PRENATAL DÖNEMDE STRES, ANKSİYETE VE DEPRESYONUN İNCELENMESİ: GELENEKSEL DERLEME

Öz

Gebelik bireyin yaşam döngüsünde fizyolojik, psikolojik ve sosyal değişimlerin yaşandığı, birey için annelik kimliğinin kazanıldığı özel bir deneyimdir. Kadın hamilelik başlangıcından itibaren gebeliğin kendisi, günlük yaşam aktivitelerinin değişen yönleri ve bebeğe bakmanın sorumlulukları ile psikolojik sorunlara karşı artan duyarlılık dönemi yaşamaktadır. Psikolojik sorunlar stresli yaşam koşullarına verilen olumsuz bir psikolojik tepkidir ve küresel sağlık sorunlarından biri olarak tanımlamaktadır. Psikolojik sorunlar olarak adlandırılan depresyon, stres ve anksiyete gebelik ve doğum sonu dönemde yaygın olarak görülmektedir. Gebelik ve yaşanan psikolojik sorunlarla ilişkili faktörler arasında yaşanmış psikiyatrik hastalık öyküsü, yetersiz sosyal destek, eş ve aile ile yaşanılan sorunlar, planlanmamış veya istenmeyen gebelik, primipar olma, riskli gebelik, sosyodemografik ve/veya ekonomik faktörler olarak belirtilmiştir. Kadınların en az %20'si prenatal dönemde depresif semptomlar yaşamaktadır. Anksiyete, doğum öncesi ve doğum sonrası dönemlerde daha az çalışılmış olmasına rağmen, doğum öncesi dönemde %13-21 oranında yaşandığı belirtilmektedir. Gebelik döneminde yaşanan psikolojik sorunların her birinin, düşük doğum ağırlığı ve erken doğum dahil olumsuz doğum sonuçları ve ilerleyen dönemde duygusal, davranışsal ve bilişsel sorunlar dahil olumsuz sonuçları ile ilişkileri olduğu belirtilmektedir. Bu nedenle, bu yaygın durumların tanımlanması ve tedavi edilmesi anne ve bebek sağlığı için son derece önemlidir. Bu çalışma prenatal dönemde en çok görülen ruhsal bozukluklar içerisinde yer alan stres, anksiyete ve depresyonu incelemek amacıyla yapılmıştır.

Anahtar Kelimeler

• gebelik
• psikoloji
• psikolojik sorunlar

EXAMINATION OF STRESS, ANXIETY AND DEPRESSION IN THE PRENATAL PERIOD: A TRADITIONAL REVIEW

Öz

Pregnancy is a special experience in which physiological, psychological and social changes are experienced in the life cycle of the individual, and the identity of motherhood is acquired for the individual. From the beginning of pregnancy, the woman experiences a period of increased sensitivity to psychological problems with the pregnancy itself, the changing aspects of daily life activities and the responsibilities of looking after the baby. Psychological problems are a negative psychological reaction to stressful life conditions and define it as one of the global health problems. Depression, stress and anxiety, which are called psychological problems, are common during pregnancy and postpartum period. History of psychiatric illness, insufficient social support, problems with spouse and family, unplanned or unwanted pregnancy, being primiparous, high-risk pregnancy, sociodemographic and/or economic factors are among the factors associated with pregnancy and psychological problems. At least 20% of women experience depressive symptoms in the prenatal period. Although anxiety has been less studied in the prenatal and postnatal periods, it is reported that it is experienced by 13-21% in the prenatal period. It is stated that each of the psychological problems experienced during pregnancy is associated with negative birth outcomes including low birth weight and preterm birth, and negative outcomes including emotional, behavioral and cognitive problems in the future. Therefore, identifying and treating these common conditions is extremely important for maternal and infant health. This study was conducted to examine stress, anxiety and depression, which are among the most common mental disorders in the prenatal period.

