18 research outputs found
Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil - ECCAGE study
<p>Abstract</p> <p>Background</p> <p>Woman's nutritional status, before and during pregnancy, is a strong determinant of health outcomes in the mother and newborn. Gestational weight gain and postpartum weight retention increases risk of overweight or obesity in the future and they depend on the pregestational nutritional status and on food consumption and eating behavior during pregnancy. Eating behavior during pregnancy may be the cause or consequence of mood changes during pregnancy, especially depression, which increases likelihood of postpartum depression. In Brazil, a study carried out in the immediate postpartum period found that one in three women experienced some type of violence during pregnancy. Violence and depression are strongly associated and both exposures during pregnancy are associated with increased maternal stress and subsequent harm to the infant. The main objectives of this study are: to identify food intake and eating behaviors patterns; to estimate the prevalence of common mental disorders and the experience of violence during and after pregnancy; and to estimate the association between these exposures and infant's health and development.</p> <p>Methods/Design</p> <p>This is a cohort study of 780 pregnant women receiving care in 18 primary care units in two cities in Southern Brazil. Pregnant women were first evaluated between the 16<sup>th </sup>and 36<sup>th </sup>week of pregnancy at a prenatal visit. Follow-up included immediate postpartum assessment and around the fifth month postpartum. Information was obtained on sociodemographic characteristics, living circumstances, food intake, eating behaviors, mental health and exposure to violence, and on infant's development and anthropometrics measurements.</p> <p>Discussion</p> <p>This project will bring relevant information for a better understanding of the relationship between exposures during pregnancy and how they might affect child development, which can be useful for a better planning of health actions aiming to enhance available resources in primary health care.</p
Developmental delay in early childhood is associated with visual-constructive skills at school age in a Brazilian cohort
Abstract We investigated differences in IQ and visual-constructive skills in school-age children evaluated as developmentally delayed or typically developed in early childhood. Sixty-four participants from a Brazilian cohort were evaluated in IQ (Wechsler Abbreviated Scale of Intelligence) and tasks of visual-spatial memory and visual-constructive skills through the Benton Visual Retention Test (BVRT) at school age. Neuropsychomotor development at 4 years of age was measured by Denver II. Developmentally delayed children showed lower IQs, lower scores, and more errors in copy and memory BVRT tasks when compared to typically developed children. Delay in neuropsychomotor development in early childhood may affect the subsequent cognitive development of children
Problemas conjugais e outros fatores associados a transtornos psiquiátricos do pós-parto Marital problems and other factors associated with postpartum psychiatric disorders
OBJETIVO: Estudar a associação entre transtornos mentais pós-parto e fatores demográficos e psicossociais, pré e perinatais. MÉTODOS: Todas as familias com crianças de quatro meses da Vila Jardim - Porto Alegre (RS) - nascidos entre novembro de 1998 e dezembro de 1999 foram avaliadas. Utilizou-se o Self Report Questionnaire (SRQ-20) e entrevistas clínicas semiestruturadas individuais e do casal para fundamentar uma hipótese diagnóstica segundo os critérios do da quarta edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV). Realizou-se a avaliação da relação conjugal e do relacionamento da mãe com as famílias de origem e a rede social utilizando-se a Escala de Avaliação Global do Funcionamento Relacional (GARF). RESULTADOS: Foram avaliadas 148 mães e os 116 pais que coabitavam. Segundo o SRQ, 34,4% das mães e 25,4% dos pais apresentaram suspeita de transtorno psiquiátrico. Clinicamente os percentuais foram maiores. Coabitar ou não com companheiro não esteve associado com transtorno mental materno. Na análise da totalidade do grupo de mulheres, estiveram associados: baixa renda familiar (OR=0,8; pPURPOSE: To study the association between postpartum psychiatric disorder and demographic and psychosocial, pre- and perinatal factors. METHODS: All families having 4-month-old infants in Vila Jardim, a district of Porto Alegre, Brazil, born at a public hospital from November 1998 through December 1999 were assessed. The Self-Report Questionnaire (SRQ-20) and semi-structured interviews were used for the psychiatric assessment that included a possible diagnosis using Diagnostic and Statistical Manual of Mental Disorders IV (DSM- IV) criteria. Relational functioning between couples, the relationship with mother's family of origin and social network were assessed using the DSM-IV Global Assessment of Relational Functioning Scale (GARF). RESULTS: A total of 148 mothers and 116 cohabiting fathers were assessed. According to the SRQ, 34.4% of the mothers and 25.4% of the fathers had a suspicion of psychiatric disorder. Clinical assessments using DSM-IV criteria detected larger numbers. In the analysis of the whole group of women, low family income (OR=0.8; p<0.05) and presence of previous maternal disorder (OR=2.2; p<0.05) were associated. When only women living with partners were assessed (n=116), there was an exclusive association with quality of marital relationship (OR=7.3; p<0.05). CONCLUSION: This study reinforces the need of investigating the presence of maternal psychiatric disorder during prenatal care, introduces data about the father, and especially, the importance of routine assessment of the marital relationship
A dinâmica da família que coabita e cuida de um idoso dependente La dinámica de la familia que coabita y cuida de un familiar anciano dependiente The dynamics of the family that lives with and takes care of an elderly dependent relative
