The peculiarities of the psychological profile in the perinatal period in pregnant adolescents

Abstract

Introduction. The mental health of pregnant women has long been a focus of reproductive health. Pregnant adolescents, being an important link, are at greater risk of developing reproductive health problems. To be able to support the health and well-being of pregnant adolescents it is essential to have a comprehensive understanding of the mental health issues they face during pregnancy. Aim of study. The overall birth rate among adolescents has declined over the past two decades - from 56 births/1000 to 43.9/1000 - but this decline has been slower in low- and middle-income countries. In an analysis of Demographic and Health Survey data from 30 low- and middle-income countries, the proportion of all new-borns with adolescent mothers varied between countries with an average of 18% for young people under the age of 20. Methods and materials. The study was carried out in the Level III Perinatal Centre, IMSP Institute of Mother and Child, where 261 patients were evaluated, divided into two groups: group no. 1 with age 13 18 years 11 months 29 days - 126 (48.3%) of patients and group no. 2 comprising adult pregnant women aged 19 - 25 years - 135 (51.7%) of patients. The Symptom Checklist - 90 ( SCL-90) questionnaire was used to analyze the peculiarities of psychological status. This is a widely applied self-report instrument to assess a wide range of mental disorders, through the following symptoms: somatization, obsessivecompulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. It also includes three global indices of psychological distress: Global Severity Index, Distress Index for Positive Symptoms, and Total Positive Symptoms. Analysis of the data obtained was performed using Microsoft Office Excel and EpiInfo 7.1 software. Results. A statistically significant higher frequency in the intensity of psychological symptoms was identified in pregnant adolescents. Thus, in pregnant adolescents, a somatization index of 0.83, a level of interpersonal sensitivity index of 0.86, a depression index of 0.78, an anxiety index of 0.76, a phobic anxiety index of 0. 68, a level of paranoid ideation index of 0.77 and a level of psychoticism index of 0.55, compared to the level of the same indices in adult pregnant women: 0.71, 0.64, 0.63, 0.56, 0.48, 0.55, 0.33, these data having a statistical significance p<0.05/0.01. Prenatal Depression (PD) occurred in 94 (55.95%) cases in the adolescent group, compared to 74 (54.8%) cases in the adult pregnant group. The severity of psychological impairment in pregnant adolescents who suffered from PD is manifested by elevation of the indices: obsessive-compulsive p<0.004; anxiety p<0.02; oscillatory p<0.04; phobic anxiety p<0.04; paranoid ideation p<0.006; psychoticism p<0.01. In pregnant women aged 19-25 years with PD, elevated indices were identified: anxiety p<0.002; phobic anxiety p<0.009 and psychoticism p<0.005. Postpartum, the study shows that the severity of psychological symptoms increases in both groups investigated, but the more significant increase prevails in the group of pregnant teenagers. Conclusion. The psychological profile during pregnancy is affected in both adult and adolescent women, the former being much more vulnerable during the perinatal period, which directly influences the bearing of the psychological consequences of pregnancy. adolescents, being an important link, are at greater risk of developing reproductive health problems. To be able to support the health and well-being of pregnant adolesce nts it is essential to have a comprehensive understanding of the mental health issues they face during pregnanc y. Aim of study. The overall birth rate among adolescents has declined over the past two decades - from 56 births/1000 to 43.9/1000 - but this decline has been slower in low- and m iddle-income countries. In an analysis of Demographic and Health Survey data from 30 low - and middle-income countries, the proportion of all new-borns with adolescent mothers varied between c ountries with an average of 18% for young people under the age of 20. Methods and materials. The study was carried out in the Level III Perinatal Cent re, IMSP Institute of Mother and Child, where 261 patients were evaluated, divided int o two groups: group no. 1 with age 13 18 years 11 months 29 days - 126 (48.3%) of patients and group no. 2 com prising adult pregnant women aged 19 - 25 years - 135 (51.7%) of patients. The Symptom Checklist - 90 ( SCL-90) questionnaire was used to analyze the peculiarities of psychological status. This i s a widely applied self-report instrument to assess a wide range of mental disorders, through the following sym ptoms: somatization, obsessivecompulsive, interpersonal sensitivity, depression, anxiety, hosti lity, phobic anxiety, paranoid ideation, and psychoticism. It also includes three global indices of psychological distress: Global Severity Index, Distress Index for Positive Symptoms, and Total Positive Symptoms. Analysis of the data obtained was performed using Microsoft Office Excel and EpiInfo 7.1 software. Results. A statistically significant higher frequency in the intensi ty of psychological symptoms was identified in pregnant adolescents. Thus, in pregnant adolescen ts, a somatization index of 0.83, a level of interpersonal sensitivity index of 0.86, a depression index of 0.78, a n anxiety index of 0.76, a phobic anxiety index of 0. 68, a level of paranoid ideation index of 0.77 and a level of psychoticism index of 0.55, compared to the level of the same indices in adult pregnant women: 0.71, 0 .64, 0.63, 0.56, 0.48, 0.55, 0.33, these data having a statistical significance p<0.05/0.01. Prenatal Depression ( PD) occurred in 94 (55.95%) cases in the adolescent group, compared to 74 (54.8%) cases in the adult pregna nt group. The severity of psychological impairment in pregnant adolescents who suffered from PD is manifested by elevation of the indices: obsessive-compulsive p<0.004; anxiety p<0.02; oscillatory p<0.04; pho bic anxiety p<0.04; paranoid ideation p<0.006; psychoticism p<0.01. In pregnant women aged 19- 25 years with PD, elevated indices were identified: anxiety p<0.002; phobic anxiety p<0.009 and psychoticism p<0.005. Postpartum, the study shows that the severity of psychological symptoms increase s in both groups investigated, but the more significant increase prevails in the group of pregnant t eenagers. Conclusion. The psychological profile during pregnancy is affected in both ad ult and adolescent women, the former being much more vulnerable during the perinatal pe riod, which directly influences the bearing of the psychological consequences of pregnancy.