Anahtar Kelimeler

• Pregnancy
• psychology

Kaynakça

1. Akın, G. (2014). İnsan sağlığı ve çevre etkileşimi. Ankara Üniversitesi Dil ve Tarih-Coğrafya Fakültesi Dergisi, 54 (1), 105-116.
2. Aksoy, A.N. (2015). Doğum korkusu: literatür değerlendirmesi. ODÜ Tıp Dergisi, 2, 161-165.
3. Alipour, M., Lamyian, E. & Hajizadeh, E. (2012). Anxiety and fear of childbirth as predictors of postnatal depression ın nulliparous women. Women Birth, 25(3), 37–43. https://doi.org/10.1016/j.wombi.2011.09.002
4. Andersson, L., Sundstrom-Poromaa, I., Wulff, M., Astrom, M., Bixo M. (2004). Neonatal outcome following maternal antenatal depression and anxiety: A population-based study. American Journal of Epidemiology, 159(9), 872-81. doi: 10.1093/aje/kwh122
5. Ayvaz, S., Hocaoğl, Ç., Tiryaki, A., Ak, İ. (2006). Trabzon il merkezinde doğum sonrası depresyon sıklığı ve gebelikteki ilişkili demografik risk etmenleri. Türk Psikiyatri Dergisi, 17(4), 243-251.
6. Baran, G.K., Şahin, S., Öztaş, D., Demir, P. & Desticioğlu, R. (2020). Gebelerin algılanan stres düzeylerinin ve stres nedenlerinin değerlendirilmesi. Cukurova Medical Journal, 45(1), 170-180. doı: 10.17826/cumj.633534.
7. Biaggi, A. & Pariante, C. M. (2020). Risk factors for depression and anxiety during the perinatal period. ın r. m. quatraro, & p. grussu (eds.), handbook of perinatal clinical psychology: risk factors for depression and anxiety during the perinatal period. In Handbook of Perinatal Clinical Psychology, Routledge, 239-265.
8. Biaggi, A., Conroy, S., Pawlby, S. & Pariante C. M. (2016). Identifying the women at risk of antenatal anxiety and depression: a systematic review. Journal of Affective Disorders, 191: 62–77. doi: 10.1016/j.jad.2015.11.014.

