A saúde mental de mulheres com morbidade materna grave e near miss em Sergipe

• Ano de defesa: 2017
• Autor(a) principal: Silveira, Mônica Silva
• Orientador(a): Gurgel, Ricardo Queiroz
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Sergipe
• Programa de Pós-Graduação: Pós-Graduação em Ciências da Saúde
• País: Brasil
• Palavras-chave em Português: Período pós-parto; Morbidade; Near miss; Transtornos mentais; Relações mãe-filho; Apoio social; Enfermagem obstétrica; Saúde materna; Transtornos de estresse pós-traumáticos
• Palavras-chave em Inglês: Social support; Obstetric nursing; Morbidity; Maternal health; Posttraumatic stress disorders
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: https://ri.ufs.br/handle/riufs/3635

Introduction: The severe maternal morbidity and near miss (MMG / NM) study refers to complications related to pregnancy, childbirth and the puerperium, and, in sequence, brings the discussion about the quality of involved maternal mental health. Objectives: To study the relationship between common mental disorders, adult attachment and maternal postnatal attachment presence and the perceived social support in women who experienced severe maternal morbidity and near miss. Method: Observational, prospective cohort study. It was carried out in two public reference maternity hospitals in Sergipe state. There were 549 participants, divided into two groups, exposed and not exposed to MMG / NM., the Beck inventory for BAI anxiety and the Beck inventory for BDI depression, the Edinburgh EDPS postpartum depression scale, the adult EVA binding scale, the AEAS postnatal attachment scale, the IES impact scale, and the SSQ-6 social support scale, The collection was performed in three distinct periods during 12 months, in sequence mothers and their respective controls. The data were analyzed with the software R version 3.3.2 (R CORE TEAM, 2016). A descriptive statistic was performed with the Mann-Whitney test, chi-square or Fisher's exact test for categorical variables and multivariate analysis to define possible associations. The significance of differences between groups was estimated (χ2) with level of Significance of 0.05. Results: Women exposed to MMG / NM were more frequently from inland districts, did not work, did not prenatal fallow up, and used alcohol. They were more likely to have anxiety disorders (OR 2.77 p <0.000), depression (OR 10.9 p <0.000), postpartum depression (OR 6.5, p <0.000), and post-traumatic stress disorder (RR 2.76 [95% CI 2.44-3.14]); and 20% of intrusion memory (RR 2.07; 95% CI: 1,89-2.26), The lowest social support (0.11, SD: 0.001, p <0.001), greater attachment style with an anxious adult 16,11% and lower comfort with proximity were observed in women exposed to MMG / NM.(p <0.001), and a lower presence of maternal attachment in the postpartum period 43,90 (<0.001). The women exposed to MMG/NM had statistically significant trend for the presence of symptoms for mental illness in the three collection periods (p <0.001). Conclusions: A situation of severe and near miss maternal morbidity has a negative impact on women's psychological health and affects psychosocial relationships. The results of this study aim to contribute to the implementation of specific protocols and practices, integrating mental health and psychosocial care to implement preventive and treatment actions to improve maternal health.