Qualidade de vida de mães de recém-nascidos pré-termos de muito baixo peso

Abstract

Preterm birth is a worldwide public health problem by presenting an increased overall rate, high rate of morbidity and mortality of newborns with a high probability of sequelae, and generates a burden on family and at society. Mothers of preterm infants may develop psychological stress, anxiety and depression, and possible impaired of quality of life (QOL). This study aimed at assessing and comparing the QOL of mothers of VLBW (very low birth weight) preterms infants with mothers of healthy full terms and evaluates the impact of symptoms of maternal depression and chronic comorbidities of the VLBW preterm infants in the QOL of these mothers. This is a cross-sectional study was held from November 2009 to November 2010, in the Clinics of Hospital of Federal University of Uberlandia after approval by the Ethics Committee in Research of Federal University of Uberlandia. Study group consisted of 152 mothers of VLBW preterm infants with gestational age <34sem and birth weight <1.500 g. The control group consisted of 152 mothers of at healthy full terms with birth weight >2.500 g. The WHOQOL-bref and the Beck Depression Inventory (BDI) were completed in four periods after childbirth: the mother s discharge, 3m, 6m and 12m. The scores of the instruments, the demographic and clinical variables were compared between the two groups over time by ANOVA, Tukey, Chi square and Kruskal-Wallis tests and Spearman correlation. Demographic characteristics were similar between the two groups (p> 0.05) except for the number of visits to prenatal care, cesarean delivery and the presence of maternal diseases that predominated in the group of mothers of VLBW preterm infants. At the time of discharge from hospital, the WHOQOL-bref scores of mothers of VLBW preterm infants were lower (p <0.05) than those of the control group, especially in the physical (61.88 versus 69.63) and psychological (66.44 versus 73.31) domains. Six months after delivery, the mean of the scores of the mothers of preterm infants was higher than that of mothers of healthy full terms in the physical (71.81 versus 62.94) and psychological (71.75 versus 64.31) domains, but was lower in total score of WHOQOL-bref (61.47 versus 74.53). Mothers of preterm infants reported a poorer "health perception" than mothers of healthy full terms (p <0.05) at the time of discharge from hospital and three months after childbirth. Higher BDI scores were observed in the study group especially at the time of discharge from hospital (p <0.05). There was no significant difference between groups in other domains of WHOQOL- bref, or in other periods. At the time of discharge from hospital and three months later, the presence of peri-intraventricular hemorrhage and hydrocephalus negatively correlated with the physical and psychological domains and with the physical and environment domains, respectively. It is concluded that mothers of preterm infants of very low birth weight show impaired QOL compared to mothers of healthy full terms at the time of discharge from hospital and six months postpartum, particularly in the physical and psychological domains. This group also tends to presents higher intensity of depressive symptoms at the time of discharge. Mothers of preterm infants with peri-intraventricular hemorrhage or hydrocephalus are particularly vulnerable to the negative impact on quality of life at the time of discharge and three months later, respectively.