SP registers rate postpartum depression twice the world average

Study with 273 women who gave birth in a public hospital in São Paulo revealed a prevalence of postpartum depression about twice the global average described in the scientific literature. The results also show that in the first year of life, infants of depressed mothers showed a loss in development.

The investigation was conducted under a FAPESP Thematic Project coordinated by Emma Otta, Institute of Psychology, University of São Paulo (USP-IP).

According Otta, the survey was developed from the theoretical and methodological approach of ethology, the science of animal behavior. The evolutionary perspective guided the formulation of several hypotheses investigated, the relationship between the remarkable dependence of the human infant, his natural predisposition for the formation of bonds (attachment and intersubjectivity primary) and the need for immersion in a family group and cultural cognitive development . We also investigated the influence of the difficulties of the social and emotional about the investment strategies of parental and child development.

The type of support network in various stages of reproductive life of the mother can influence parental investment and the occurrence of postpartum depression, "said Otta. According to her, the Thematic Project aimed at understanding this network determinants and possible functions adaptive of depressive reactions and the effects of the characteristics of mother-infant interaction in development, with particular attention to neurodevelopmental and cognitive development, involving language, empathy and prosocial behavior.

Were recruited initially about 400 pregnant women who received prenatal consultations in Basic Health Units (BHU) in the district of Butantan and whose birth was planned to take place at the University Hospital (UH-USP) between September and December 2006. Of these, 273 gave birth in HU and were included in the study.

Women and their children were followed for three years following childbirth. During this period, several interviews were conducted in order to evaluate the interaction between mother and baby, the presence of depressive symptoms in women, maternal perception of the relationship with the child and its development. The first filming was done even in the delivery room, the first mother-infant interaction.

In the evaluation performed in the fourth month after birth, the 150 women who have participated in the study completed a questionnaire screening for postpartum depression and 28% showed signs of the disorder. According Otta, the average global described in the literature varies between 10% and 15%.

In an integrated approach to the theme, the results should be published soon, the researchers compared the data of women who gave birth in HU-USP with 257 women who had their children in a private hospital in the capital's upscale. In this second case, the prevalence of postpartum depression in the sample was 7% below the world average.

In both samples, the newborns had similar health conditions. Maternal age, education, number of prenatal visits and cesarean sections were higher among mothers private hospital.

Although the signs of depression were less depending on the hospital or socioeconomic status, the most important variables, according to the statistical model used in the analysis were education and social support, told Maria de Lima Morais and Salum, a researcher at the Institute of Health of São Paulo agency of the State Department of Health

Other factors that showed a strong correlation with the risk of postpartum depression were the frequency and severity of conflicts with the partner in the largest sample of the public hospital and the occurrence of previous episodes of depression.

A greater number of mothers in the sample reported having private hospital previously spent by consultations and treatment for depression, perhaps because these women have more access to health services. In the sample of private hospital, all mothers with postpartum depression reported having experienced previous episodes of depression, said Morais.

To Otta, it is possible that only part of women diagnosed in the two samples have in fact developed postpartum depression. Some probably had depression and the problem remained or returned after the birth of the child, he said.

Other risk factors for postpartum depression identified in the survey, but with less weight, were a greater number of children, the existence of children from previous relationships, greater number of children living in the same house, unwanted pregnancy, childhood rejection, early menarche and lower maternal age. The data were published in the Bulletin of the Institute of Health

<b> Reflexes between mother and son </ b>

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