Background The diagnosis of mood disorders (MD) during pregnancy is challenging and may bring negative consequences to the maternal-fetal binomial. The long waitlist for specialized psychiatric evaluation in Brazil contributes to the treatment omission. Almost 20.0% of women treated with antidepressants have a positive screening for bipolar disorder. Therefore, it has been recommended the investigation of depressive and bipolar disorder during prenatal care. Unfortunately, the screening for mood disorders is not a reality in Brazil and many childbearing women remain undiagnosed. The objective of this study is to observe the frequency of MD and the effectiveness of screening scales for routine use by health professionals during prenatal care in high-risk pregnancies. Methodology/Principal findings This cross-sectional study included 61 childbearing women in their second trimester who were interviewed using the Edinburgh Postnatal Depression Scale (EPDS) and the Mood Disorder Questionnaire (MDQ). The cut-off point was EPDS ≥ 13 and MDQ ≥ 7 and the SCID-5 was the gold standard diagnosis. MD were diagnosed in 24.6% of the high-risk pregnancies. EDPS was positive in 19.7% and the frequency of major depression was 8.2%. 16.4% of the childbearing women were diagnosed with bipolar disorder, while MDQ was positive in 36.1%. 11.5% of the women had EPDS and MDQ positive. EPDS sensitivity was 80.0% and specificity 92.1%, whereas MDQ presented a sensitivity of 70.0% and specificity of 70.6%. Conclusion/Significance There is a high prevalence of MD in high-risk pregnancies. The routine use of EPDS simultaneously to MDQ during antenatal care is effective and plays an important role in early diagnosis, counselling, and promotion of perinatal mental health.

Background: The fear of childbirth harms maternal and fetal health, but it is little studied in Brazil. This study aimed to calculate the prevalence of fear of childbirth in a maternity hospital in southern Brazil and its associated factors, besides to identify the content of the fear and the information sources about childbirth. Methods: The Wijma Delivery Expectancy Questionnaire (Version A) was used to calculate the prevalence of fear of childbirth, and it's score was associated with sociodemographic variables, gestational history, aspects of the current pregnancy, knowledge about childbirth, anxiety symptoms (Beck Anxiety Inventory), depressive symptoms (Edinburgh Postnatal Depression Scale) and perception of social support (Multidimensional Scale of Perceived Social Support). Were also applied questionnaires about the content of the fear of childbirth and information sources about childbirth. The non-parametric Mann-Whitney, Spearman and Kruskal-Wallis correlation tests were used in the statistical analysis. Results: Were included 125 pregnant women between 28 and 36 weeks of pregnancy, and 12% of them scored ≥85 on the Wijma Delivery Expectancy Questionnaire (Version A), indicating severe fear of childbirth. There was a significant correlation between fear of childbirth and anxiety symptoms (r=0.50, p<0.001), depressive symptoms (r=0.34, p<0.001) and social support (r=-0.23, p=0.008). The fear was lower in pregnant women with complete elementary education compared to those with higher education (p=0.003), and those with negative experiences in previous deliveries had more fear of childbirth than who had positive experiences (p=0.001). More than 85% of them fear fetal distress. Conclusions:Fear of childbirth is a prevalent condition and health professionals must know how to recognize and address it during prenatal care, improving maternal-fetal care.

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