Fatores associados a transtornos mentais comuns e desejo de engravidar em gestantes adolescentes

Abstract

According to the World Health Organization (WHO) adolescence is the period between 10 and 19 years of age. Each year sixty in thousand girls become pregnant. Researches show that the city of Rio de Janeiro follows the country tendency of increasing the number of adolescent pregnancies; a worrying scenario in which the age of 10 to 14 years old presents the highest variation 7.1% per year. Paper I: To determine the prevalence of common mental disorders (CMD) and associations with socioeconomic and demographic factors and social support network in a population of pregnant adolescents. Paper II: Assess the prevalence of pregnancy willingness and possible associations with socioeconomic and demographic factors and social support network in a population of pregnant adolescents and verify if age should be an effect modifier in these associations. Papers I & II: Cross-sectional studies with 232 pregnant adolescents regularly attending two public maternity hospitals in Rio de Janeiro from May to October, 2007. Self-reported questionnaires were used to assess socioeconomic and demographic data as well as information about social support network. GHQ-12 was used to assess common mental disorders. Paper I: The prevalence of CMD was 45.3%. Final adjusted model showed that CMD was associated with low income (PR= 2.32; CI 95% 1.15-4.67), lack of familiar support (PR = 2.18; CI 95%1.69 -2.81), do not have friends (PR=1.48; CI 95% 1.13 -1.92) and having no religion (PR = 1.72; CI 95% 1.25-2.36). Paper II: The prevalence of pregnancy willingness was 46.2%. Final adjusted model showed that being married (PR = 1.80; CI 95% 1.27-2.56) and do not have friends (PR = 1.48; CI 95% 1.15 - 1.90) was associated with desire of being pregnant. Girls studying in the elementary grade and with 12 to 16 years of age showed less desire of being pregnant (PR = 0.57; IC 95% 0.38 0.88). Paper I: Results show due to the strong association found between CMD and adolescent pregnancy this condition could be very harmful to the mental health of these young mothers; government policies should manage this important issue; families and friends should have important rolls to help in these cases. Paper II: Pregnancy may not always be unwanted. Some factors, as being married and do not have friends may have influence in these cases. Professionals dealing with adolescents should be aware of these issues to identify risk situations that could be successfully managed.