Estresse percebido em gestantes assistidas por equipes da Estratégia Saúde da Família: estudo transversal aninhado a uma coorte de base populacional.

Abstract

The gestational period is full of physical, emotional and social changes that may cause stress in women. Its high levels might create a variety of adversal maternal-infant health outcomes. Epidemiological surveys are very relevant, since these can reveal information that help us understand the topic and the health care of the pregnant woman in the sphere of the Primary Health Care. The knowledge around the prevalence and aspects associated with stress might contribute with the planning of specific policies and strategies in order to promote health during prenatal care. This study aims to evaluate the prevalence of stress and check its aspects on pregnant woman assisted by the teams working in Family Health Strategy in the city of Montes Claros, Minas Gerais - Brazil. A coss-sectional and analytical epidemiologic study was carried out, nested in a population based cohort, in which the scenario were the Family Health Units in the urban area of Montes Claros. Sociodemographic, obstetric, physical and mental health conditions were evaluated. The stress level was estimated through the Perceived Stress Scale, PPS-14. For the statistical treatment of data, descriptive and bivariate analysis were conducted, followed by the Poisson Regression model with robust variance to identify the factors associated with perceived stress. Crude and adjusted Prevalence Ratios (PR) were estimated, with respective 95% confidence intervals (CI 95%). International and Brazilian ethical standards for research with human beings were considered, and the project was approved by means of Opinion Embodied No. 2.483.623/2018 and also by the Municipal Health Department. 1,279 pregnant women participated in the investigation. The prevalence of high stress levels was 23,5%; CI 95%=20,8%-26,2%. As determined in the adjusted model, the investigated outcome was more predominant among pregnant women aged over 35 years old (PR=1,38; CI 95%=1,09-1,74) and less than or equal to 19 (PR=1,41; CI 95%=1,13-1,77); pregnant women with no partner (PR =1,41; CI 95%=1,13-1,77); pregnant women with low social support (PR =1,42; CI 95%=1,18-1,70); multiparous pregnant women (PR =1,30; CI 95%=1,02-1,66); women with a current unplanned pregnancy (PR =1,23; CI 95%=1,00-1,52); pregnant women wtih urinary tract infection (PR =1,35; CI 95%=1,12-1,62); with high levels of anxiety symptoms (PR =1,42; CI 95%=1,18-1,71); with severe (PR =4,74; CI 95%=3,60- 6,26) and moderate (PR =3,19; CI 95%=2,31-4,39) depression symptoms; and pregnant women with neurological complaints (PR =1,77; CI 95%=1,27-2,47). This study evidenced a significant prevalence of high perceived stress among pregnant women assisted by Primary Health Care. Such result was associated to sociodemographic, clinic and obstetric aspects and to emotional conditions. It was found that stress in pregnancy has a multideterminant nature, which proves the need for extended and full time care to women’s health during pregnancy.