Posição canguru em recém-nascidos prematuros: associação com sintomas maternos de ansiedade, depressão e violência por parceiro íntimo aos 7 e 30 dias após o parto e aos 6 meses de idade gestacional corrigida

Abstract

The Kangaroo Method (KM), combined with skilled essential care in appropriate settings, can prevent up to 60% of the 2.5 million deaths per year that occur among preterm newborns (PTNB) before reaching one year of age. Skin-to-skin contact stimulates neurological and psycho-affective development in PTNB and seems to protect maternal mental health. In contrast, maternal symptoms of anxiety and depression (MSAD) and intimate partner violence (IPV) during perinatal phases are strongly associated with prematurity, low birth weight, altered infant behavior, substance abuse, postpartum depression, and maternal death. The objectives of this study were to investigate the association between MSAD and IPV with onset day (KPOD) and frequency of KP (KPf) at seven days postpartum. And, at 30 days of life and six months of corrected gestational age (CoGA) of PTNB, to investigate the effects of KPOD and KPf on MSAD and VPI. The validated instruments that were used were State Trait Anxiety Inventory (STAI), Edinburg Postnatal Depression Scale (EPDS) and the Intimate Partner Violence Scale (IPVS). A total of 140 mothers of PTNB ≤ 32 weeks of gestation, from two public maternity hospitals in Belo Horizonte, Brazil, were included and followed up from the neonatal period until six months of CoGA. There was daily recording of the onset and duration of each KP. In the population studied, 54.3% had anxiety symptoms, 33.3% depression symptoms, and 58.4% suffered some type of IPV. There was no statistically significant association between MSAD and IPV with KPOD and KPf at seven days postpartum. At 30 days postpartum and at six months CoGA, the outcomes maternal symptoms of anxiety, depression, and IPV were not associated with KPOD or KPf. The history of alcohol use by the mother, the partner's psychiatric history, intrauterine restriction growth (IURG) and daily maternal visit were associated with KPOD with p<0.05. The use of alcohol by the partner, twin birth and days of maternal stay in the Intensive Care Unit (ICU) were associated with KPf with p<0.05. At 30 days postpartum, maternal psychiatric history and partner alcohol use also had p<0.05. At the same period, other maternal socioeconomic variables, paternal income, IURG and days of stay in the Neonate Intensive Care Unit (NICU) were associated with MSAD and KPf, with p<0.05. At six months, father’s use of alcohol and education, as well as the mother’s history of alcohol and drug use, psychiatric history, marital and socioeconomic status were associated with MSAD and IPV, with p<0, 05. Days of PTNB hospitalization and days of mother's stay in the Kangaroo Intermediate Care Unit were associated with IPV with p<0.05. Although no association was found between anxiety, depression and IPV symptoms with KPOD and KPf, socioeconomic factors, parental mental health, length of hospitalization of PTNB and the mother's stay in the Kangaroo Unit emerged as strong indicators that require attention and intervention by the care teams during hospital stay and post-discharge