Variáveis sociodemográficas, depressão pós-parto e a interação entre mães e bebês de quatro a seis meses de idade
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2016-02-24
Autores
Campos, Bárbara Camila de [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Desde o nascimento a interação do recém-nascido com o mundo é facilitada pela mãe. Estudos indicam que a saúde mental materna pode afetar a qualidade desta interação e, por exemplo, mães deprimidas podem interagir pouco com seu bebê, podendo gerar déficits comportamentais e cognitivos, identificáveis ao longo do desenvolvimento. Este trabalho, composto por dois estudos, pretendeu descrever e relacionar o índice de depressão pós-parto apresentado por mães de bebês com as variáveis sociodemograficas e avaliar a relação entre a presença da depressão e a qualidade da interação mãe-bebê. Participaram mães e seus bebês, usuárias do Projeto de Extensão “Acompanhamento do desenvolvimento de bebês: avaliação e orientação aos pais”. No primeiro estudo pretendeu-se identificar fatores de risco para a depressão pós-parto considerando variáveis sociodemograficas maternas, dos bebês e familiares. Uma amostra de 103 mães participou da primeira etapa em que responderam a uma entrevista inicial para a coleta de dados sociodemográficos e a “Escala de Depressão Pós-Parto de Edimburgo” (EDPE). Os resultados apontaram que 33% das mães apresentaram depressão pós-parto. Segundo o teste estatístico ρ de Pearson observou-se correlação linear negativa com a escolaridade materna (p=0,008), ou seja, quanto maior o índice de depressão, menor o número de anos de estudo. Além disso, houve uma correlação linear positiva entre a depressão e a condição socioeconômica (p=0,044), sendo que a variação da ABEP é decrescente. Desta forma, quanto mais pontos na EDPE mais pontos na ABEP, caracterizando menor nível socioeconômico. A análise da regressão linear múltipla indicou que a baixa escolaridade materna (p=0,010) pode ser um preditor para depressão pós-parto. No segundo estudo, pretendeu-se descrever comportamentos interativos maternos e do bebê considerando o índice de depressão pós-parto. Neste estudo a amostra foi de 30 díades divididas em Grupo 1 (grupo clínico) e Grupo 2 (grupo não clínico) de acordo com o ponto de corte 12 na EDPE, a análise da interação foi feita pelo Sistema de Codificação da Interação Mãe-Criança Revisado (CITMI-R). As participantes do G1 apresentaram pontuação média na EDPE de 14 pontos e as do G2 cinco pontos. Ao comparar G1 e G2, com o Teste T de amostras independentes, houve uma diferença significativa no comportamento de choro ou Protesto de Choro/Protesto (p=0,002) e para o Comportamento Protetor Neutro o Negativo (p=0.020) com médias mais altas para bebês filhos de mães deprimidas (L: 8,46; 2,94 e P0/-: 5,46; 3,60). O resultado da correlação de Pearson indicou correlação positiva entre a depressão com comportamento de Choro/Protesto (p=0,009) e correlação negativa entre a depressão e o Comportamento Protetor Positivo (p=0,039). Há diferenças importante para os resultados obtidos na análise de correlação dos comportamentos interativos dos grupos separadamente, no G1, houve correlação positiva significativa entre o Comportamento de Aproximação Social Neutro com o Sensível Neutro (p=0,049) e de Passividade ou Apatia com Comportamento Não-Responsivo (p=0,005), os resultados do G2 indicam que na interação das díades os comportamentos que se correlacionaram, positivamente foram os de Aproximação Social Positiva com os Comportamentos Sensível Positivo (p=0,031) e Sensível Neutro (p=0,050), além da correlação negativa do primeiro com o Comportamento Protetor Neutro (0,005). Os dados contribuem para compreensão do papel presença da depressão para a interação e o desenvolvimento infantil. Ao identificar as diferenças entre os comportamentos expressos nos dois grupos considerando a variável depressão, houve diferença em algumas categorias. Os resultados confirmam outros estudos e tendências em relação à baixa responsividade e sincronia da díade em que a mãe está deprimida, desta forma têm-se aí um grupo de risco em que a díade deve ser cuidada, garantindo saúde e um desenvolvimento adequado.
