Anxiety Disorders During Pregnancy and Postpartum

Levine, Ruth E.; Oandasan, Aileen; Primeau, Loree A.; Berenson, Abbey B.

doi:10.1055/s-2003-42342

Cited by 36 publications

(17 citation statements)

References 56 publications

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“…No estudo australiano citado anteriormente, foram observadas incidências de fobia, entre 5,7 e 10,6% e de síndrome do pânico, entre 0,5 e 2,7% 3 . Por sua vez, a exata incidência ou prevalência de transtorno obsessivo-compulsivo de início no puerpério não é conhecida, mas aceita-se que a gravidez e o pós-parto sejam fatores importantes desencadeadores do problema 27,28 . Por sua vez, os quadros denominados de transtorno do estresse pós-traumático, desencadeados pelo parto, têm sido mais estudados.…”

Section: Renda Da Mulher (R$unclassified

Ansiedade no puerpério: prevalência e fatores de risco

Faisal-Cury¹,

Menezes²

2006

Rev. Bras. Ginecol. Obstet.

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RESUMOObjetivos: estimar a prevalência de ansiedade puerperal (AP) e fatores de risco associados, em amostra de mulheres de clínica privada. Métodos: foi realizado estudo de corte transversal com 299 mulheres, atendidas em consulta ginecológica de rotina, durante o período de agosto de 2000 a maio de 2003. Foram utilizados o STAIT (Spielberger State-Trait Anxiety Inventory), para avaliação de ansiedade puerperal, e um questionário com dados sociodemográficos e obstétricos. Os critérios de inclusão foram: puérperas sem história atual ou passada de depressão ou tratamento psiquiátrico, alcoolismo ou abuso de drogas e cujos filhos estavam vivos. As prevalências de AP-traço e AP-estado que avaliam, respectivamente, características de personalidade e ansiedade transitória, segundo o STAIT, foram estimadas, conjuntamente com o intervalo de confiança (IC) 95%. Estimaram-se os odds ratios (OR) e os intervalos de confiança de 95%, na avaliação da associação entre AP e as variáveis explicativas. Utilizou-se o teste do χ PALAVRAS-CHAVE:Ansiedade; Transtornos puerperais; Fatores de risco; Prevalência ABSTRACT Purpose: postpartum anxiety (PPA) is highly prevalent and has important consequences on mother and newborn. The aim of the present study was to estimate the prevalence of PPA and its risk factors, in a sample of women attending a private setting. Methods: a cross-sectional study was performed with 299 women, at a routine gynecological visit, from August 2000 to May 2003. The Spielberger State-Trait Anxiety Inventory (STAIT) and a questionnaire with sociodemographic data and obstetric data were used. Inclusion criteria were: women with no past or present history of depression, psychiatric treatment, alcohol or drug abuse and whose children were alive. The prevalences of PPA-trace and PPA-state, that evaluate characteristics of personality and transitory anxiety, respectively, were estimated with 95% confiance intervals (CI). Odds ratios and 95% CI were used to examine the association between PPA and exposure variables. Hypothesis testing was done by the χ 2 test or χ 2 test for linear trend, when categories were ordered. A p value < 0.05 was considered to be statistically significant. Results: the prevalences of PPA-state and PPA-trace were 44.8% (CI 95%: 39.1 -50.7) and 46.1% (CI 95%: 40.4 -52.0, respectively). Formal agreement between scales was moderate (kappa = 0.55; p≤0.001). By univariate analysis, lower mother income and presence of newborn complications were associated with PPA-state and PPA-trace. Lower maternal age and greater number of alive children were associated with PPA-trace and PPA-state, respectively. By multivariate analysis, PPAtrace and PPA-state were associated with higher mother income (OR:0.39; IC 95%: 0.21 -0.74, p=0,005; OR:0.46; IC 95%: 0.24 -0.87, p=0.02) and presence of complications in newborns (OR:2.15; IC 95%: 1.02 -4.54, p=0.04) (OR:2.47; IC 95%: 1.16 -5.25, p=0.02), respectively. PPA-trace was associated with greater maternal age (OR:0.34; IC 95%: 0.13 -0.88, p=0.008), while PPAstate ...

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Section: Renda Da Mulher (R$unclassified

Ansiedade no puerpério: prevalência e fatores de risco

Faisal-Cury¹,

Menezes²

2006

Rev. Bras. Ginecol. Obstet.

