Depresión posparto en pacientes de bajo riesgo atendidas en la Maternidad del Hospital Santo Tomás, Panamá. Estudio prospectivo.

F Espinosa, O Reyes

Texto completo:

[PDF]

Resumen


[Postpartum depression in low-risk patients seen at the Maternity Hospital Santo Tomás, Panama. Prospective study.]

RESUMEN
Objetivo: Establecer la prevalencia de depresión posparto en pacientes de bajo riesgo, atendidas en la Maternidad del Hospital Santo Tomás, entre agosto y septiembre de 2019. Métodos: Se evaluaron 411 pacientes, clasificadas como embarazos de bajo riesgo, que acudieron para la atención del parto en la Maternidad del Hospital Santo Tomás. Al momento de su egreso (< 3 días posparto) se les aplicó el Cuestionario sobre Depresión Posnatal de Edimburgo (EPDS por sus siglas en inglés) y se volvió a repetir la aplicación del cuestionario a los 15 y 42 días posparto. Según el puntaje obtenido en el cuestionario, en cada uno de los tres momentos de evaluación, las pacientes se clasificaron en “sin riesgo”, “en riesgo” y “probable depresión”. Resultados: En su puerperio mediato, el 9.98% de las pacientes de bajo riesgo presentaron puntajes en la EPDS compatibles con “probable depresión”. Sin embargo, a los 15 y 42 días el porcentaje de pacientes se reducía a 2.6% y 3.49%, respectivamente. De los diferentes factores de riesgo analizados, ninguno alcanzó significancia estadística. Conclusión: En pacientes de bajo riesgo obstétrico, independiente de la presencia o no de factores de riesgo conocidos de depresión posparto, el 9.98% presentan síntomas compatibles con esta condición en sus primeros días de puerperio. A pesar de que el riesgo se reduce notablemente en su puerperio tardío (2-3%), nuestro estudio sugiere que la pesquisa por estos síntomas debe formar parte de la evaluación estándar posparto.

ABSTRACT
Objective: To establish the prevalence of postpartum depression in low-risk patients seen at the Saint Thomas Maternity Hospital, between August and September 2019. Methods: A total of 411 patients, classified as low-risk pregnancies, were evaluated and attended at the Saint Thomas Maternity Hospital for delivery. Upon discharge (< 3 days postpartum), the Edinburgh Postpartum Depression Questionnaire (EPDS) was applied and the questionnaire was repeated at 15 and 42 days postpartum. According to the score obtained in the questionnaire, in each of the three evaluation moments, the patients were classified as "without risk", "at risk" and "probable depression". Results: In their puerperium, 9.98% of low-risk patients presented EPDS scores compatible with "probable depression". However, at 15 and 42 days the percentage of patients was lower (2.6% and 3.49%, respectively). Of the different risk factors analyzed, none reached statistical significance. Conclusion: In patients with low obstetric risk, regardless of the presence or absence of known risk factors for postpartum depression, 9.98% present symptoms compatible with this condition in their first days of puerperium. Although the risk is significantly reduced in their late puerperium (2-3%), our study suggests that screening for these symptoms should be part of the standard postpartum evaluation.


Referencias


Referencias

Robertson, E., Celasun, N., and Stewart, D.E. (2003). Risk factors for postpartum depression. In Stewart, D.E., Robertson, E., Dennis, C.-L., Grace, S.L., & Wallington, T. (2003). Postpartum depression: Literature review of risk factors and interventions.

Siu AL, US Preventive Services Task Force (USPSTF). Screening for depression in adults. US Preventive Services Task Force Recommendation Statement. JAMA 2016; 315(4): 380-387.

World Health Organization. WHO Recommendations on postnatal care of the mother and newborn. October 2013.

American College of Obstetrician and Gynecologists. ACOG Committee Opinion: Presidential Task Force on Redefining the Postpartum Visit. Number 736, Mayo 2018.

Caparros-Gonzalez R, Romero-Gonzalez B, Peralta-Ramirez MI Depresión posparto, un problema de salud pública mun-dial [carta]. Rev Panam Salud Publica. 2018;42:97.

Arifin, S., Cheyne, H., & Maxwell, M. Review of the prevalence of postnatal depression across cultures. 2018. AIMS public health; 5(3): 260–295.

England R. Infant development and management of infant problems in a family setting. Aust Fam Physician. 1994 Oct;23(10):1877-82.

Segre LS, O'Hara MW, Arndt S, Stuart S. The prevalence of postpartum depression: the relative significance of three social status indices. Social Psychiatry & Psychiatric Epidemiology. 2007;42(4):316–321.

Miranda J, Chung JY, Green BL, Krupnick J, Siddique J, Revicki DA, et al. Treating depression in predominantly low-income young minority women: a randomized controlled trial. JAMA. 2003;290(1):57–65.

Homish GG, Cornelius JR, Richardson GA, Day NL. Antenatal risk factors associated with postpartum comorbid alcohol use and depressive symptomatology. Alcoholism: Clinical & Experimental Research. 2004;28(8):1242–1248.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association.

World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM V). Washington, DC: American Psychiatric Association.

Elliott S. Report on the Satra Bruk workshop on classification of postnatal mental disorders on november 7–10, 1999, convened by Birgitta Wickberg, Philip Hwang and John Cox with the support of Allmanna Barhuset represented by Marina Gronros. Arch Wom Ment Health. 2000;3: 27–33.

Epidemiology of puerperal psychoses. Kendell RE, Chalmers JC, Platz C. Br J Psychiatry. 1987 May; 150():662-73.

Moraes GPA, Lorenzo L, Pontes GAR, Montenegro MC, Cantilino A. Screening and diagnosing postpartum depression: when and how?. Trends in Psychiatry and Psychotherapy. Jan/Mar 2017; 39(1): 54-61.

Cox, J., Holden, J., & Sagovsky, R. (1987). Detection of Postnatal Depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150(6), 782-786.

Guedeney N, Fermanian J. Validation study of the French version of the Edinburgh postnatal depression scale (EPDS): new results about use and psychometric properties. European psychiatry. 1998;13(2):83–9.

Bunevičius A, Kusminskas L, Bunevičius R. Validation of the Lithuanian version of the Edinburgh postnatal depression scale. Medicina. 2009;45(7):544–8.

Smith-Nielsen, J., Matthey, S., Lange, T. et al. Validation of the Edinburgh Postnatal Depression Scale against both DSM-5 and ICD-10 diagnostic criteria for depression. BMC Psychiatry. 2018; 18(393):1-12.

Terrén C, Lluïsa GE, Purificación N, Jaume A, Ojuel J, Tarragona, M. Prevalence of postpartum depression in Spanish mothers: comparison of estimation by mean of the structured clinical interview for DSM-IV with the Edinburgh Postnatal Depression Scale. Medicina clínica. 2003; 120: 326-9.




Enlaces refback

  • No hay ningún enlace refback.


Revista de la Federación Centroamericana de Asociaciones y Sociedades de Obstetricia y Ginecología. Editorial Infomedic International ISSN: 0428-0911 e-ISSN:2710-7604   - Soporte técnico