Aspectos evolutivos da depressão pós-parto e fatores associados

Abstract

Postpartum depression (PPD) is a prevalent condition that affects women globally after they have given birth. An evolutionary hypothesis deals with depression, and consequently PPD, as a response from the evolution of human behavior throughout history, through natural selection. The parental investment theory suggests that parents do not automatically invest in all offspring, so that the investment is directed towards maximum reproductive success. If the risks outweigh fittness benefits, symptoms of depression develop as a warning sign. The objective of the study was to identify factors associated with PPD that were consistent with parental investment theory. Cross-sectional study with 811 mothers of infants up to five months of age in the municipality of Rio de Janeiro. The presence of PPD was defined based on scores on the Edinburgh Scale (EPDS). Factors potentially associated with PPD were analyzed by logistic regression with adjustment for confounding factors. Factors significantly associated with PPD were: inadequate social support (OR 3,38; 95% CI 2,32-4,94), low educational level (OR 2,82; 95% CI 1,69-4,70), physical violence between partners in gestation (OR 2,33; 95% CI 1,56- 3,47), maternal age under 35 years (OR 2,20; 95% CI 1,05-4,64), lack of partner (OR 1,90; 95% CI 1,16-3,12), hospitalization during pregnancy (OR 1,87; 95% CI 1,12- 3,14) and prematurity of the newborn (OR 1,87; 95% CI 1,02- 3,42). In summary, we identified factors associated with PPD which can be useful in tracking and monitoring women at risk. Some of the factors associated with PPD can be explained through the evolutionary hypotheses considered in this study. However, the findings are not sufficient to exhaust the knowledge regarding this question. Future research should focus on different aspects of this condition and monitoring of the consequences for women and their families.