ASPECTOS PSICOSSOCIAIS MATERNOS E PREJUÍZOS NA RELAÇÃO MÃEFILHO: ESTUDO DA COORTE PRÉ-NATAL BRISA.

Abstract

Pregnancy and motherhood has been increasingly under investigation by the scientific community, with the risk of developing psychopathology, thus becoming a major public health problem for the mother-child dyad. This study had two objectives: to analyze the effects of psychosocial factors in the mother-child relationship; and analyze the psychometric properties of the Population Screening Scale for Depression (CES-D) to measure symptoms of depression in pregnant women both held in the city of Sao Luís-MA. In the first article, we used the Postpartum Bonding Questionnaire (PBQ) to assess the mother-child relationship in 1140 mother-child pairs. In the proposed model, socioeconomic status determined demographic, maternal psychosocial and social support, which determined the outcome of mother-child relationship, analyzed as latent variable. The models were adjusted for structural equation modeling using mplus 7.0. The final model had good fit (RMSEA = 0.047, CFI = 0.984; TLI = 0.981). The models of the first and second article were estimated by the method of least squares (WLSMV) adjusted for mean and variance. In the second article, the Exploratory Factor Analysis suggested models with up to four dimensions, with good adjustment only for models with 3 and 4 dimensions. In addition to these models were tested on Confirmatory Factor Analysis of the reference models and new model without items 4 and 8, which had low factor loadings (<0.40). if found to have symptoms of depression during pregnancy and postpartum presented more often, mother-child relationship impaired. These effects were direct and positive. The greatest effect was the symptoms of depression during pregnancy. They associated themselves also to impaired mother-child relationship, less social support, unfavorable socioeconomic status and marital status informal, indirect pathway. Symptoms of anxiety and maternal age showed no effect on the mother-child relationship. It was found that models with four dimensions were suitable to assess symptoms of depression in pregnant women in the city of São Luís. It is confirmed using the CES-D to measure symptoms of depression in pregnant women, considering its practical use, as a scale with good fit index. It was also observed that greater attention to the womwn health of during the prenatal and postpartum may be a strategy for identifying psychopathological symptoms, in order to prevent possible damage in the mother-child relationship.