Abstract
Objetivo
Determinar la cifra de incidencia de depresión posparto y sus factores asociados en mujeres de la ciudad de Bucaramanga (Colombia).
Diseño
Estudio de cohorte.
Participantes
Participaron 286 mujeres puérperas seleccionadas entre mayo de 2003 y abril de 2004 y seguidas durante 6 semanas.
Emplazamiento
El estudio se realizó en 11 centros asistenciales de diferente nivel de complejidad en el área metropolitana de Bucaramanga.
Mediciones
Se recogió información sobre variables sociodemográficas, obstétricas, antecedentes psiquiátricos, variables relacionadas con el niño, satisfacción con el nacimiento y lactancia materna. El diagnóstico fue establecido por un especialista en psiquiatría, mediante una entrevista clínica semiestructurada, según los criterios de DSM IV. Se establecieron la tasa de incidencia y, mediante la construcción de un modelo de regresión, los factores asociados.
Resultados
La tasa de incidencia de depresión posparto fue de 1 caso por cada 1.000 días/persona de seguimiento (intervalo de confianza [IC] del 95%, 0,5-1,7).
Una vez realizado el ajuste, sólo los antecedentes personales de depression (hazard ratio [HR] = 3,87; IC del 95%, 1,02-14,7), la falta de control prenatal (HR = 3,87; IC del 95%, 1,1-13,2) y los antecedentes de disforia (HR = 15,13; IC del 95%, 1,9-118,2) permanecieron asociados.
Conclusiones
La depresión posparto es un trastorno poco reconocido. En Bucaramanga puede considerarse como un problema de salud pública. Su frecuencia podría disminuir si se realiza un control prenatal adecuado y un seguimiento estrecho de las mujeres puérperas durante las primeras semanas del posparto.
Palabras clave: Depresión posparto, Incidencia, Factores de riesgo
Abstract
Objective
Depression is a major public health problem, which women present, as well as at other periods of their lives, at the puerperium. Postnatal depression is the most frequent complication at this period, with worldwide prevalence as high as 15%. In Colombia, its frequency and associated factors were not clearly defined.
Design
To establish the incidence and associated factors for postnatal depression in the Bucaramanga, Colombia, metropolitan area.
Methods
Between May 2003 and April 2004, a cohort was assembled of 286 puerperal women from 11 health centres at different levels, within the Bucaramanga metropolitan area. Women were monitored for 6 weeks. Information was obtained on social, demographic and obstetric variables, psychiatric history, variables concerning the newborn, satisfaction with delivery, and breast-feeding. Postnatal depression was established by a psychiatrist, in a semi-structured clinical interview, using DSM-IV criteria. Incidence rate and associated factors were calculated through a regression model.
Results
Incidence rate of postnatal depression was: 1 case per 1000 days/person monitored (95% CI, 0.5-1.7). After the data were then fitted, only these factors were associated with postnatal depression: depression background, HR 3.87 (95% CI, 1.02-14.7), absence of prenatal monitoring, HR 3.87 (95% CI, 1.1-13.2), and background of dysphoria, HR 15.13 (95% CI, 1.9-118.2).
Conclusions
Postnatal depression is little recognized during the puerperium. It is a major public health problem in Bucaramanga, where an appropriate prenatal monitoring program could reduce it. A follow-up program for mother and child would help its early diagnosis and management.
Key words: Postnatal depression, Incidence, Risk factors
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