1007/s00127-019-01730-w
Gelaye, B., Rondon, M. B., Araya, R., & Williams, M. A. (2016). Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. The Lancet Psychiatry, 3(10), 973–982. http://dx.doi.org/10.1016/S2215-0366(16)30284-X DOI: https://doi.org/10.1016/S2215-0366(16)30284-X
Gelaye, B., Domingue, A., Rebelo, F., Friedman, L. E., Qiu, C., Sanchez, S. E., Larrabure-Torrealv, G. & Williams, M. A. (2018). Association of antepartum suicidal ideation during the third trimester with infant birth weight and gestational age at delivery. Psychology, Health & Medicine, 24(2), 127–136. http://dx.doi.org/10.1080/13548506.2018.1539235 DOI: https://doi.org/10.1080/13548506.2018.1539235
Hermon, N., Wainstock, T., Sheiner, E., Golan, A. & Walfisch, A.(2019). Impact of maternal depression on perinatal outcomes in hospitalized women – A prospective study. Archives of Women's Mental Health, 22, 85–91. https://doi.org/10.1007/s00737-018-0883-5 DOI: https://doi.org/10.1007/s00737-018-0883-5
Instituto Brasileiro de Geografia e Estatística. (2022). Cidades e estados do Brasil. https://cidades.ibge.gov.br/brasil/rs/rio-grande/panorama
Kubota, C., Inada, T., Shiino, T., Ando, M., Sato, M., Nakamura, Y., Yamauchi, A., Morikawa, M., Okada., T., Ohara, M., Aleksic, B., Murase, S., Goto, S., Kanai., A. & Ozaki, N. (2020). The risk factors predicting suicidal ideation among perinatal women in Japan. Frontiers in Psychiatry, 11, 441. http://dx.doi.org/10.3389/fpsyt.2020.00441 DOI: https://doi.org/10.3389/fpsyt.2020.00441
Lee, K. W., Ching, S. M., Hoo, F. K., Ramachandran, V., Chong, S. C., Tusimin, M., & Mohd Nordin, N. (2019). Prevalence and factors associated with depressive, anxiety and stress symptoms among women with gestational diabetes mellitus in tertiary care centres in Malaysia: A cross-sectional study. BMC Pregnancy and Childbirth, 19, 1–11. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2519-9 DOI: https://doi.org/10.1186/s12884-019-2519-9
Mandell, L. N., Parrish, M. S., Rodriguez, V. J., Alcaide, M. L., Weiss, S. M., Peltzer, K., Jones, D. L. (2022). Blood Pressure, Depression, and Suicidal Ideation Among Pregnant Women with HIV. AIDS and Behavior, 26(4), 1289–1298. https://doi.org/10.1007/s10461-021-03486-4 DOI: https://doi.org/10.1007/s10461-021-03486-4
Ministry of Health. (2025). Sistema de Informações sobre Mortalidade (SIM). Departamento de Informática do SUS – DATASUS. https://datasus.saude.gov.br/mortalidade/
Moseholm, E., Aho, I., Mellgren, Å., Pedersen, G., Katzenstein, T. L., Johansen, I. S., Bach, D., Storgaard., M. & Weis, N. (2022). Psychosocial health in pregnancy and postpartum among women living with-and without HIV and non-pregnant women living with HIV living in Nordic countries – Results from a longitudinal survey study. BMC Pregnancy and Childbirth, 22(1), 1–14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8740861/ DOI: https://doi.org/10.1186/s12884-021-04357-5
National Perinatal Epidemiology Unit (2020). MBRRACE-UK: Saving Lives, Improving Mothers' Care 2020 – Lessons to inform maternity care from the UK and Ireland Confidential Enquiries in Maternal Death and Morbidity 2016-18. https://www.npeu.ox.ac.uk/mbrrace-uk/presentations/saving-lives-improving-mothers-care
Palma, E., Armijo, I., Cifuentes, J., Ambiado, S., Rochet, P., Díaz, B., Gutierrez, J., & Mena, C. (2020). Hospitalisation in high-risk pregnancy patients: Is prenatal attachment affected? Journal of Reproductive and Infant Psychology, 39(1), 30–42. https://doi.org/10.1080/02646838.2020.1740661 DOI: https://doi.org/10.1080/02646838.2020.1740661
Qin, S., Tan, Y., Lu, B., Cheng, Y., Nong, Y. (2019). Survey and analysis for impact factors of psychological distress in HIV-infected pregnant women who continue pregnancy. Journal of Maternal-Fetal & Neonatal Medicine, 32(19), 3160–3167. https://doi.org/10.1080/14767058.2018.1459550 DOI: https://doi.org/10.1080/14767058.2018.1459550
Ribeiro, G. M., Cieto, J. F., Silva, M. M. J. (2022). Risk of depression in pregnancy among pregnant women undergoing high-risk prenatal care. Revista da Escola de Enfermagem da USP, 56, e20210470. https://doi.org/10.1590/1980-220X-REEUSP-2021-0470en DOI: https://doi.org/10.1590/1980-220x-reeusp-2021-0470pt
