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Common mental disorders during pregnancy: prevalence and associated factors among low-income women in São Paulo, Brazil

Depression and Anxiety during Pregnancy

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Abstract

To estimate the prevalence of common mental disorders (CMD) and factors associated with these disorders among pregnant women of low socio-economic status (SES) in São Paulo. We performed a cross-sectional study with 831 women in their 20th to 30th weeks of pregnancy, who were attending antenatal clinics in primary care in São Paulo, Brazil. CMD were assessed with the Clinical Interview Schedule-Revised. Crude and adjusted prevalence ratios and 95%CI were calculated to examine the association between CMD and exposure variables. The prevalence of CMD was 20.2% (95%CI 17.5 to 23.0). Age at current pregnancy and at first delivery, current obstetric complications, not having friends in the community, living in a crowded household, lower occupational status and history of previous psychiatric treatment were all independently associated with increased prevalence of CMD. CMD is highly prevalent among pregnant women of low SES seen in primary care settings in São Paulo. A combination of distal and proximal psychosocial factors increase the risk for CMD. Primary health care professionals need to be aware of how common CMD in such settings and properly trained to deal with CMD during pregnancy.

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References

  • Abiodun OA, Adetoro OO, Ogunbode OO (1993) Psychiatric morbidity in a pregnant population in Nigeria. Gen Hosp Psychiatry 15:125–128

    Article  PubMed  CAS  Google Scholar 

  • Adewuya AO, Ola BA, Aloba OO, Dada AO, Fasoto OO (2007) Prevalence and correlates of depression in late pregnancy among Nigerian women. Depress Anxiety 24:15–21

    Article  PubMed  Google Scholar 

  • American Academy of Pediatrics (2000) Committee on Substance Abuse and Committee on children with disability. Fetal Alcohol syndrome and alcohol-related neurodevelopmental disorders. Pediatrics 106:358–361

    Article  Google Scholar 

  • Andersson L, Sundström-Poromaa I, Bixo M, Wulff M, Bondestam K, Aström M (2003) Point prevalence of psychiatric disorders during the second trimester of pregnancy: a population–based study. Am J Obstet Gynecol 189:148–154

    Article  PubMed  Google Scholar 

  • Araya R, Rojas G, Fritsch R, Acuña J, Lewis G (2001) Common mental disorders in Santiago, Chile: Prevalence and socio- demographic correlates. Br J Psychiatry 178:228–233

    Article  PubMed  CAS  Google Scholar 

  • Araya R, Gaete J, Rojas G, Fritsch R, Lewis G (2007) Smoking and common mental disorders: a population-based survey in Santiago, Chile. Soc Psychiatry Psychiatr Epidemiol 42:874–80

    Article  PubMed  Google Scholar 

  • Austin MP, Leader L (2000) Maternal stress and obstetric and infant outcomes: epidemiological findings and neuroendocrine mechanisms. Aust NZ J Obstet Gynaecol 40:331–337

    Article  CAS  Google Scholar 

  • Barros AJ, Hirakata VN (2003) Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 20;3:21

    Article  Google Scholar 

  • Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103:698–709

    PubMed  Google Scholar 

  • Birndorf CA, Madden A, Portera L, Leon AC (2001) Psychiatric symptoms, functional impairment, and receptivity toward mental health treatment among obstetrical patients. Int J Psychiat Med 31:355–65

    Article  CAS  Google Scholar 

  • Botega NJ, Pereira WA, Bio MR, Garcia Junior C, Zomignani MA (1995) Psychiatric morbidity among medical in-patient: a standardized assessment (GHQ-12 and CIS-R) made by “lay” interviewers in a Brazilian hospital. Soc Psychiatry Psychiatr Epidemiol 30:127–131

    Article  PubMed  CAS  Google Scholar 

  • Chang G, McNamara TK, Orav EJ, Koby D, Lavigne A, Ludman B, Vincitorio NA, Wilkins-Haug L (2005) Brief intervention for prenatal alcohol use: a randomized trial. Obstet Gynecol 105:991–998

    PubMed  Google Scholar 

  • Chen H, Chan YH, Tan KH, Lee T (2004) Depressive symptomatology in pregnancy. Soc Psychiatry Psychiatr Epidemiol 39:975–979

    Article  PubMed  CAS  Google Scholar 

  • Chung TKH, Lau TK, Yip ASK, Chiu HFK, Lee DTS (2001) Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med 63:830–834

    PubMed  CAS  Google Scholar 

  • Dayan J, Creveuil C, Herlicoviez M, Herbel C, Baranger E, Savoye C, Thouin A (2002) Role of anxiety and depression in the onset of spontaneous preterm labor. Am J Epidemiol 155:293–301

    Article  PubMed  CAS  Google Scholar 

  • Dole N, Savitz A, Hertz-Picciotto I, Siega-Riz AM, McMahon MJ, Buekens P (2003) Maternal stress and preterm birth. Am J Epidemiol 157:14–24