9. Bilgen, Ö. & Tekin, U. (2020). Evlilik uyumunun gebeliğin son üç ayında yaşanan depresyona etkisi. Uluslararası Sosyal Bilimler ve Eğitim Dergisi–USBED, 2(2), 138-153.
10. Bobo, W.V, Yawn, B.P. (2014). Concise review for physicians and other clinicians: postpartum depression. Mayo Clinic Proceedgins, 89, 835-844. doi: 10.1016/j.mayocp.2014.01.027.
11. Bodecs, T., Szilagyi, E., Cholnoky, P., Sandor, J., Gonda, X., Rihmer, Z. et al. (2013). Prevalence and psychosocial background of anxiety and depression emerging during the first trimester of pregnancy: data from a hungarian population‐based sample. Psychiatria Danubina, 25(4), 352–358.
12. Clavarino, A.M., Mamun, A. A., M, Aird R, Bor, W., O & callaghan F. et al. (2010). Maternal anxiety and attention problems in children at 5 and 14 years. Journal Of Attention Disorders 13(6), 658 – 667. https://doi.org/10.1177/1087054709347203.
13. Coşkun, A.M., Arslan, S.E. & Okcu, G. (2020). Gebe kadınlarda gebelik algısının stres, demografik ve obstetrik özellikler açısından incelenmesi. Hemşirelikte Eğitim ve Araştırma Dergisi, 17(1), 1-8. doi:10.5222/HEAD.2020.001
14. Çelik, A.S., Atasever, İ. (2020). Gebelerde algılanan stres düzeylerinin ve etkileyen faktörlerin belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 23(2), 267-276. doı: 10.17049/ataunihem.622304.
15. Dennis, C. L., Falah-Hassani, K. & Shiri, R. (2017). Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry., 210, 315-23. doi: 10.1192/bjp.bp.116.187179.
16. Dennis, C.L. & Dowswel, T. (2013). Psychosocial and pyschological interventions for preventing postpartum depression. Cochrane Database of Systematic Reviews, 2, 1-21. doi: 10.1002/14651858.CD001134.pub3.
17. Dunkel Schetter, C. & Tanner, L. (2012). Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry, 25, 141-8. doi: 10.1097/YCO.0b013e3283503680.
18. Eastwood, J., Ogbo, F. A., Hendry, A., Noble, J., & Page, A. (2017). Early years research g. The ımpact of antenatal depression on perinatal outcomes ın australian women. PLoS One, 12(1) :e0169907. doi: 10.1371/journal.pone.0169907
19. Emmanuel, E. & St John, W. (2010). Maternal distress: a concept analysis. J Adv Nurs. 66, 2104-2115. https://doi.org/10.1111/j.1365-2648.2010.05371.x
20. Fairbrother, N., Young, A.H., Janssen, P., Antony, M.M.& Tucker, E. (2015). Depression and anxiety during the perinatal period. BMC Psychiatry, 15(1), 1-9. doi: 10.1186/s12888-015-0526-6.
21. Felder, J.N. (2019). Implementing the uspstf recommendations on prevention of perinatal depression—opportunities and challenges. JAMA Intern. Med, 179(4), 467-468. doi: 10.1001/jamainternmed.2018.7729.
22. Field, T. (2017). Prenatal depression risk factors, developmental effects and ınterventions: a review. Journal Of Pregnancy And Child Health, 4(1), 301. doı: 10.4172/2376-127X.1000301
23. Fisher, J., Mello, M.C, Patel, V., Rahman, A, Tran, T., Holton, S. & Holmes, W. (2012). Prevalence and determinants of common perinatal mental disorders in women in low-and lower-middle-incomecountries: a systematic review, Bull. World Health Organ, 90, 139–149. doi: 10.2471/BLT.11.091850.
24. Gao, M., Hu, J., Yang, L., Ding, N., Wei, X, Li, L Ma Y, Wen, D. (2019). Association of sleep quality during pregnancy with stress and depression: a prospective birth cohort study in china. BMC Pregnancy and Childbirth, 19, 1-8. doi: 10.1186/s12884-019-2583-1.
25. Gelaye, B., Rondon, M. B., Araya, R.& Williams M.A. (2016). Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle- income countries. Lancet Psychiatry, 3 (10), 973–982. doi: 10.1016/S2215-0366(16)30284-X.
26. Giakoumaki, O., Vasilaki, K., Lili, L., Skouroliakou, M. & Liosis, G. (2009). The role of maternal anxiety in the early postpartum period: Screening for anxiety and depressive symptomatology in Greece. Journal of Psychosomatic Obstetrics and Gynaecology, 30(1): 21– 28. doi: 10.1080/01674820802604839.
