Banca de QUALIFICAÇÃO: DANIELA APARECIDA DE FARIA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : DANIELA APARECIDA DE FARIA
DATE: 30/05/2023
TIME: 14:00
LOCAL: Videoconferência
TITLE:

DEPRESSION AND ANXIETY DURING PREGNANCY: A STUDY ON THE IMPACT OF PHYSICAL ACTIVITY AND INFLAMMATORY BIOMARKERS


KEY WORDS:
Pregnancy; Anxiety; Depression; Physical activity; Inflammatory biomarkers

PAGES: 154
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:
Introduction: The perinatal period is a vulnerable period in women's health, during which
depression and anxiety commonly occur. If not treated or diagnosed early, they can lead to
negative maternal-fetal outcomes. However, the numerous benefits of regular physical activity
in reducing symptoms of anxiety and depression are known. Research has sought to understand
the role of inflammation and the presence of inflammatory biomarkers in depression. There is
evidence that both inflammatory and metabolic factors can modify neurotransmission and,
therefore, affect mood and behavior, inducing the onset of depression during pregnancy.
However, little is known about the role of cytokines in depression during pregnancy. There are
still gaps in the literature about the characteristics of interventions such as dose, intensity,
frequency, modality, progression, level of supervision of physical activity during pregnancy,
puerperium and postpartum in depression and anxiety. This information is essential to support
the implementation of effective interventions in clinical practice. Objective Systematic
Review 1: Evaluate the effects of interventions and/or physical activity programs on anxiety
and depression in women during the perinatal period. Systematic Review Methodology 1:
This is a systematic review of the literature, carried out in January and February 2022 and
updated in April 2023 in the PEDro databases (Physiotherapy Evidence Database); BASE;
PsycInfo; Pubmed (National Library of Medicine National Institutes of Health) / (OVIDE) and
Sportcus. It was conducted following the Cochrane Manual for Systematic Reviews of
Interventions and reported in accordance with the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) statement and filed in PROSPERO. Results of
Systematic Review 1: 2,572 articles were retrieved, of which 9 studies met the eligibility
criteria. Physical exercise interventions reduced depressive symptoms in the postpartum period
(MD: -1.61, 95% IC [-3.16 to -0.07]; I2=93%, p=0.04). Regarding the characteristics of
physical exercises, those with a frequency of 3x a week in the perinatal period reduced
depressive symptoms (SMD: -0.32, IC 95% [-0.62 to -0.03]; I2=83%, p=0.03) and 2x per week
in the perinatal period (SMD: -0.63, 95% IC [-1.07 to -0.18]; I2=0%, p=0.06); those lasting 60
minutes in the perinatal period (SMD: -0.35, 95% IC [-0.69 to -0.01]; I2=0%, p=0.04); with
moderate intensity in the perinatal period (SMD: -0.34, IC 95% [-0.63 to -0.06]; I2=82%,
p=0.02); and in the aerobic modality in the perinatal period (MD: -0.66, IC 95% [-1.07 to -
0.25]; I2=0%, p=0.82). Only one study reported data on physical exercise on symptoms of
depression and anxiety in the perinatal period, but it was not suitable for meta-analysis. The
quality of evidence (GRADE criteria) was low to very low for all outcomes. Conclusion of
Systematic Review 1: The evidence highlights the positive effects of physical activity in the
perinatal period on depressive symptoms. However, studies of high quality and methodological
rigor are still needed that address the role of activity as an intervention for anxiety and
depression in the perinatal period, in order to clarify and support clinical practice based on
scientific evidence. Objectives of Systematic Review 2: To analyze which inflammatory
biomarkers are altered in perinatal depression and/or in depressive symptomatology.
Systematic Review Methodology 2: This is a systematic review of the literature, with a search
carried out in April 2023 in the EMBASE databases; PsycInfo; Pubmed (National Library of
Medicine National Institutes of Health) / (OVIDE) and Web of Science. It was conducted
following the Cochrane Manual for Systematic Reviews of Interventions and reported in
accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and filed in PROSPERO. Partial results of Systematic Review 2: On
April 24, 2023, a search was carried out in all selected databases. 3,233 articles were retrieved,
956 from the Web of Science; 994 from Pubmed; 859 from EMBASE and 424 from PsycInfo.
1,955 articles were duplicates, so they were excluded. Thus, a total of 1,278 will be initially
analyzed by screening by title and abstract by two independent reviewers. Then, these two
reviewers will also evaluate the full text of the potentially eligible studies selected in the next
step. In case of disagreement, the decision will be taken by discussion between these reviewers
or by a third reviewer, if necessary. The COVIDENCE software will be used in this step.
General objective of the Cross-sectional Study: to evaluate inflammatory biomarkers in
pregnant women with and without depression treated in a municipality in Minas Gerais. Cross
sectional Study Methodology: A cross-sectional study was carried out with 55 pregnant
women assisted by the Unified Health System in the city of Ouro Preto, MG, who were
clinically evaluated and answered questionnaires about socioeconomic aspects and their mental
health. Two validated instruments were used to assess mental health: the Edinburgh Postpartum
Depression Scale and the Beck Depression Questionnaire. Clinical, socioeconomic, gestational
and mental health data were also collected from medical records and prenatal cards. Finally,
peripheral blood was collected for measurement of inflammatory mediators: CCL27, CXCL16
and later, IL-10, TNF-alpha will be measured by immunoenzymatic assay (ELISA). Pearson's
correlation was used for bivariate analysis For data analysis, Odds Ratio (OR) was used and
their respective confidence intervals (95% IC) were calculated in the crude and bivariate
models. P values <0.05 were considered statistically significant in all analyses. Cross-sectional
Study Results: A total of 55 pregnant women were evaluated with a mean age of 27.58 ± 6.17
years old. Regarding the presence of depression related to the gestational trimester, a higher
occurrence was identified in the second trimester (40.0%, n=10). No significant difference was
observed between the presence of depression and the socioeconomic variables of the pregnant
women. As for the classification regarding the intensity of depression, a higher occurrence of a
minimum level of depression was observed with 63.0% (n=34). As for anthropometric data,
gestational age, clinical data and inflammatory mediators, there was no statistical significance
regarding the presence or absence of depression (p>0.05). A weak positive correlation was
observed between inflammatory mediators CXCL16 and CCL27 and gestational age in the
group of pregnant women without depression (r=0.34, p=0.033 and r=0.341, p=0.036,
respectively). However, in the group of pregnant women with depression, no significant
correlation was detected between gestational age and inflammatory mediators (p>0.05).
Regarding the obstetric history, it was observed that primiparous and nulliparous pregnant
women had a higher risk of depression (7.18; 95% CI: 1.43-36.04 and 5.32; 95% CI: 1.06 -
26.71, respectively).

BANKING MEMBERS:
Externo à Instituição - KELERSON MAURO DE CASTRO PINTO - UFOP
Externa à Instituição - JUSSARA DE SOUZA MAYRINK NOVAIS - UFMG
Presidente - 1039964 - ANDRE DE OLIVEIRA BALDONI
Notícia cadastrada em: 11/05/2023 13:46
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