Ambiente externo da mulher e sífilis congênita à luz da Teoria da Conservação de Levine <span class="so-article-trans-title" dir="auto"> Translated title: External environment of woman and congenital syphilis in the light of Levine´s Conservation Theory </span> <span class="so-article-trans-title" dir="auto"> Translated title: Ambiente externo de la mujer y sífilis congénita a la luz de la Teoría de la Conservación de Levine </span>

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Abstract

RESUMO Objetivo discutir os elementos do ambiente externo da mulher com recém-nascido portador de sífilis congênita. Método estudo qualitativo, descritivo e exploratório, realizado entre janeiro e março de 2020, com 25 puérperas internadas em uma maternidade estadual da Baixada Fluminense do estado do Rio de Janeiro, em acompanhamento de recém-nascidos com sífilis congênita. Tratamento dos dados realizado por análise temática e discutidos à luz da Teoria da Conservação proposta por Myra Estrin Levine. Protocolo de pesquisa aprovado por Comitê de Ética em Pesquisa. Resultados antes e durante a gravidez, o ambiente externo das participantes se caracteriza por baixa escolaridade, desconhecimento acerca da sífilis, violências intrafamiliar e perpetrada por parceiro íntimo, e não tratamento do homem. Conclusão o acompanhamento pré-natal é um momento privilegiado por aproximar os profissionais das gestantes e oportunizar o reconhecimento dos elementos externos influenciadores dos desfechos maternos e fetais.

Translated abstract

ABSTRACT Objective to discuss elements of the external environment of women with newborns with congenital syphilis. Method this exploratory, qualitative, descriptive study was conducted between January and March 2020 with 25 puerperal women inpatients in follow-up of newborns with congenital syphilis at a Rio de Janeiro state maternity hospital in the Baixada Fluminense. The data were treated by thematic analysis and discussed in the light of the Conservation Theory proposed by Myra Estrin Levine. The research protocol was approved by the research ethics committee. Results before and during pregnancy, the participants’ external environment featured little education, lack of knowledge about syphilis, intra-family violence and violence perpetrated by an intimate partner, and non-treatment of men. Conclusion antenatal care is an especially favorable setting, because it brings health personnel together with pregnant women and provides opportunities for recognizing external elements that influence maternal and fetal outcomes.

Translated abstract

RESUMEN Objetivo discutir los elementos del ambiente externo de mujeres cuyos recién nacidos tienen sífilis congénita. Método investigación cualitativa, descriptiva y exploratoria realizada entre enero y marzo de 2020 junto a 25 puérperas hospitalizadas en una maternidad estatal de la Baixada Fluminense del estado de Rio de Janeiro que acompañaban sus recién nacidos con sífilis congénita. Los datos fueron tratados por análisis temático y discutidos a la luz de la Teoría de Conservación propuesta por Myra Estrin Levine. El protocolo de la investigación fue aprobado por el Comité de Ética en Investigación. Resultados antes y durante el embarazo, el ambiente externo de las participantes se caracteriza por baja escolaridad, desconocimiento sobre sífilis, violencia intrafamiliar y ejercida por compañero, y ausencia de tratamiento de los hombres. Conclusión la atención prenatal es un momento privilegiado ya que acerca los profesionales a las embarazadas y permite el reconocimiento de elementos externos que influyen en los desenlaces maternos y fetales.

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Intimate partner violence around the time of pregnancy and postpartum depression: The experience of women of Bangladesh

Md. Jahirul Islam, Lisa M Broidy, Kathleen Baird … (2017)

Background and objectives Intimate partner violence (IPV) around the time of pregnancy is a serious public health concern and is known to have an adverse effect on perinatal mental health. In order to craft appropriate and effective interventions, it is important to understand how the association between IPV and postpartum depression (PPD) may differ as a function of the type and timing of IPV victimization. Here we evaluate the influence of physical, sexual and psychological IPV before, during and after pregnancy on PPD. Methods Cross-sectional survey data was collected between October 2015 and January 2016 in the Chandpur District of Bangladesh from 426 new mothers, aged 15–49 years, who were in the first six months postpartum. Multivariate logistic regression models were used to estimate the association between IPV and PPD, adjusted for socio-demographic, reproductive and psychosocial confounding factors. Results Approximately 35.2% of women experienced PPD within the first six months following childbirth. Controlling for confounders, the odds of PPD was significantly greater among women who reported exposure to physical (AOR: 1.79, 95% CI [1.25, 3.43]), sexual (AOR: 2.25, 95% CI [1.14, 4.45]) or psychological (AOR: 6.92, 95% CI [1.71, 28.04]) IPV during pregnancy as opposed to those who did not. However, both before and after pregnancy, only physical IPV evidences a direct effect on PPD. Results highlight the mental health consequences of IPV for women of Bangladesh, as well as the influence of timing and type of IPV on PPD outcomes. Conclusions and implications The findings confirm that exposure to IPV significantly increases the odds of PPD. The association is particularly strong for physical IPV during all periods and psychological IPV during pregnancy. Results reinforce the need to conduct routine screening during pregnancy to identify women with a history of IPV who may at risk for PPD and to offer them necessary support.