The newborn interaction with the world is facilitated by his mother. Studies indicates that maternal mental health can affect the quality of this interaction, for example, depressed mothers may interact less with their baby and it can cause behavioral and cognitive deficits throughout the development. This work, consisting on two studies which describe and relate the index of postpartum depression presented on the baby’s mothers with socio-demographic variables and evaluate the relationship between the presence of depression and quality of mother-infant interaction. Participated mothers and their babies, Extension Project users "Monitoring the development of babies: evaluation and guidance for parents." In the first study aimed to identify risk factors for postpartum depression considering maternal, babies and family socio-demographic variables. A sample of 103 mothers participated in the first step in responding to an initial interview to collect demographic data and "Edinburgh Postpartum Depression Scale" (EPDS). The results showed that 33% of the mothers had postpartum depression. The average age of the infants was 4.4 months, the gestational age of 36.9 weeks, with respect to risk condition (prematurity, low birth weight and teen mom), 46% had some of these characteristics. The average age of the mothers was 27.2, about the type of family, 78% of the sample is nuclear family and the socioeconomic level of the sample is Class B (68%). In the second study was intended to describe maternal interactive behaviors and baby considering the postpartum depression index. The results showed that 33% of mothers had postpartum depression. According to statistical Pearson test was observed negative linear correlation with maternal education (p = 0.008), the higher the rate of depression, lower the number of years of study. In addition, there was a positive linear correlation between depression and socioeconomic status (p = 0.044), and the variation of ABEP is decreasing. In this way, the more points in EDPE more points in ABEP, featuring lower socioeconomic status. The analysis of multiple linear regression showed that low maternal education (p = 0.010) can be a predictor of postpartum depression. In the second study was intended to describe maternal interactive behaviors and baby considering the postpartum depression index. In this study the sample was 30 dyads divided into Group 1 (clinical group) and Group 2 (non-clinical group) according to the cutoff point 12 in EDPE, the analysis of the interaction was taken by System of the Mother-Child Interaction Coding revised (CITMI-R). The participants of the G1 had a mean score in EDPE 14 points and G2 five points. When comparing G1 and G2, with the T test for independent samples, there was a significant difference in Crying or Protest Behavior (p = 0.002) and the Neutral or Negative Behavior of Protect (p = 0.020) with higher average for children of depressed mothers babies (L: 8.46; 2.94 and P0 / -: 5.46; 3.60). The result of Pearson correlation showed a positive correlation between depression with Crying or Protest Behavior (p = 0.009) and negative correlation between depression and Positive Protect Behavior (p = 0.039). There are important differences in the results obtained in the analysis of correlation of interactive behaviors of the groups separately, the G1, there was a significant positive correlation between Neutral Behavior of Social Approaching with Neutral Sensibility (p = 0.049) and Passivity or Apathy Behavior with Non-Responsive (p = 0.005), results in G2 indicate that the interaction of dyads behaviors that correlate positively were the Positive Social Approach to Positive Behavior of Sensibility (p = 0.031) and Neutral Sensibility (p = 0.050), and the negative correlation of the first with the Neutral Behavior of Protect (0,005). The data contribute to understanding the role of the presence on depression for interaction and child development. By identifying the differences between the behaviors expressed in both groups considering the variable depression, there were differences in some categories. The results confirm other studies and trends in relation to low responsiveness and timing of the pair in which the mother is depressed in this way to have there as a risk of group in which the dyad must be looked after, ensuring health and proper development.
The newborn interaction with the world is facilitated by his mother. Studies indicates that maternal mental health can affect the quality of this interaction, for example, depressed mothers may interact less with their baby and it can cause behavioral and cognitive deficits throughout the development. This work, consisting on two studies which describe and relate the index of postpartum depression presented on the baby’s mothers with socio-demographic variables and evaluate the relationship between the presence of depression and quality of mother-infant interaction. Participated mothers and their babies, Extension Project users "Monitoring the development of babies: evaluation and guidance for parents." In the first study aimed to identify risk factors for postpartum depression considering maternal, babies and family socio-demographic variables. A sample of 103 mothers participated in the first step in responding to an initial interview to collect demographic data and "Edinburgh Postpartum Depression Scale" (EPDS). The results showed that 33% of the mothers had postpartum depression. The average age of the infants was 4.4 months, the gestational age of 36.9 weeks, with respect to risk condition (prematurity, low birth weight and teen mom), 46% had some of these characteristics. The average age of the mothers was 27.2, about the type of family, 78% of the sample is nuclear family and the socioeconomic level of the sample is Class B (68%). In the second study was intended to describe maternal interactive behaviors and baby considering the postpartum depression index. The results showed that 33% of mothers had postpartum depression. According to statistical Pearson test was observed negative linear correlation with maternal education (p = 0.008), the higher the rate of depression, lower the number of years of study. In addition, there was a positive linear correlation between depression and socioeconomic status (p = 0.044), and the variation of ABEP is decreasing. In this way, the more points in EDPE more points in ABEP, featuring lower socioeconomic status. The analysis of multiple linear regression showed that low maternal education (p = 0.010) can be a predictor of postpartum depression. In the second study was intended to describe maternal interactive behaviors and baby considering the postpartum depression index. In this study the sample was 30 dyads divided into Group 1 (clinical group) and Group 2 (non-clinical group) according to the cutoff point 12 in EDPE, the analysis of the interaction was taken by System of the Mother-Child Interaction Coding revised (CITMI-R). The participants of the G1 had a mean score in EDPE 14 points and G2 five points. When comparing G1 and G2, with the T test for independent samples, there was a significant difference in Crying or Protest Behavior (p = 0.002) and the Neutral or Negative Behavior of Protect (p = 0.020) with higher average for children of depressed mothers babies (L: 8.46; 2.94 and P0 / -: 5.46; 3.60). The result of Pearson correlation showed a positive correlation between depression with Crying or Protest Behavior (p = 0.009) and negative correlation between depression and Positive Protect Behavior (p = 0.039). There are important differences in the results obtained in the analysis of correlation of interactive behaviors of the groups separately, the G1, there was a significant positive correlation between Neutral Behavior of Social Approaching with Neutral Sensibility (p = 0.049) and Passivity or Apathy Behavior with Non-Responsive (p = 0.005), results in G2 indicate that the interaction of dyads behaviors that correlate positively were the Positive Social Approach to Positive Behavior of Sensibility (p = 0.031) and Neutral Sensibility (p = 0.050), and the negative correlation of the first with the Neutral Behavior of Protect (0,005). The data contribute to understanding the role of the presence on depression for interaction and child development. By identifying the differences between the behaviors expressed in both groups considering the variable depression, there were differences in some categories. The results confirm other studies and trends in relation to low responsiveness and timing of the pair in which the mother is depressed in this way to have there as a risk of group in which the dyad must be looked after, ensuring health and proper development.
Descrição
Palavras-chave
Depressão pós-parto, Comportamento materno, Interação mãe-bebê, Interação mãe-criança, Postpartum depression, Maternal behavior, Mother-infant interaction, Mother-child interaction