27. Giardinelli, L., Innocenti, A., Benni, L., Stefanini, M., Lino, G., Lunardi, C. & Faravelli, C. (2012). Depression and anxiety ın perinatal period: prevalence and risk factors ın an ıtalian sample. Archives of Women Mental Health 15(1), 21–30. doi:https://doi.org/10.1007/s00737‐ 011‐0249‐8.
28. Glasheen, C., Richardson, G.A., Fabio, A. A. (2010). A Systematic review of the effects of postnatal maternal anxiety on children. Archives of Women Mental Health, 13: 61-74. doı: 10.1007/s00737-009-0109-y
29. Glover, V. (2011). Annual research review: prenatal stress and the origins of psychopathology: an evolutionary perspective. Journal of Child Psychology and Psychiatry, 52 (4), 356–367. https://doi.org/10.1111/j.1469-7610.2011.02371.x
30. Glover, V. (2014). Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. best practice research. Clinical Obstetrics And Gynaecology, 28, 25-3. doi: 10.1016/j.bpobgyn.2013.08.017.
31. Goodman, J.H., Chenausky, K. L. & Freeman, M.P. (2014). Anxiety disorders during pregnancy: a systematic review. The Journal Of Clinical Psychiatry, 75(10), 1177. doi: 10.4088/JCP.14r09035.
32. Grote, N, K., Bridge, J, A., Gavin, A, R., Melville, J, L., Iyengar, S. & Katon, W. J. (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry, 67, 1012-1024. doi: 10.1001/archgenpsychiatry.2010.111.
33. Grote, N.K, Bridge, J.A., Gavin, A.R., Melville, J.L., Iyengar, S., Katon, W. J. (2010). A Meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatr, 67(10), 1012. doi: 10.1001/archgenpsychiatry.2010.111.
34. Herbison, C, E., Allen, K., Robinson, M., Newnham, J. & Pennell C. (2017). The ımpact of life stress on adult depression and anxiety ıs dependent on gender and timing of exposure. Development and Psychopathology, 29(4), 1443–1454. doi: 10.1017/S0954579417000372.
35. Hess, C., Teti, D., Hussey-Gardner, B. (2004). Self-efficacy and parenting of high-risk infants: the moderating role of parent knowledge of infant development. J Appl Dev Psychol, 25, 423- 37. https://doi.org/10.1016/j.appdev.2004.06.002
36. Hung, C. H., Lin, C.J., Stocker, J. & Yu, C.Y. (2011). Predictors of postpartum stress. Journal of Clinical Nursing, 20 (5-6): 666–674. doi: 10.1111/j.1365-2702.2010.03555.x.
37. Iwata, H., Mori, E., Sakajo, A., Aoki, K.& Maehara, K. (2016). Tamakoshi K. Prevalence of postpartum depressive symptoms during the first 6 months postpartum: association with maternal age and parity. Journal of Affective Disorders, 203: 227–232. doi: 10.1016/j.jad.2016.06.002.
38. Kaplan, S., Bahar, A. & Sertbaş, G. (2007). Gebelerde doğum öncesi ve doğum sonrası dönemlerde durumluk kaygıyı düzeylerinin incelenmesi. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 10(1), 113-1 21.
39. Karacam, Z. & Ancel, G. (2009). Depression, anxiety and ınfluencing factors ın pregnancy: a study ın a turkish population. Midwifery, 25(4), 344–356. doi: 10.1016/j.midw.2007.03.006
40. Khoury, E., Giles, L., Kaur, H., Johnson, D., Gonzalez, A., Atkinson, L. (2022). Associations between psychological distress and hair cortisol during pregnancy and the early postpartum: a meta- analysis. Psychoneuroendocrinology, 147, 105969. https://doi.org/10.1016/j.psyneuen.2022.105969
41. Leach, L.S. & Poyser, C. (2017). Fairweather‐Schmidt K. Maternal perinatal anxiety: A review of prevalence and correlates. Clinical Psychologist, 21, 4-19. https://doi.org/10.1111/cp.12058
42. Lee, K.W., Ching, S.M., Hoo, F.K, Ramachandran, V., Chong, S.C., Tusimin, M., et al. (2019). Prevalence and factors associated with depressive, anxiety and stress symptoms among women with gestational diabetes mellitus ın tertiary care centres ın malaysia: a cross-sectional study. BMC Pregnancy and Childbirth, 19 (1);367. doi: 10.1186/s12884-019-2519-9.
