Transtorno depressivo maior e cuidados parentais em adolescentes grávidas: estudo de base populacional

Abstract

Objective: To assess the association of major depressive disorder (MDD) with the perceived quality of parental bonding in a sample of pregnant teenagers. Methods: A cross-sectional study with a consecutive sample of pregnant adolescents recipient of prenatal medical assistance by the national public health system in the urban area of Pelotas, Southern Brazil. The sample size was estimated in 871 participants. Major depressive disorder was assessed with the Mini International Neuropsychiatric Interview (MINI). To measure the perceived quality of parental bonding, the Parental Bonding Instrument (PBI) was used. To collect socio-demographic, obstetric and other psychosocial data, a self-report questionnaire was used. Results: Forty-three (4.94%) teenagers refused to participate, resulting in 828 participants. Prevalence MDD was 17.8%. MDD was significantly associated with low education, stressful life events, violence in the last 12 months, violence during pregnancy and low social support. MDD in the pregnant adolescents, after adjustment in the multivariate analysis, was independently associated with the style of parental bonding, with an PR= 4.58 (95%CI: 2.55-8.20) for the maternal affectionless control , PR= 3.24 (95%CI: 1.35-7.79) for the maternal neglectful parenting and PR= 2.14 (95%CI: 1.2o-3.82) for the maternal affectionate constraint . Conclusions: We found that maternal affectionless control , neglectful parenting and affectionate constraint were independent predictors of major depressive disorder in the pregnant adolescents of this sample