Mental disorders in the Postpartum Period in Rio de Janeiro 2021-2023: Nascer no Brasil II Study

To analyze the prevalence and interrelationship of symptoms of depression, anxiety, and birth-related post-traumatic stress disorder.

Data from a cohort of postpartum women from the Nascer no Brasil II study, representative of births that occurred in the state of Rio de Janeiro between 2021 and 2023, were analyzed. Participants were interviewed face-to-face in the immediate postpartum period and again by telephone two months after birth. Women who responded to all questions on the Edinburgh Postnatal Depression Scale, Generalized Anxiety Disorder 7, and City Birth Trauma Scale were included, whereas pregnancies that ended in miscarriage or stillbirth were excluded, resulting in a total of 1,752 postpartum women. To test the homogeneity of proportions, the chi-square test (χ²) was used, with p-values below 5% considered statistically significant. The analysis of the interrelationships among the three symptoms was conducted using structural equation modeling (SEM), employing the weighted least squares mean and variance adjusted (WLSMV) estimator and theta parameterization.

The prevalence of symptoms of depression, anxiety, and birth-related post-traumatic stress disorder was 17.9, 16.3, and 7.7%, respectively. A positive score on at least one of the scales was found in 24.6% of participants, and the simultaneous occurrence of two or three comorbidities was 12% and 3.7%, respectively. Low educational attainment and a history of mental disorders were significantly more prevalent in all three conditions analyzed. Structural equation modeling (SEM) revealed a significant and positive association among the three scales, and all latent variables in the model showed items with factor loadings greater than 0.5.

The postpartum period is critical for the diagnosis of mental disorders and may involve complex conditions in which symptoms of depression, anxiety, and stress overlap. It is important that healthcare professionals be aware of the occurrence and co-occurrence of these disorders, as well as their potential consequences for the health of both the woman and the newborn.