43. Leiferman, J. A., Dauber, S.E., Heisler, K. & Paulson, J. F. (2008). Primary care physicians' beliefs and practices toward maternal depression. Journal of Womens Health (Larchmont), 17, 1143-1150. doi: 10.1089/jwh.2007.0543.
44. Littleton, H.L, Bye, K., Buck, K. & Amacker, A. (2010). Psychosocial stress during pregnancy and perinatal outcomes: a meta-analytic review. Journal of Psychosomatic Obstetrics Gynecology. 31 (4), 219-228. https://doi.org/10.3109/0167482X.2010.518776
45. Liu, Y., Kaaya, S., Chai, J. McCoy, D.C., Surkan, P.J., Black, M.M. et al. (2017). Maternal depressive symptoms and early childhood cognitive development: a meta-analysis. Psychological Medicine, 47(4), 680–689. doi: 10.1017/S003329171600283X.
46. Long, M. M., Cramer, R. J., Jenkins, J., Bennington, L. & Paulson, J. F. (2019). A systematic review of interventions for healthcare professionals to improve screening and referral for perinatal mood and anxiety disorders. Archives of Womens Mental Health, 22:25-36. doi: 10.1007/s00737-018-0876-4.
47. Lydsdottir, L.B., Howard, L.M., Olafsdottir, H., Thome, M., Tyrfingsson, P. & Sigurdsson, J. F. (2014). The mental health characteristics of pregnant women with depressive symptoms ıdentified by the edinburgh postnatal depression scale. The Journal of Clinical Psychiatry, 75(4), 393–398. doi: 10.4088/JCP.13m08646.
48. Mangialavori, S., Terrone, G., Cantiano, A., Chiara Franquillo, A., Di Scalea, G. L., Ducci, G. & Cacioppo, M.F.D. (2019). Dyadic adjustment and prenatal parental depression: a study with expectant mothers and fathers. Journal of Social And Clinical Psychology, 38(10), 860–881. https://doi.org/10.1521/jscp.2019.38.10.860
49. Marchesi, C., Ampollini, P., Paraggio, C., Giaracuni, G., Ossola, P., De Panfilis, C. et al. (2014). Risk factors for panic disorder in pregnancy: a cohort study. Journal of Affective Disorders, 156, 134-138. doi: 10.1016/j.jad.2013.12.006
50. McDonald, H.M., Sherman, K.A. & Kasparian, N. A. (2021). Factors associated with psychological distress among australian women during pregnancy. Personality and Individual Differences. 172, 110577. https://doi.org/10.1016/j.paid.2020.110577
51. McMahon, C, A., Boivin, J., Gibson, F. L., Hammarberg, K., Wynter, K., Saunders, D. et al. (2013). Pregnancy-specific anxiety, art conception and ınfant temperament at 4 months post-partum. Human Reproduction, 28(4), 997–1005. https://doi.org/10.1093/humrep/det029
52. Mélancon, J., Bernard, N., Forest, J.C, Tessier, R., Tarabulsy, G.M., Bouvier, D., et al. (2020). Impact of maternal prenatal psychological stress on birth weight. Health Psychol, 39 (12), 1100- 1108. https://doi.org/10.1037/hea0001017
53. Muzik, M., Marcus, S. M., Heringhausen, J. E., Flynn, H.A. (2009). When depression complicates child bearing: guidelines for screening and treatment during antenatal and postpartum obstetric care. Obstet Gynecol Clin North Am., 36,771–788. doı: 10.1016/j.ogc.2009.10.006
54. Norhayati, M. N., Nik Hazlina, N. H., Asrenee, A. R. & Wan Emilin, W. M. A. (2015). Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord, 1(175), 34. https://doi.org/10.1016/j.jad.2014.12.041
55. O’Donnell, K., O’Connor, T.K. & Glover, V. (2009). Prenatal stress and neurodevelopment of the child: focus on the hpa axis and role of the placenta. Developmental Neuroscience, 31(4), 285–292. https://doi.org/10.1159/000216539
56. Obrochta, C, A., Chambers, C., Bandoli, G. (2020). Psychological distress ın pregnancy and postpartum. Women and Birth. 33, 583–591. https://doi.org/10.1016/j.wombi.2020.01.009
