Abstract
Objectives: To analyze the prevalence of major depression disorder, anxiety disorders and substance abuse in women with high-risk pregnancy and identify maternal-fetal pathologies and other variables associated with higher prevalence of mental disorders. Methodology: This cross-sectional study included 46 women in the high-risk gestation outpatient clinic of the Maternidade Escola Assis Chateaubriand in Fortaleza - Ceará. A sociodemographic and a clinical data questionnaire were applied, as well as Abuse Assesment Screen, Edinburgh Postpartum Depression Scale, State-Trait Anxiety Inventory and Alcohol Smoking and Substance Screening Test. Mini International Neuropsychiatry Interview (MINI) was applied to women with positive screening in the mentioned scales. Results: Using the screening tools, the prevalence was 30.4% for depression and 52.2% for anxiety; with the MINI the prevalence was 30,4% and 34,8%, respectively. Pregnant women with cardiac diseases had a 66,7% depression prevalence and a 77.8% anxiety prevalence, both higher than those with other pathologies. Depression and anxiety were also associated with unwanted pregnancy and domestic violence during life. Conclusion: The prevalence of depression and anxiety was high in this sample of pregnant women and the associated risk factors need to be understood, so that better interventions in the treatment of pregnant women can be implemented.
Highlights
There are still relatively few national studies evaluating depression during pregnancy, with most of the research being directed at evaluating the prevalence of this condition and correlated risk factors.[1]
There is a minimal number of Brazilian studies that address the question of how obstetric and specific fetal pathologies in current pregnancy are correlated with gestational depression and other mental disorders in this period
The prevalence of depression found by the screening instruments was quite elevated and higher than that found in a national study previously performed in pregnant women of the general population,[1] while the prevalence of anxiety by the State-Trait Anxiety Inventory (STAI) was in line with a national survey that previously showed a high anxiety index in 64,9% of non-high-risk pregnant women.[11]
Summary
There are still relatively few national studies evaluating depression during pregnancy, with most of the research being directed at evaluating the prevalence of this condition and correlated risk factors.[1]. The main risk factors identified for gestational depression in previous studies were: previous history of depression, financial difficulties, low schooling levels, unemployment, lack of social support, substance dependence and domestic violence.[1] There are still few studies using standardized diagnostic interviews in this population group[3,4,5] and the use of screening interviews may lead to an overestimation of observed prevalence rates.[6]. International research indicates the existence of an association between preeclampsia and depression.[8,9,10]
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