    Article  PubMed  CAS  Google Scholar 

  • England LJ, Kendrick JS, Wilson HG, Merritt RK, Gargiullo PM, Zahniser SC (2001) Effects of smoking reduction during pregnancy on the birth weight of term infants. Am L Epidemiol 154:694–701

    Article  CAS  Google Scholar 

  • Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. BMJ 323:257–260

    Article  PubMed  CAS  Google Scholar 

  • Evans J, Heron J, Patel RR, Wiles N (2007) Depressive symptoms during pregnancy and low birth weight at term: longitudinal study. Br J Psychiatry 191:84–85

    Article  PubMed  Google Scholar 

  • Faisal-Cury A, Menezes PR (2007) Prevalence of anxiety and depression during pregnancy in a private setting sample. Arch Women Mental Health 10:25–32

    Article  CAS  Google Scholar 

  • Ferri CP, Mitsuhiro SS, Barros MC, Chalem E, Guinsburg R, Patel V, Prince M, Laranjeira R (2007) The impact of maternal experience of violence and common mental disorders on neonatal outcomes: a survey of adolescent mothers in São Paulo, Brazil. BMC Public Health 7:209–218

    Article  PubMed  Google Scholar 

  • Goldberg D, Huxley P (1992) Common Mental Disorders: A Biopsychosocial Approach. Routledge, London

    Google Scholar 

  • Gureje O, Lasebikan VO (2006) Use of mental health services in a developing country. Results from the Nigerian survey of mental health and well-being. Soc Psychiatry Psychiatr Epidemiol 41:44–49

    Article  PubMed  Google Scholar 

  • Halbreich U (2005) The association between pregnancy processes, preterm delivery, low birth weight, and postpartum depressions. The need for interdisciplinary integration. Am J Obstet Gynecol 193:1312–22

    Article  PubMed  Google Scholar 

  • Heron J, O’Connor TH, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73

    Article  PubMed  Google Scholar 

  • Instituto Brasileiro de Geografia e Estatistica (2001) Sinopse preliminar do censo demografico 2000. www.ibge.gov.br/home/estatistica/populacao/sinopse_preliminar/Censo2000sinopse.pdf (accessed 22/10/2007)

  • Instituto Brasileiro de Geografia e Estatística (2000). http://sidra.ibge.gov.br/cd/default.asp (accessed 23/06/2008)

  • Jacob KS, Bhugra D, Mann AH (1997) The validation of the 12-item General Health Questionnaire among ethnic Indian women living in the United Kingdom. Psychol Med 27:1215–1217

    Article  PubMed  CAS  Google Scholar 

  • Johnson RC, Slade P (2003) Obstetric complications and anxiety during pregnancy: is there a relationship? J Psychosom Obstet Gynecol 24:1–14

    Article  CAS  Google Scholar 

  • Kelly RH, Zatzick DF, Anders TF (2001) The Detection and Treatment of Psychiatric Disorders and Substance Use Among Pregnant Women Cared for in Obstetrics. Am J Psych 158:213–219

    Article  CAS  Google Scholar 

  • Kroeff LC, Mengue SS, Schimdt MI, Duncan BB, Favaretto ALF, Nucci LB (2004) Fatores associados ao fumo em gestantes avaliadas em cidades brasileiras. Rev Saude Publica 38:261–267

    Article  PubMed  Google Scholar 

  • Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O (2000) Depression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol 95:487–490

    Article  PubMed  CAS  Google Scholar 

  • Lee DT, Chan SS, Sahota DS, Yip AS, Tsui M, Chung TK (2004) A prevalence study of antenatal depression among Chinese women. J Affect Disord 82:93–99

    Article  PubMed  Google Scholar 

  • Lewis G, Pelosi A, Araya R, Dunn G (1992) Measuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychol Med 22:465–486

    Article  PubMed  CAS  Google Scholar 

  • Lima MS, Hotopf M, Mari JJ, Beria JU, De Bastos AB, Mann A (1999) Psychiatric disorder and the use of benzodiazepines: an example of the inverse care law from Brazil. Soc Psychiatry Psychiatr Epidemiol 34:316–322

    Article  PubMed  Google Scholar 

  • Limlomwongse N, Liabsuetrakul T (2006) Cohort study of depressive moods in Thai women during late pregnancy and 6–8 weeks of postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Arch Womens Ment Health 9:131–138

    Article  PubMed  CAS  Google Scholar 

  • Lovisi GM, López JRA, Coutinho ESF, Patel V (2005) Poverty, violence and depression during pregnancy: a survey of mothers attending a public hospital in Brazil. Psychol Med 35:1485–1492

    Article  PubMed  Google Scholar 

  • Matthews S, Meaney MJ (2005) Maternal adversity, vulnerability and disease. In: Riecher-Rössler A, Steiner M (eds) Perinatal Stress, Mood and Anxiety Disorders: from bench to bedside. Karger, Basel

    Google Scholar 

  • Ministerio da Saude (2007) Saude da Familia. www.dtr2004.saude.gov.br/dab/atencaobasica.php (accessed in 22/10/2007).