57. O'Connor, T.G, Heron, J., Glover, V. (2002). Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Adolesc Psychiatry, 41(12), 1470. doi: 10.1097/00004583-200212000-00019.
58. Okagbue, H.I., Adamu, P.I, Bishop, S.A, Oguntunde, P.E, Opanuga, A, A & Akhmetshin, E, M. (2019). Systematic review of prevalence of antepartum depression during the trimesters of pregnancy. Open Access Maced J Med Sci, 7; 1555-60. doi: 10.3889/oamjms.2019.270
59. Ölçer, Z. & Oskay, U. (2015). Yüksek riskli gebelerin yaşadığı stresörler ve stresle baş etme yöntemleri. Hemşirelikte Eğitim ve Araştırma Dergisi, 12, 85-92. doi:10.5222/HEAD.2015.085
60. Prenoveau, J., Craske, M., Counsell, N., West, V., Davies, B., Cooper, P. et al. (2013). Postpartum GAD is a risk factor for postpartum MDD: the course and longitudinal relationships of postpartum GAD and MDD. Depression and Anxiety, 30(6), 506-514. doi: 10.1002/da.22040
61. Qiu, X., Zhang, S., Sun, X., Li, H., Wang, D. (2020). Unintended pregnancy and postpartum depression: a meta-analysis of cohort and case-control studies. Journal Of Psychosomatic Research, 138, 110259. doi: 10.1016/j.jpsychores.2020.110259.
62. Räisänen, S., Lehto, S. M., Nielsen, H.S., Gissler, M., Kramer, M. R. (2014). Heinonen S. Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002–2010 in finland. BMJ Open. 4(11), e004883. doi: 10.1136/bmjopen-2014-004883.
63. Singla, D.R., Lemberg-Pelly, S., Lawson, A., Zahedi, N., Thomas-Jacques, T. & Dennis, C.L. (2020). Implementing psychological interventions through nonspecialist providers and telemedicine in high-income countries: Qualitative study from a multistakeholder perspective. JMIR Mental Health ,7:p. e19271. doi: 10.2196/19271.
64. Shishehgar, S., Dolatian, M., Majd, H.A., Bakhtiary, M. (2014). Perceived pregnancy stress and quality of life amongst Iranian women. Global Journal of Health Science, 6(4), 270-277.
65. Stewart, D. (2005). Depression during pregnancy. Can Fam Physician, 51, 1061-1063.
66. Szegda, K., Markenson, G., Bertone-Johnson, E.R. & Chasan-Taber, L. (2014). Depression during pregnancy: a risk factor for adverse neonatal outcomes? a critical review of the literature. The Journal of Maternal-Fetal Neonatal Medicine, 27 (9), 960–967. doi: 10.3109/14767058.2013.845157
67. Tomfohr-Madsen, L. M., Racine, N., Giesbrecht, G.F., Lebel, C., Madigan, S. (2021). Depression and anxiety in pregnancy during COVID-19: A rapid review and meta-analysis. Psychiatry Research. 300, 113912. doi: 10.1016/j.psychres.2021.113912.
68. Tunçel, N. T. & Süt, H. K. (2019). Gebelikte Yaşanan Anksiyete, Depresyon ve Prenatal distres düzeyinin doğum öncesi bebeğe bağlanmaya etkisi. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 16(1), 9-17.
69. Ture, P., Dambhar, D., Mundra, A., Raut, A. V., Maliye, C. H, Deshmukh, P, R. et al. (2022). Magnitude and determinants of psychological morbidities among pregnant women: results from a pregnancy cohort ın rural central ındia. Medical Journal Armed Forces India. 11, 1-7. https://doi.org/10.1016/j.mjafi.2022.05.008
70. Virit, O., Akbaş, E., Savaş, H. A., Sertbaş, G. & Kandemir, H. (2008). Gebelikte depresyon ve kaygı düzeylerinin sosyal destek ile ilişkisi. Nöropsikiyatri Arşivi, 45(1), 9-13. https://search.trdizin.gov.tr/en/yayin/detay/84646/
71. Yelland, J., Sutherland, G., Brown, S. J. (2010). Postpartum anxiety, depression and social health: findings from a population‐based survey of australian women. BMC Public Health, 10, 771. doi: 10.1186/1471-2458-10-771
72. Zietlow, A. L., Schlüter, M. K., Nonnenmacher, N., Müller, M. & Reck, C. (2014). Maternal self- confidence postpartum and at pre-school age: the role of depression, anxiety disorders, maternal attachment insecurity. Maternal and Child Health Journal, 18, 1873-1880. doi: 10.1007/s10995-014-1431-1