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“…j Key words pregnancy AE heart rate variability AE depression AE anxiety AE antidepressant Introduction Although pregnancy is thought by many to be ''protective'' in terms of mental health and well-being, recent cohort studies have reported a similar incidence of depression and anxiety during gestation as in the postpartum period [3,29]. Depression, anxiety, as well as stress during pregnancy have been associated with a number of adverse outcomes, including preeclampsia, premature delivery, fetal growth restriction, decreased mental and motor development and difficult infant temperament [26,41,54].…”

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The effect of depression on heart rate variability during pregnancy

et al. 2008

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Depression during pregnancy has been associated with a number of adverse outcomes, but the underlying physiological mechanisms involved remain unclear. The purpose of this study was to examine the effects of maternal depression during pregnancy on the autonomic modulation of heart rate, in a naturalistic setting. Eighty-one pregnant women were studied between 25 and 31 weeks of gestation and were identified as either Depressed (n = 46), or healthy, Control (n = 35), based on depression scores and lifetime psychiatric history. Subjects wore a 24-h Holter recorder to measure time-domain and frequency-domain of heart rate variability (HRV). Pregnant women in the Depressed Group had significantly reduced time-domain measures: standard deviation of all 24-h NN intervals (SDNN) and the standard deviation of the averages of NN intervals in all 5-min segments of the entire recording (SDANN) (P = 0.013, 0.016, respectively), as well as higher heart rates while asleep (P = 0.028), compared to Controls, after controlling for age, smoking, and antidepressant (AD) medication. The low frequency/high frequency (LF/HF) ratio during the sleeping hours was associated with higher depression scores (R = 0.24; P = 0.041). HRV measures improved in women taking AD medication. The autonomic nervous system may be affected in women experiencing depression during pregnancy, indicating a possible decreased parasympathetic (vagal) influence. Women taking AD medication showed some improvement in HRV measures. These data suggest that psychophysiological changes occur in women experiencing depression during pregnancy.

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“…maternal depression is diagnosed using the same criteria for major depressive disorder, but may also include specific symptoms such as a preoccupation with infant well-being, disinterest in the infant, fear of being left alone with the infant, or intrusiveness that prevents infant rest (APA 2000). Anxiety affects up to 24% of mothers (Heron et al 2004); it includes panic disorder, obsessive compulsive disorder, post-traumatic stress disorder and generalized anxiety disorder (Levine et al 2003). Psychosis affects approximately 0.1-0.2% of new mothers and is characterized by agitation, hallucinations, mood swings or abnormal perceptions that can lead to suicide and homicide (Brokington et al 2002).…”

Section: Résumémentioning

confidence: 99%

MotherFirst: Developing a Maternal Mental Health Strategy in Saskatchewan

Bruce

Béland²,

Bowen³

2012

hcpol

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up to 20% of women experience maternal mental health problems, but most jurisdictions lack policy for prevention, identification and treatment. To address this gap, a multi-stakeholder working group formed in saskatchewan, Canada. As a result, the motherfirst project emerged to create policies to improve the mental healthcare of mothers and to increase public and professional awareness. This paper critically analyzes the project using a policy cycle framework that can inform similar policy development. It explores the strengths of diverse partnerships, relationship building and public awareness campaigns, and the challenges that were encountered in the decision-making and implementation stages. RésuméPrès de 20% des femmes éprouvent des problèmes de santé mentale liés à la maternité. Pourtant dans la plupart des provinces, il y a un manque de prévention, de dépistage et de traitement concertant ces problèmes. Pour corriger cette situation, on a créé un groupe de travail à intervenants multiples en saskatchewan (Canada). de cette initiative est né le projet motherfirst, qui vise à établir des politiques pour améliorer les soins de santé mentale maternelle et pour accroî-tre la sensibilisation du public et des professionnels. Cet article propose une discussion critique du projet, effectuée à l' aide d'un cadre d' analyse sur les cycles de politiques, qui peut éclairer l' élaboration de ce type de politiques. L' article examine les points forts des divers partenariats, des relations entre acteurs des campagnes de sensibilisation publique. Il examine également les défis rencontrés au cours de la prise de décision et pendant les étapes de mise en oeuvre.

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Anxiety Disorders During Pregnancy and Postpartum

Cited by 36 publications

References 56 publications

Ansiedade no puerpério: prevalência e fatores de risco

Ansiedade no puerpério: prevalência e fatores de risco

The effect of depression on heart rate variability during pregnancy

MotherFirst: Developing a Maternal Mental Health Strategy in Saskatchewan

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