Saúde mental materna e desenvolvimento neuropsicomotor de crianças nascidas prematuras no contexto da COVID-19

Abstract

This doctoral thesis had the general objective of investigating the association between parental psychological variables such as stress, anxiety, depression, hopelessness and relating them to the neuropsychomotor development of children born prematurely in the first 24 months of corrected age. To this end, it was structured into three studies. Study I entitled “Parental stress and associated symptoms in parents of premature babies: a systematic review”, aimed to identify in scientific production the variables associated with parental stress in parents of premature babies through the graph analysis technique. The CINAHL, Cochrane library, Medline, PsycInfo and Web of Science databases were consulted. The searches resulted in 12 articles, submitted to the data analysis and visualization technique in graphs using the NodeXL Program. Among the variables analyzed, the following stand out: parental psychological distress, risk factors, maternal characteristics, child characteristics, environmental characteristics, parent-baby relationship, and intervention. The main symptoms associated with parental stress were depression, anxiety and post-traumatic stress. It was concluded that the implementation of interventions aimed at the well-being of the baby and family can minimize the difficulties faced. Study II “Maternal mental health and neuropsychomotor development in the first year of life of children born prematurely”, aimed to investigate the association between parental stress, anxiety, depression, hopelessness and the neuropsychomotor development of children born prematurely at 3 and 12 months of corrected age. . This is a longitudinal, analytical, quantitative study, carried out in an outpatient clinic. 91 dyads participated, divided into two groups: (G1) mothers of children born prematurely and (G2) mothers of children born at term. A sociodemographic form, SWYC, PSI-SF, Beck scales: BAI, BDI and BHS were used. Student's t-test was used to compare independent and paired samples. The results indicated that at 3 months of corrected age, mothers of children born prematurely showed high stress in the “Parental Suffering” dimension, mild depression and moderate hopelessness. At 12 months of corrected age, G1 showed statistically significant differences in the “Difficult child” dimension of the PSI-SF and moderate hopelessness. The comparison between psychological variables over time demonstrated that at 12 months of corrected age, mothers of children born prematurely showed high stress in the “Parental Suffering” dimension, mild depression and moderate hopelessness. Study III “Prematurity and Covid-19: a study of parents' perceptions”, aimed to explore parents' perceptions of prematurity in the context of the Covid-19 pandemic. This is a retrospective, exploratory and qualitative study, carried out in a premature outpatient clinic. 20 parents of children born prematurely (14 mothers and 6 fathers), who were 24 months of corrected age, participated. The parents' perceptions were analyzed with the help of the Iramuteq software and the light of the Duplo ABC-X model. The results gave rise to three classes, Prematurity in the context of the Covid-19 Pandemic, Mental health of parents of children born prematurely during Covid-19 and Motor, language and social development of children born prematurely. The mental health of parents of children born prematurely must be systematically assessed and its results must be the basis for planning interventions that promote parental well-being. This research confirmed the complex nature surrounding the phenomenon of prematurity, constituting a multi-determined and multifaceted experience that is influenced by several factors. The experience of having a premature child during the Covid-19 pandemic emergency heightened anxieties, tensions, fear and concern for parents, especially mothers. Furthermore, the support network was reduced or non-existent, which increased the burden of care. These data reinforce the premise that prematurity cannot be investigated out of context, it is necessary to consider the set of stressors to which families are exposed, the individual characteristics of each member and their perception of events that can generate crisis in the family system.