Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2015-0067
Trends in Psychiatry and Psychotherapy
Review Article

Special features of high-risk pregnancies as factors in development of mental distress: a review

Particularidades da gravidez de alto risco como fatores para o desenvolvimento de sofrimento mental

Paula Borba Rodrigues; Carla Fonseca Zambaldi; Amaury Cantilino; Everton Botelho Sougey

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Abstract

Abstract Introduction: Approximately 22% of all pregnant women are classified as having high-risk pregnancies, which may involve feelings of vulnerability because of having a high-risk pregnancy, resulting in greater exposure to stressful feelings. Objective: To review aspects of high-risk pregnancy that can have a negative impact on the these women's mental health status. Method: Original articles were identified by conducting searches of the PubMed/MEDLINE, LILACS and SciELO databases, followed by a manual search of references to select articles and additional bibliographic material. Articles from the last 22 years were included in the review (1992-2014). Results: Fifteen articles were found that specifically studied high-risk pregnancies and mental health outcomes. Women with high-risk pregnancies exhibited a significantly higher level of stress and reported negative emotions as they dealt with stress and had worse emotional status than women with normal pregnancies. Researchers found that hospitalized pregnant women had higher levels of anxiety than non-hospitalized women. Studies of women going through normal and high-risk pregnancies show that women with normal pregnancies had good self-perceived quality of life. Conclusion: Special features of high-risk pregnancies could be factors in development of mental distress, in addition to psychological and social factors. Therefore, only a biopsychosocial research study would be able to identify the factors that can affect the quality of mental health during high-risk pregnancy.

Keywords

High-risk pregnancy, mental disorder, depression, anxiety, risk

Resumo

Resumo Introdução: Aproximadamente 22% de todas as mulheres grávidas são classificadas como tendo gravidezes de alto risco, podendo experimentar vulnerabilidade por esta situação. Desta forma, estão mais expostas a sentimentos de estresse. Objetivo: Revisar aspectos da gravidez de alto risco que podem ter um impacto negativo sobre o estado de saúde mental dessas mulheres. Métodos: Artigos originais foram localizados por meio de uma busca eletrônica nas bases de dados PubMed/MEDLINE, LILACS e SciELO, bem como uma busca manual de referências para selecionar artigos e material bibliográfico adicional. Foram selecionados artigos publicados nos últimos 22 anos (1992-2014). Resultados: Foram encontrados 15 artigos que estudavam especificamente gravidez de alto risco e o desfecho saúde mental. Mulheres grávidas de alto risco demonstraram um nível significativamente mais elevado de estresse e relataram emoções negativas ao lidar com o estresse; elas também apresentavam pior estado emocional quando comparadas a mulheres com gravidez normal. Os pesquisadores observaram que as mulheres grávidas internadas tinham níveis mais elevados de ansiedade do que mulheres não hospitalizadas. Outros estudos envolvendo mulheres com gestações normais e de alto risco mostram que as mulheres com uma gravidez normal têm uma boa percepção de sua qualidade de vida. Conclusões: As particularidades das gestações de alto risco, além de fatores psicológicos e sociais, podem ser fatores no desenvolvimento de transtornos mentais. Portanto, somente um estudo biopsicossocial seria capaz de identificar os fatores que podem afetar a qualidade da saúde mental durante a gravidez de alto risco.

Palavras-chave

Gravidez de alto risco, doença mental, depressão, ansiedade, risco

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