Factors associated with depressive and symptoms of anxiety during the puerperium in the covid-19 pandemic
Abstract
Objective: to identify the presence of symptoms of postpartum depression, anxiety and associated factors in women who had children during the COVID-19 pandemic. Method: a cross-sectional study, based on an online survey, conducted between August 2021 and January 2022, with women, followers of a social network, who were between 30 and 40 days postpartum. To identify symptoms suggestive of postpartum depression, the Edinburgh Postnatal Depression Scale and the Generalized Anxiety Disorder 7 were used for symptoms of anxiety. In the analysis, chi-square and Fisher’s exact tests were applied, and variables with a p-value <0.20 were inserted into the Poisson regression model with robust variance. Results: the sample consisted of 50 postpartum women, of whom 18 (36%) reported COVID-19 infection. A mean score of 9.9 ± 5.6 points was obtained on the Edinburgh Postnatal Depression Scale, and 50% had symptoms of postpartum depression. The mean score obtained for symptoms of anxiety was 7.9 ± 5.9 points, and 34% had moderate or severe anxiety. In the bivariate analysis, an association was found between symptoms of postpartum depression and lower education (p = 0.010), symptoms of anxiety (p <0.001) and anxiety in moderate or severe intensity (p = 0.002). Obesity justified the symptoms of postpartum depression (p <0.001) by the Poisson regression model with robust variance. Conclusion: changes in postpartum women’s mental health were observed during the pandemic, and obesity was associated with depressive symptoms. This highlights the urgent need for healthcare professionals to pay attention to and intervene in the face of symptoms of anxiety and postpartum depression.
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References
World Health Organization. Number of COVID-19 cases reported to WHO (cumulative total). World Health Organization [on-line]. 2024. [citado em 27 maio 2024]. Disponível em: URL:https://data.who.int/dashboards/covid19/cases?n=c.
World Health Organization. Number of COVID-19 deaths reported to WHO (cumulative total). World Health Organization [on-line].2024. [citado em 27 maio 2024]. Disponível em: URL: https://data.who.int/dashboards/covid19/deaths?n=c.
Sutton D, Fucks K, D'Alton M, Goffman D. Universal screening for SARS‐CoV‐2 in women admitted for delivery. N. Engl. J. Med. 2020; 382: 2163–2164. Doi: http://dx.doi.org/10.1056/NEJMe2009316
Observatório Obstétrico Brasileiro. OOBr SRAG: Síndrome respiratória aguda grave em gestantes e puerpéras. Observatório Obstétrico Brasileiro [on-line]. 2021. [citado em 27 maio 2024]. Doi: http//dx.doi.org/10.7303/syn44142724
Maciel LP, Costa JCC, Campor GMB, Santos NM, Melo RA, Diniz LFB. Mental disorder in puerperio: risks and mechanisms of counseling for the promotion of health. Rev. Pesqui. Fund. Cuid. 2019; 11(4): 1096-1102. Doi: http://dx.doi.org/10.9789/2175-5361.2019.v11i4.1096-1102
Jeong YJ, Nho JH, Kim JY. Factors influencing quality of life in early postpartum women. Int. J. Environ. Res. Public Health. 2021;18(6): 2988. Doi: http://dx.doi.org/10.3390/ijerph18062988
Zanardo V, Manghina V, Giliberti L, Vettore M, Severino L, Starface G. Psychological impact of COVID-19 quarantine measures in northeastern Italy on mothers in the immediate postpartum period. Int. J. Gynaecol. Obstet. 2020; 150(2): 184-188. Doi: http://dx.doi.org/10.1002/ijgo.13249
Ostacoli L, Cosma S, Bevilacqu P, Berchialla P, Bovetti M, Carosso AR, et al. Psychosocial factors associated with postpartum psychological distress during the Covid-19 pandemic: a cross-sectional study. BMC Pregnancy Childbirth. 2020; 20(1):703. Doi: http://dx.doi.org/ 10.1186/s12884-020-03399-5
Hartmann JM, Mendonza SRA, Cesar JA. Depressão entre puérperas: prevalência e fatores associados. Cad. Saúde Pública. 2017; 33 (9): e00094016. Doi: http://dx.doi.org/10.1590/0102-311x00094016
Fawcett EJ, Fairbrother N, Cox ML, White IR, Fawcett JM. The prevalence of anxiety disorders during pregnancy and the postpartum period: a multivariate Bayesian meta-analysis. J. Clin. Psychiatry. 2019; 80(4): 18r12527. Doi: http://dx.doi.org/10.4088/JCP.18r12527
Safi-Keykaleh M, Aliakbari F, Safarpour H, Safari M, Tahernejad A, Sheikhbardsiri H, et al. Prevalence of postpartum depression in women amid the COVID-19 pandemic: a systematic review and meta-analysis. Int. J. Gynaecol. Obstet. 2022;157(2): 240-247. Doi: http://dx.doi.org/10.1002/ijgo.14129
Cuschiere S. The STROBE guidelines. Saudi. J. Anaesth. 2019;13(Suppl 1): S31-S34. Doi: http://dx.doi.org/10.4103/sja.SJA_543_18.
