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Doctoral Thesis
DOI
https://doi.org/10.11606/T.17.2024.tde-12042024-091123
Document
Author
Full name
Cibele Santini de Oliveira Imakawa
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2024
Supervisor
Committee
Moisés, Elaine Christine Dantas (President)
Bussadori, Jamile Claro de Castro
Polido, Carla Betina Andreucci
Santos, Luciane Loures dos
Title in Portuguese
Impacto do diagnóstico de risco gestacional no medo do parto
Keywords in Portuguese
Diabetes mellitus gestacional
Escala de medo do parto
Medo do parto
Risco gestacional
Abstract in Portuguese
O medo do parto (MP) pode influenciar a preferência materna sobre a via de parto. Considerando a relação entre o diabetes mellitus gestacional e desfechos adversos maternos e perinatais, é pertinente investigar se esse diagnóstico é preditor de MP. Como existem poucos dados de MP no Brasil, é necessário conhecer melhor esta população e desta forma poder-se-ia identificar fatores que influenciam esse medo, bem como propor políticas de saúde pública para tratá-lo, contribuindo para uma potencial diminuição nas taxas de cesarianas no Brasil. Os objetivos do trabalho foram comparar a prevalência do medo do parto entre os grupos de gestação de risco habitual (GRH) com o grupo de diabetes mellitus gestacional (DMG), identificar as variáveis que influenciam o medo do parto e analisar se existe associação entre o medo do parto parto e a via do resultado do parto. A amostra de 319 pacientes foi dividida em grupo de gravidez de baixo risco (GRH, n= 167) e grupo de diabetes mellitus gestacional (DMG, n= 152). As pacientes foram submetidas a uma entrevista semiestruturada que continha dados epidemiológicos, obstétricos e antropométricos. Responderam também a Escala de Medo do Parto (EMDP) e a principal causa do medo do parto. O EMDP é composto por duas escalas visuais analógicas que quantificam a preocupação e o medo em relação ao parto e a média dessas duas escalas foi comparada com pontos de corte ≥ 54 ou ≥ 60, que indicam FOC com relevância clínica. Após o nascimento, os dados relativos ao nascimento foram coletados por meio de prontuário eletrônico. Os resultados mostram que os grupos GRH e DMG foram homogêneos quanto aos dados epidemiológicos e sociodemográficos. Não houve diferença estatística quanto à prevalência de MP com ponto de corte ≥ 60, porém houve maior taxa de MP no grupo DMG quando considerado o ponto de corte ≥ 54 (34,73% para o grupo GRH e 46,05% para o grupo DMG). A pontuação média na escala de medo do parto foi maior no grupo DMG em comparação ao grupo GRH (51,30 versus 44,85, p = 0,0489). Independentemente do valor de corte utilizado, as três principais causas do medo do parto foram: medo da dor do parto, da vida do bebê e de não poder parir. Concluiu-se as prevalências encontradas no presente estudo foram superiores às descritas na literatura. Para o ponto de corte ≥ 54, o grupo DMG apresentou maior prevalência em comparação ao grupo GRH. Além disso, o grupo DMG apresentou pontuação média mais elevada na escala de medo do parto em comparação ao grupo GRH.
Title in English
Impact of gestational risk diagnosis on fear of childbirth
Keywords in English
Fear of birth scale
Fear of childbirth
Gestational diabetes mellitus
Gestational risk
Abstract in English
Fear of childbirth (FOC) can influence maternal preference about the mode of delivery. Considering the relationship between gestational diabetes mellitus and maternal and perinatal adverse outcomes, it is pertinent to investigate whether this diagnosis is a predictor of FOC. As there are few data of FOC in Brazil, it is necessary to understand better this population and this way it would be able identify factors that influence this fear as well as propose public health policies to treat it, contributing to a potential decrease in cesarean rates in Brazil. Goals were to compare the prevalence of fear of childbirth between the groups of low-risk pregnancy (LRP) with the gestational diabetes mellitus (GDM) group, identify the variables which influence the fear of childbirth and analyze whether there is an association between fear of childbirth and the route of childbirth outcome. The sample of 319 patients were divided into a low-risk pregnancy (LRP, n= 167) and a gestational diabetes mellitus group (GDM, n= 152). The patients underwent a semi-structured interview that contained epidemiological, obstetric and anthropometric data. They also answered the Fear of Childbirth Scale (EMDP) and the main cause of fear of childbirth. The EMDP consists of two visual analogue scales that quantify concern and fear in relation to childbirth and the average of these two scales was compared to cutoff points ≥ 54 or ≥ 60, which indicate FOC with clinical relevance. After birth, data relating to the birth were collected through electronic medical records. The results indicated that LRP and GDM groups were homogeneous in terms of epidemiological and sociodemographic data. There was no statistical difference regarding the prevalence of MP with a cutoff score ≥ 60, however there was a higher rate of MP in the GDM group when considering the cutoff ≥ 54 (34.73% for the LRP group and 46.05% for the GDM group). The mean score on the fear of childbirth scale was higher for the GDM group compared to the HRM group (51.30 versus 44.85, p = 0.0489). Independently of the cutoff value used, the three main causes of fear of childbirth were: fear of the pain of childbirth, the baby's life and not being able to give birth. The conclusion was that the prevalence rates found in the present study were higher than those described in the literature. For the cutoff point ≥ 54, the GDM group showed a higher prevalence compared to the LRP group. Furthermore, the GDM group had a higher mean score on the fear of childbirth scale compared to the LRP group.
 
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Publishing Date
2024-07-12
 
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