  • Ministerio da Saude (2008). www.ans.gov.br/portal/upload/informacoesss/caderno_informaca_o6_2008.pdf (accessed 23/06/2008).

  • O’Hara MW, Swain AM (1996) Rates and risks of postpartum depression: a meta analysis. Int Rev Psychiatry 8:37–45

    Article  Google Scholar 

  • Orr ST, James AS, Prince CB (2002) Maternal prenatal depressive symptoms and spontaneous preterm births among African-Americans women in Baltimore, Maryland. Am J Epidemiol 156:797–802

    Article  PubMed  Google Scholar 

  • Patel V, Kleinman A (2003) Poverty and common mental disorders in developing countries. Bull WHO 81:609–615

    PubMed  Google Scholar 

  • Patel V, Prince M (2006) Maternal psychological morbidity and low birth weight in India. Br J Psychiatry 168:284–285

    Article  Google Scholar 

  • Patel V, Araya R, Lima M, Ludemir A, Todd A (1999) Women, poverty and common mental disorders in four restructuring societies. Soc Sci Med 49:1461–1471

    Article  PubMed  CAS  Google Scholar 

  • Patel V, Rodrigues M, DeSouza N (2002) Gender, poverty, and postnatal depression: a study of mothers in Goa, India. Am J Psychiatry 159:43–47

    Article  PubMed  Google Scholar 

  • Patel V, Araya R, Chowdhary N, King M, Kirkwood B, Nayak S, Simon G, Weiis HA (2008) Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires. Psychol Med 38:221–228

    Article  PubMed  CAS  Google Scholar 

  • Pinheiro SN, Laprega MR, Furtado EF (2005) Psychiatric morbidity and alcohol use by pregnant women in a public obstetric service. Rev Saude Publica 39:593–598

    Article  PubMed  Google Scholar 

  • Rahman A, Iqbal Z, Harrington R (2003) Life events, social support and depression in childbirth: perspectives from a rural community in the developing world. Psychol Med 33:1161–1167

    Article  PubMed  CAS  Google Scholar 

  • Rahman A, Bunn J, Lovel H, Creed F (2007) Association between antenatal depression and lowbirthweight in a developing country. Acta Psychiatr Scan 115:481–486

    Article  CAS  Google Scholar 

  • Riecher-Rössler A, Rohde A (2005) Diagnostic classification of perinatal mood disorders. In: Riecher-Rössler A, Steiner M (eds) Perinatal Stress, Mood and Anxiety Disorders: from bench to bedside. Karger, Basel

    Google Scholar 

  • Rigotti NA, Park ER, Regan S, Chang Y, Perry K, Loudin B, Quinn V (2006) Efficacy of telephone counselling for pregnant smokers: a randomized controlled trial. Obstet Gynecol 108:83–92

    PubMed  Google Scholar 

  • Seade. Governo do Estado de São Paulo, 2003. www.seade.gob.br/produtos/anuario/2003.

  • Seguin L, Potvin L, STDenis M, Loiselle J (1995) Chronic stressors, social support, and depression during pregnancy. Obstet Gynecol 85:583–589

    Article  PubMed  CAS  Google Scholar 

  • Shen YC, Zhang MY, Huang YQ, He YL, Liu ZR, Cheng H, Tsang A, Lee S, Kessler RC (2006) Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China. Psychol Med 36:257–267

    Article  PubMed  Google Scholar 

  • Smith MV, Rosenheck RA, Cavaleri MA, Howell HB, Poschman K, Yonkers KA (2004) Screening for and detection of depression, panic disorder, and PTSD in public-sector obstetric clinics. Psychiatr Serv 55:407–414

    Article  PubMed  Google Scholar 

  • StataCorp. Stata Statistical software. Stata Corporation, 2005

  • Susan JA, Sterling KC, Ruth EL, Paul DS, Janet RD (1992) Analysis of facials shape in children gestationally exposed to marijuana, alcohol, and/or cocaine. Pediatrics 89:67–77

    Google Scholar 

  • WHO (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291:2581–2590

    Article  Google Scholar 

Download references

Acknowledgements

The study was funded by FAPESP (proc. no. 05/05333-9). PRM was partly funded by the CNPq-Brazil (proc. no. 300747/2005-5). AFC received post-doctoral fellowships from the CNPq-Brazil (proc. no. 509141/2003-0) and FAPESP (proc. no.07/50273-2).

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Correspondence to Alexandre Faisal-Cury.

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Faisal-Cury, A., Menezes, P., Araya, R. et al. Common mental disorders during pregnancy: prevalence and associated factors among low-income women in São Paulo, Brazil. Arch Womens Ment Health 12, 335–343 (2009). https://doi.org/10.1007/s00737-009-0081-6

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  • DOI: https://doi.org/10.1007/s00737-009-0081-6

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