Rooks-Peck, C. R., Adegbite, A. H., Wichser, M. E., Ramshaw, R., Mullins, M. M., Higa, D., & Sipe, T. A. (2018). Mental health and retention in HIV care: A systematic review and meta-analysis. Health Psychology, 37(6), 574. https://doi.org/10.1037/hea0000606 DOI: https://doi.org/10.1037/hea0000606
Rodriguez, V. J., Mandell, L. N., Babayigit, S., Manohar, R. R., Weiss, S. M., & Jones, D. L. (2018). Correlates of suicidal ideation during pregnancy and postpartum among women living with HIV in rural South Africa. AIDS and Behavior, 22, 3188–3197. http://dx.doi.org/10.1007/s10461-018-2153-y DOI: https://doi.org/10.1007/s10461-018-2153-y
Shi, P., Ren, H., Li, H., & Dai, Q. (2018). Maternal depression and suicide at immediate prenatal and early postpartum periods and psychosocial risk factors. Psychiatry research, 261, 298-306. https://doi.org/10.1016/j.psychres.2017.12.085 DOI: https://doi.org/10.1016/j.psychres.2017.12.085
Soares, L. B., Bello, A. F., & Trabert, J. (2023). Positive screening for major depressive disorder in high-risk pregnant women. Jornal Brasileiro de Psiquiatria, 72(1), 12–18. https://doi.org/10.1590/0047-2085000000401 DOI: https://doi.org/10.1590/0047-2085000000401
Soltsman, S., Tomsis, Y., Konforty, A., Ben Shlomo, I. (2021). The Impact of Prenatal Depression in Patients of High Risk Pregnancy Clinic on Obstetric Outcomes. The Psychiatric Quarterly, 92(4), 1673–1684. https://doi.org/10.1007/s11126-021-09925-8 DOI: https://doi.org/10.1007/s11126-021-09925-8
Souza, G. F. A., Souza, A. S. R., Praciano, G. A. F., França, E. S. L., Carvalho, C. F., Paiva Júnior, S. S. L., Souza, M. B. R., & Asano, N. M. J. (2022). Apego materno-fetal e transtornos psiquiátricos em gestantes com fetos malformados / Maternal-fetal attachment and psychiatric disorders in pregnant women with malformed fetuses. Jornal Brasileiro de Psiquiatria, 71(1), 40-49. https://doi.org/10.1590/0047-2085000000339 DOI: https://doi.org/10.1590/0047-2085000000339
Tasnim, S., Auny, F. M., Hassan, Y., Yesmin, R., Ara, I., Mohiuddin, M. S., Kaggwa, M. M., Gozal, D., Mamun, M. A. (2022). Antenatal depression among women with gestational diabetes mellitus: a pilot study. Reproductive Health, 19(1), 71. https://doi.org/10.1186/s12978-022-01374-1 DOI: https://doi.org/10.1186/s12978-022-01374-1
Vergel, J., Gaviria, S. L., Duque, M., Restrepo, D., Rondon, M., Colonia, A. (2019). Gestation-related psychosocial factors in women from Medellin, Colombia. Revista Colombiana de Psiquiatría (English Ed.), 48(1), 26–34. https://doi.org/10.1016/j.rcp.2017.06.003 DOI: https://doi.org/10.1016/j.rcpeng.2018.12.002
Yoon, S. H., Sung, M. H. (2021). Does family support mediate the effect of anxiety and depression on maternal-fetal attachment in high-risk pregnant women admitted to the maternal-fetal intensive care unit? Korean Journal of Women Health Nursing, 27(2), 104-112. https://doi.org/10.4069/kjwhn.2021.05.14 DOI: https://doi.org/10.4069/kjwhn.2021.05.14
Yin, X., Sun, N., Jiang, N., Xu, X., Gan, Y., Zhang, J., Qiu, L., Yang, C., Shi, X., Chang, J. & Gong, Y. (2021). Prevalence and associated factors of antenatal depression: Systematic reviews and meta-analyses. Clinical Psychology Review, 83, 101932. https://doi.org/10.1016/j.cpr.2020.101932 DOI: https://doi.org/10.1016/j.cpr.2020.101932
Zewdu, L. B., Reta, M. M., Yigzaw, N., & Tamirat, K. S. (2021). Prevalence of suicidal ideation and associated factors among HIV positive perinatal women on follow-up at Gondar town health institutions, Northwest Ethiopia: A cross-sectional study. BMC Pregnancy and Childbirth, 21, 1–9. http://dx.doi.org/10.1186/s12884-020-03529-z DOI: https://doi.org/10.1186/s12884-020-03529-z
Zhong, Q. Y., Gelaye, B., Smoller, J. W., Avillach, P., Cai, T., & Williams, M. A. (2018). Adverse obstetric outcomes during delivery hospitalizations complicated by suicidal behavior among US pregnant women. PLoS One, 13(2), e0192943. http://dx.doi.org/10.1371/journal.pone.0192943 DOI: https://doi.org/10.1371/journal.pone.0192943
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