Associado à progressão do envelhecimento, constata-se uma diminuição de algumas capacidades funcionais e um aumento da vulnerabilidade. A dependência acaba por surgir, sendo a família a principal instituição de apoio. Parece-nos assim pertinente questionar: qual a relação entre a dinâmica familiar e o coabitar e cuidar de um familiar idoso dependente? O objectivo foi, analisar o funcionamento da família cuidadora, relacionando o nível de dependência do familiar idoso e a idade dos cuidadores com a dinâmica familiar. Desenvolveu-se um estudo correlacional e transversal, com amostra intencional constituída por 80 famílias e 143 cuidadores. Usámos uma escala de avaliação do nível de dependência aos idosos e outra de avaliação da coesão e adaptabilidade familiar (FACES III). Conclui-se que o nível de dependência do idoso não altera a coesão e adaptabilidade familiar, contudo, o grupo etário do cuidador altera a dinâmica familiar, induzindo um potencial patológico.<br>Asociado a la progresión del envejecimiento se constata una disminución de algunas capacidades funcionales y un aumento de la vulnerabilidad. La dependencia acaba por surgir, sendo la familia la principal institución de apoyo. Nos parece así pertinente cuestionar: cual es la relación entre la dinámica familiar y el coabitar y cuidar de un familiar anciano dependiente? El objetivo fue analizar el funcionamento de la familia cuidadora, relacionando el nivel de dependencia del familiar anciano y la edad de los cuidadores con la dinamica familiar. Se desarrollo un estudio correlacional y transversal con la muestra intencional constituida por 80 familias y 143 cuidadores. Usamos una escala de avaliación de nivel de dependencia a los ancianos y otra de avaliación de la coesión y la adaptabilidad familiar (FACES III). Se concluye que el nivel de dependencia del anciano no altera la coesión y adaptabilidad familiar, con todo, el grupo etario del cuidador altera la dinámica familiar induciendo un potencial patológico.<br>Constant depletion of some functional capacities and an increasing vulnerability are associated with the ageing process. Eventually, the individual becomes dependent on someone and the family is the main supportive institution. In view of this situation, one question guided our study: What is the relation between the family dynamics and to live with and take care of an elderly dependent relative? Our purpose is to analyse how the care provided by the family works, relating the family dynamics with the level of dependency of that relative and the age of the caregivers. We developed a related and transversal study, with an intentionally sample composed by 80 families and 143 caregivers. An evaluation scale was used to measure the dependency level of the elderly and a family adaptability and cohesion evaluation scale (FACES III). We concluded that the elderly level of dependency does not change the cohesion and adaptability of the family. Nonetheless, we also observed that the age of the caregiver alters the family dynamics, what can lead to the development of a pathological picture
Problematic parent-infant relationships in two-parent families: prevalence and risk factors in a Brazilian neighborhood Relações problemáticas entre pais e criança em famílias com pai e mãe: prevalência e fatores de risco em um bairro brasileiro
Introduction: Although the quality of parent-child relationships is known to be associated with the offspring's mental health, little is known about the prevalence of problematic relationships in this scenario. This cross-sectional study aims to investigate the prevalence and risk factors of different types of early parent-infant relationships in a Brazilian population group. Methods: During 1 year, all families (n = 230) from an urban community of Porto Alegre, southern Brazil, with 4-month-old infants born in public hospitals were identified, and 148 were fully investigated by two family therapists. This study describes data on the 116 infants with two-parent families. Demographic, obstetric, and relational variables were collected through questionnaires and scales (Parent-Infant Relationship Global Assessment Scale, Global Assessment of Relational Functioning, and Self-Report Questionnaire). Prevalence ratios were calculated, and Poisson regression with robust variance was performed to adjust for covariates. Results: Almost 10% of mothers and 12% of fathers showed at least a significantly perturbed relationship with their 4-month-old infants. Inadequate mother-infant bonding coincided with evidence of paternal mental disorder, poor maternal social network, and discontinuation of breastfeeding at 4 months. A problematic father-infant relationship was associated with a dysfunctional couple relationship and with low infant birth weight. Conclusions: There is a high prevalence of early parent-child relationship problems, suggesting a need for health system interventions. Parent-infant relational problems are prevalent very early in life and more associated with other relational problems than with socioeconomic burden.<br>Introdução: Embora seja consenso que a qualidade das relações pais-filho influencie a saúde mental da prole, pouco se sabe sobre a prevalência de relações problemáticas nessa esfera. Este estudo transversal teve como objetivo investigar a prevalência e os fatores de risco de diferentes tipos de relações entre pais e lactentes em um bairro brasileiro. Métodos: Durante 1 ano, todas as famílias (n = 230) residentes em uma comunidade urbana de Porto Alegre, sul do Brasil, com filhos de 4 meses de idade nascidos em hospitais públicos foram identificadas, e 148 foram investigadas em detalhe por dois terapeutas familiares. Este estudo descreve os dados dos 116 lactentes com famílias formadas por pai e mãe. Variáveis demográficas, obstétricas e relacionais foram coletadas através de questionários e escalas (Parent-Infant Relationship Global Assessment Scale, Global Assessment of Relational Functioning e Self-Report Questionnaire). Razões de prevalência foram calculadas, e a regressão de Poisson com variância robusta foi utilizada para ajuste de covariáveis. Resultados: Quase 10% das mães e 12% dos pais mostraram pelo menos uma relação significativamente perturbada com seus lactentes de 4 meses de idade. Vínculo inadequado entre mãe e lactente coincidiu com evidências de transtorno mental paterno, uma rede social de apoio insatisfatória por parte da mãe e interrupção do aleitamento materno aos 4 meses. Relação problemática entre o pai e o lactente associou-se com relação disfuncional do casal e com baixo peso do lactente ao nascimento. Conclusões: Há uma alta prevalência de problemas nas relações precoces entre pais e filho, sugerindo a necessidade de intervenções do sistema de saúde. Problemas relacionais pais-filho são altamente prevalentes logo no início na vida do lactente e são mais associados a outros problemas relacionais do que a sobrecarga socioeconômica