Sintomas depressivos na gestação e no pós-parto e sua associação com o temperamento de crianças durante o primeiro ano de vida
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2021-02-25
Autores
Garcia, Natália Vanzo
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Universidade Estadual Paulista (Unesp)
Resumo
No contexto da maternidade, há pesquisas que comprovam que a depressão materna ocasiona diversos prejuízos para a relação mãe-bebê e para o desenvolvimento infantil. No entanto, poucos estudos avaliaram os efeitos da depressão materna no comportamento emocional e no temperamento infantil. Entende-se por temperamento o conjunto de diferenças individuais de base constitucional, influenciadas ao longo do tempo pela hereditariedade, maturação e pela experiência, percebidas através da reatividade e da autorregulação, que formam a base para a futura personalidade. Ele é composto por três fatores: afeto negativo, extroversão e controle com esforço, que são subdivididos em várias dimensões. Este estudo teve como objetivo comparar os fatores e dimensões do temperamento de bebês que tinham entre 7 e 12 meses, filhos de mães com sintomas depressivos na gestação e/ou pós-parto, com o temperamento de filhos de mães sem sintomas depressivos. Pretendeu-se, também, identificar os fatores de risco e de proteção para os três fatores do temperamento. A amostra foi composta por 54 díades de mães/bebês, selecionadas de um estudo de coorte anterior em que as gestantes foram avaliadas pela escala de Depressão Pós-Parto de Edimburgo para presença de sintomas depressivos. Quando o bebê tinha entre sete e 12 meses, as mães que aceitaram participar, foram re-avaliadas com a mesma escala e o temperamento infantil foi avaliado a partir do Infant Behavior Questionnaire (IBQ). A amostra final foi composta por 7 mães que apresentaram sintomas depressivos na gestação, 8 com sintomas depressivos no pós parto, 12 com sintomas depressivos nos dois momentos e 27 mães sem sintomas depressivos. Os quatro grupos foram comparados, estatisticamente, quanto a fatores sociodemográficos, clínicos e temperamento infantil. Verificou-se que mães com sintomas depressivos nos dois momentos foram as que menos desejaram a gravidez e contaram com menor apoio social na gestação. Filhos de mães com sintomas depressivos no pós-parto tiveram maior escore de afeto negativo e, filhos de mães com sintomas depressivos nos dois momentos tiveram maior nível de atividade e menor controle com esforço, quando comparados aos filhos de mães sem sintomas. Como se previa, quadros recorrentes, que se iniciaram na gestação e se mantiveram no puerpério, se associaram com maiores prejuízos no temperamento infantil. Na regressão múltipla, sintomas depressivos no pós-parto se mostraram como fatores de risco para altos índices de afeto negativo e baixos índices de controle com esforço. O gênero masculino foi fator de proteção para extroversão. Confirmando a hipótese inicial, sintomas depressivos maternos, em especial no pós-parto e nos dois momentos, se associaram com fatores do temperamento infantil no primeiro ano de vida, mostrando que o temperamento, embora tendo uma constituição biológica, sofre a influência das interações mãe/filho, após o nascimento.
In the context of motherhood, research shows that maternal depression causes several losses for the mother-baby relationship and for child development. However, few studies have assessed the effects of maternal depression on children's emotional behavior and temperament. Temperament is defined as the set of individual differences with constitutional basis, influenced over time by heredity, maturation and experience, perceived through reactivity and self-regulation, which form the basis for the future personality. It consists of three factors: negative affectivity, sugency and effortful control, which are subdivided into several dimensions. The aim of this was to compare the factors and dimensions of the temperament of infants who were between 7 and 12 months old, children of mothers with depressive symptoms during pregnancy and / or postpartum, with the temperament of children of mothers without depressive symptoms. Moreover, it was intended to identify risk and protective factors for the three factors of temperament. The sample consisted of 54 dyads of mothers / babies, selected from a previous cohort study in which pregnant women were assessed using the Edinburgh Postpartum Depression scale for the presence of depressive symptoms. When the baby was between seven and 12 months old, the mothers who agreed to participate were re-evaluated using the same scale and the child's temperament was assessed using the Infant Behavior Questionnaire (IBQ). The final sample consisted of 7 mothers who had depressive symptoms during pregnancy, 8 with postpartum depressive symptoms, 12 with depressive symptoms at both times and 27 mothers without depressive symptoms. The four groups were compared, statistically, in relation to sociodemographic, clinical and child temperament factors. It was found that mothers with depressive symptoms at both times were those who least desired pregnancy and had less social support during pregnancy. Children of mothers with depressive symptoms in the postpartum period had a higher negative affect score and children of mothers with depressive symptoms at both times had a higher level of activity and less control with effort when compared to the children of mothers without symptoms. As expected, recurrent conditions, which began during pregnancy and remained in the puerperium, were associated with greater impairments in children's temperament. In multiple regression, postpartum depressive symptoms were shown to be risk factors for high rates of negative affect and low rates of control with effort. The male gender was a protective factor for extroversion. Confirming the initial hypothesis, maternal depressive symptoms, especially in the postpartum period and in both moments, were associated with factors of infant temperament in the first year of life, showing that the temperament, although having a biological constitution, it is influenced by mother / child interactions after birth
In the context of motherhood, research shows that maternal depression causes several losses for the mother-baby relationship and for child development. However, few studies have assessed the effects of maternal depression on children's emotional behavior and temperament. Temperament is defined as the set of individual differences with constitutional basis, influenced over time by heredity, maturation and experience, perceived through reactivity and self-regulation, which form the basis for the future personality. It consists of three factors: negative affectivity, sugency and effortful control, which are subdivided into several dimensions. The aim of this was to compare the factors and dimensions of the temperament of infants who were between 7 and 12 months old, children of mothers with depressive symptoms during pregnancy and / or postpartum, with the temperament of children of mothers without depressive symptoms. Moreover, it was intended to identify risk and protective factors for the three factors of temperament. The sample consisted of 54 dyads of mothers / babies, selected from a previous cohort study in which pregnant women were assessed using the Edinburgh Postpartum Depression scale for the presence of depressive symptoms. When the baby was between seven and 12 months old, the mothers who agreed to participate were re-evaluated using the same scale and the child's temperament was assessed using the Infant Behavior Questionnaire (IBQ). The final sample consisted of 7 mothers who had depressive symptoms during pregnancy, 8 with postpartum depressive symptoms, 12 with depressive symptoms at both times and 27 mothers without depressive symptoms. The four groups were compared, statistically, in relation to sociodemographic, clinical and child temperament factors. It was found that mothers with depressive symptoms at both times were those who least desired pregnancy and had less social support during pregnancy. Children of mothers with depressive symptoms in the postpartum period had a higher negative affect score and children of mothers with depressive symptoms at both times had a higher level of activity and less control with effort when compared to the children of mothers without symptoms. As expected, recurrent conditions, which began during pregnancy and remained in the puerperium, were associated with greater impairments in children's temperament. In multiple regression, postpartum depressive symptoms were shown to be risk factors for high rates of negative affect and low rates of control with effort. The male gender was a protective factor for extroversion. Confirming the initial hypothesis, maternal depressive symptoms, especially in the postpartum period and in both moments, were associated with factors of infant temperament in the first year of life, showing that the temperament, although having a biological constitution, it is influenced by mother / child interactions after birth
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Palavras-chave
Temperamento infantil, Depressão materna, Depressão gestacional, Depressão pós-parto, Infant temperament, Maternal depression, Prenatal depression, Postpartum depression