Eysenbach G. Improving the Quality of Web Surveys: The Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J. Med. Internet Res. 2004;6(3): e34. Doi: http:/dx./doi.org/10.2196/jmir.6.3.e34
Santos IS, Matijasevich A, Tavares BF, Barros AJD, Botelho IP, Lapolli C, et al. Validação da Escala de Depressão Pós-natal de Edimburgo (EPDS) em uma amostra de mães do estudo de coorte de nascimentos de Pelotas, 2004. Cad. Saúde Pública. 2007; 23 (11): 2577-2588. Doi: http://dx.doi.org/10.1590/S0102-311X2007001100005
Figueira P, Correa H, Malloy DL, Romano-Silva MA. Escala de Depressão Pós-natal de Edimburgo para rastreamento no sistema público de saúde. Rev, Saúde Pública. 2009; 43(1): 79-84. Doi: http://dx.doi.org/10.1590/S0034-89102009000800012
Gibson J, Mckenzie MCH, Shakespeare J, Gray R. A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatr. Scand. 2009; 119(5): 350-364. Doi: http://dx.doi.org/10.1111/j.1600-0447.2009.01363.x
Bartolo AM, Anabela SP. Factor structure and construct validity of the Generalized Anxiety Disorder 7-item (GAD-7) among portuguese college students. Cad. Saúde Pública. 2017; 33 (9): e00212716. Doi: http://dx.doi.org/10.1590/0102-311X00212716
Brasil. Conselho Nacional de Saúde. Resolução no. 466, de 12 de dezembro de 2012. [on-line].2012. [citado em 06 nov 2024]. Disponível em: URL: https://www.gov.br/conselho-nacional-de-saude/pt-br/acesso-a-informacao/legislacao/resolucoes/2012/resolucao-no-466.pdf/view.
Suzuki S. Changes in psychological status of postpartum women due to the COVID-19 pandemic in Japan. J. Matern. Fetal Neonatal Med. 2022; 35 (15): 3012-3013. Doi: http://dx.doi.org/10.1080/14767058.2020.1814250
Mateus V, Cruz S, Costa R, Mesquita A, Christoforou A, Wilson CA, et al. Rates of depressive and anxiety symptoms in the perinatal period during the COVID-19 pandemic: comparisons between countries and with pre-pandemic data. J. Affect. Disord. 2022; 316: 245-253. Doi: http://dx.doi.org/10.1016/j.jad.2022.08.017
Galletta MAK, Oliveira AMSS, Albertini JGL, Benute GG, Peres SV, et al. Postpartum depressive symptoms of Brazilian women during the COVID-19 pandemic measured by the Edinburgh Postnatal Depression Scale. J. Affect. Disord. 2022; 296: 577-586. Doi: http://dx.doi.org/ 10.1016/j.jad.2021.09.091
Goyal D, Beck CT, Webb R, Ayers S. Postpartum depressive symptoms and experiences during COVID-19. MCN Am. J. Matern. Child Nurs. 2022;47(2):77-84. Doi: http://dx.doi.org/10.1097/NMC.0000000000000802
Waschmann M, Rosen K, Gievers L, Hildebrand A, Laird A, Khaki S. Evaluating the impact of the COVID-19 pandemic on postpartum depression. J. Womens Health. 2022; 31(6): 772-778. Doi: http://dx.doi.org/10.1089/jwh.2021.0428
Racine N, Hetherington E, McArthur BA, McDonald S, Edwards S, Tough S. Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis. Lancet Psychiatry. 2021; 8 (5): 405-415. Doi: http://dx.doi.org/10.1016/S2215-0366(21)00074-2
Li T, Sun S, Liu B, Wang J, Zhang Y, Cheng G, et al. Prevalence and risk factors for anxiety and depression in patients with COVID-19 in Wuhan, China. Psychosom. Med. 2021; 83 (4): 368-372. Doi: http://dx.doi.org/10.1097/PSY.0000000000000934
Fallon V, Davies SM, Silverio SA, Jackson L, De Pascalis L, Harrold JA. Psychosocial experiences of postnatal women during the COVID-19 pandemic. A UK-wide study of prevalence rates and risk factors for clinically relevant depression and anxiety. J. Psychiatr. Res. 2021; 136:157-166. Doi: http://dx.doi.org/10.1016/j.jpsychires.2021.01.048
Radzi CWJBWM, Jenatabadi HS, Samsudin N. mHealth Apps Assessment among postpartum women with obesity and depression. Healthcare (Basel). 2020; 8(2): 72. Doi: http://dx.doi.org/10.3390/healthcare8020072.
Zhao XH, Zhang ZH. Risk factors for postpartum depression: an evidence-based systematic review of systematic reviews and meta-analyses. Asian J. Psychiatr. 2020; 53:102353. Doi: http:dx.doi.org/10.1016/j.ajp.2020.102353.
Canário MASS, Cardelli AAM, Caldeira S, Zami AV, Baggio MA, Ferrari RAP. O vivido de mulheres no puerpério: (des)continuidade da assistência na maternidade e atenção primária. Ciênc, Cuid Saúde. 2021; 20: e55440. Doi: http://dx.doi.org/ 10.4025/cienccuidsaude/v20i0.55440
Kuipers YJ, Bleijenbergh R, Van den Branden L, Van Gils Y, Rimaux S, Brosens C, et al. Psychological health of pregnant and postpartum women before and during the COVID-19 pandemic. PLoS One. 2022; 17(4): e0267042. Doi: http://dx.doi.org/10.1371/journal.pone.0267042
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