Experiências obstétricas adversas no parto e dificuldades de envolvimento emocional da mãe com o bebé : o papel dos sintomas de stress pós-traumático relacionados com o nascimento do bebé
Miniatura indisponível
Data
2024
Título da revista
ISSN da revista
Título do Volume
Editora
Resumo
Para algumas mulheres, pode ser uma experiência traumática quando ocorrem eventos obstétricos e neonatais adversos, que podem levar à emergência de sintomas de stress pós traumáticos associados ao nascimento do bebé (PSPT-RNB) e a dificuldades de envolvimento emocional mãe-bebé. No entanto, são ainda necessárias evidências sobre estas possíveis associações. O presente estudo tem como objetivos (1) explorar a associação entre as experiências adversas obstétricas (e.g., cesariana de emergência/parto vaginal instrumentado, complicações obstétricas e fetais/neonatais e prematuridade) e as dificuldades de envolvimento emocional mãe com o bebé aos 2 meses após o parto; (2) explorar a associação entre os sintomas de PSPT-RNB e as dificuldades de envolvimento emocional entre a mãe e o bebé; e (3) explorar o papel mediador dos sintomas de PSPT-RNB na associação entre as experiências adversas obstétricas no parto e as dificuldades de envolvimento emocional da mãe com o bebé aos 2 meses após o parto. A amostra constituiu 283 participantes que se encontravam nos 2 meses após o parto, recrutadas em três hospitais públicos em Portugal. As participantes preencheram um questionário sociodemográfico e obstétrico para recolher informação sobre as experiências obstétricas e neonatais adversas e medidas de autorrelato para avaliar os sintomas de PSPT-RNB (City Birth Trauma Scale) e as dificuldades de envolvimento emocional mãe bebé (Questionário de ligação ao bebé após o nascimento). A adversidade obstétrica e neonatal foi calculada através da presença do somatório da experiência de parto vaginal instrumentado ou cesariana de emergência, prematuridade e complicações obstétricas graves tanto na mãe como no bebé. Os resultados revelaram que (1) a adversidade obstétrica não se associa às dificuldades de envolvimento emocional da mãe-bebé; (2) os sintomas de negatividade e de evitamento estão associados a mais dificuldades de envolvimento emocional mãe-bebé; (3) os sintomas de negatividade e de reexperienciação mediaram a associação entre a adversidade obstétrica e as dificuldades de envolvimento emocional mãe-bebé. Providenciar cuidados de saúde mental perinatal a mulheres com experiências obstétricas e neonatais adversas pode contribuir para prevenir a emergência de sintomas de PSPT-RNB e dificuldades de envolvimento emocional mãe-bebé.
For most women, childbirth can be considered a very positive experience desired in their life and can lead to important changes in their lives. childbirth, such as changes in the woman's emotional and physical well-being, mood changes and can increase the perception of a traumatic birth in the mother and her baby, or even the lack of control with regard to the decisions that will be made. taken during childbirth by the medical team and of which the woman is not aware. Which often culminate in the emergence of post-traumatic stress symptoms associated with the birth of the baby. To prepare this study, a sample of 283 participants who were in the postpartum period, which corresponds to the period from 6 to 12 weeks, was collected. Recruitment was carried out in three Portuguese public hospitals. Participants completed the sociodemographic questionnaire and self-report measures to assess PTD symptoms associated with the birth of the baby (PSPT-RNB) using the City Birth Trauma Scale (City BiTS), the Baby bonding questionnaire after birth (PBQ - Portuguese version) in order to assess the difficulties of the mother-baby relationship. Obstetric and neonatal adversity was calculated through sociodemographic questionnaires, PSPT symptoms associated with the baby's birth and occurrence of trauma. The main results were (1) a significant association between obstetric adversities and difficulties in the mother's emotional involvement with the baby (2) the presence of PSPT-RNB symptoms as a predictor of difficulties in emotional involvement and finally (3) the mediating role of PSPT-RNB symptoms in this relationship. The study revealed an advance at the literary level with regard to adverse obstetric experiences during childbirth and difficulties in the emotional involvement of the mother with the baby and thus ensuring that there is a safeguard in the future for the well-being of the mother and baby and in terms of symptoms of post-traumatic stress related to the birth of the baby, this study raises awareness of such occurrences so that in the future, in addition to maternal health, the focus will be on the baby's mental health.
For most women, childbirth can be considered a very positive experience desired in their life and can lead to important changes in their lives. childbirth, such as changes in the woman's emotional and physical well-being, mood changes and can increase the perception of a traumatic birth in the mother and her baby, or even the lack of control with regard to the decisions that will be made. taken during childbirth by the medical team and of which the woman is not aware. Which often culminate in the emergence of post-traumatic stress symptoms associated with the birth of the baby. To prepare this study, a sample of 283 participants who were in the postpartum period, which corresponds to the period from 6 to 12 weeks, was collected. Recruitment was carried out in three Portuguese public hospitals. Participants completed the sociodemographic questionnaire and self-report measures to assess PTD symptoms associated with the birth of the baby (PSPT-RNB) using the City Birth Trauma Scale (City BiTS), the Baby bonding questionnaire after birth (PBQ - Portuguese version) in order to assess the difficulties of the mother-baby relationship. Obstetric and neonatal adversity was calculated through sociodemographic questionnaires, PSPT symptoms associated with the baby's birth and occurrence of trauma. The main results were (1) a significant association between obstetric adversities and difficulties in the mother's emotional involvement with the baby (2) the presence of PSPT-RNB symptoms as a predictor of difficulties in emotional involvement and finally (3) the mediating role of PSPT-RNB symptoms in this relationship. The study revealed an advance at the literary level with regard to adverse obstetric experiences during childbirth and difficulties in the emotional involvement of the mother with the baby and thus ensuring that there is a safeguard in the future for the well-being of the mother and baby and in terms of symptoms of post-traumatic stress related to the birth of the baby, this study raises awareness of such occurrences so that in the future, in addition to maternal health, the focus will be on the baby's mental health.
Descrição
Esta dissertação foi parcialmente financiada pela Fundação para a Ciência e Tecnologia -FCT, sob a concessão do HEI-LAB (UIDB/05380/2020) e do projecto (2022.0185525.PTDC, quero deixar um especial agradecimento a MAC (Maternidade Alfredo da Costa) e as enfermeiras que trabalham com todo o amor e dedicação na Unidade de Alto Risco
Palavras-chave
PSYCHOLOGY, CLINICAL PSYCHOLOGY, HEALTH PSYCHOLOGY, MOTHER-CHILD RELATIONSHIP, PUERPERIUM, ADVERSITY, POST-TRAUMATIC STRESS, EMOTIONAL BEHAVIOUR, POSTPARTUM DEPRESSION, EMOTIONAL ADJUSTMENT, MESTRADO EM PSICOLOGIA CLÍNICA E DA SAÚDE, PSICOLOGIA, PSICOLOGIA CLÍNICA, PSICOLOGIA DA SAÚDE, RELAÇÃO MÃE-FILHO, PUERPÉRIO, ADVERSIDADE, STRESS PÓS-TRAUMÁTICO, COMPORTAMENTO EMOCIONAL, DEPRESSÃO PÓS-PARTO, AJUSTAMENTO EMOCIONAL, Mestrado em Psicologia Clínica e da Saúde