La experiencia de la maternidad es muy gratificante y compleja desde el punto de vista psicológico, constituyendo la etapa más crítica del desarrollo femenino. Por tanto, no debe sorprendernos que muchas mujeres experimenten diversas molestias y desórdenes emocionales, tanto durante el embarazo como durante el puerperio.

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La experiencia de la maternidad es muy gratificante y compleja desde el punto de vista psicológico, constituyendo la etapa más crítica del desarrollo femenino. Por tanto, no debe sorprendernos que muchas mujeres experimenten diversas molestias y desórdenes emocionales, tanto durante el embarazo como durante el puerperio.

The concept of health is reviewed to argue that the mental component as inherent to the integral wellbeing, since mental and physical health are closely related. The relationship between depression and events of the reproductive cycle is described, especially concerning the risk posed by unwanted pregnancy, a risk factor for postpartum depression as reported in studies conducted in various parts of the world. Consequently, women with depression risk factors (history of previous depressive ailment, background of infant adversity or trauma or exposition to violence, family history of affective disorder, poverty and lack of social support, concomitant physical ailments, and altered fetus health) should receive information to allow them to decide if they wish to interrupt pregnancy for therapeutic reasons in order to protect their mental health. Practical recommendations to recognize and man...

Emotional distress during perimenopause cannot be accounted for only by hormonal fluctuations. Actually, these emotional problems arise from the complex interaction of biological, social and psychological events that coincide in this period of life. The experience of menopause, understood as the end of reproductive life, is influenced by previous psychological growth, which determines how the woman will deal with the challenges of adulthood, namely the loss of some functions and the need to make a balance of expectations and achievements, in order to widen the repertoire of coping strategies in order to face ageing successfully. Role transitions (children leaving home or returning, illness of parents or spouse, changes in the workplace, loss of support networks) impact on emotional well being as do the culturally determined conceptions about menopause of the woman and those around her. O...

Emotional distress during perimenopause cannot be accounted for only by hormonal fluctuations. Actually, these emotional problems arise from the complex interaction of biological, social and psychological events that coincide in this period of life. The experience of menopause, understood as the end of reproductive life, is influenced by previous psychological growth, which determines how the woman will deal with the challenges of adulthood, namely the loss of some functions and the need to make a balance of expectations and achievements, in order to widen the repertoire of coping strategies in order to face ageing successfully. Role transitions (children leaving home or returning, illness of parents or spouse, changes in the workplace, loss of support networks) impact on emotional well being as do the culturally determined conceptions about menopause of the woman and those around her. O...

The COVID-19 pandemic triggered a social crisis that temporarily affected the entire world population.Predictions of a massive damage to mental health have not been confirmed, but some vulnerable populations have beendisproportionately affected by the infection and the social measures thereby implemented. Many women's mental healthhas deteriorated due to their higher exposure as most of the so-called “essential workers”, and to the larger burden ofresponsibilities they had to shoulder. People at both extremes of the life cycle share common vulnerability factors and wereexposed to isolation and the unavailability of formal support networks in the face of closure of schools, health andrecreational services. Surprisingly, adolescents of both sexes have also suffered a severe emotional impact documented bythe rise in suicidal ideation and behaviors and explained by the distortion of a li...

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El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

This is the third ethics symposium published by the Peruvian Journal of Gynecology and Obstetrics (RPGO) in the last 11 years, given the importance of this discipline for medical practice, especially for the gynecologist-obstetrician(1,2). Because of the topic’s transcendence, the Peruvian Society of Gynecology and Obstetrics (SPGO) hosted an event in 2009, highlighting various issues in sexual and reproductive health ethics(3). That same year, the Society participated in a Values Clarification Workshop in Trinidad, Bolivia(4).

Genome-wide approaches including polygenic risk scores (PRSs) are now widely used in medical research; however, few studies have been conducted in low- and middle-income countries (LMICs), especially in South America. This study was designed to test the transferability of psychiatric PRSs to individuals with different ancestral and cultural backgrounds and to provide genome-wide association study (GWAS) results for psychiatric outcomes in this sample. The PrOMIS cohort (N = 3308) was recruited from prenatal care clinics at the Instituto Nacional Materno Perinatal (INMP) in Lima, Peru. Three major psychiatric outcomes (depression, PTSD, and suicidal ideation and/or self-harm) were scored by interviewers using valid Spanish questionnaires. Illumina Multi-Ethnic Global chip was used for genotyping. Standard procedures for PRSs and GWAS were used along with extra steps to rule out confoundin...

LED and HS have been funded by startup funds from Stanford and a pilot grant to LED from the Stanford Center for Clinical and Translation Research and Education (UL1 TR001085, PI Greenberg). LED has also been funded by Cohen Veterans Bioscience (CVB), and she is part of the CVB Working Group for PTSD Adaptive Platform Trial. BG has been funded by the NIH (R01-HD-059835, PI Williams) and CVB. HH has been funded by the NIH (NIH K01DK114379 and NIH R21AI139012), the Zhengxu and Ying He Foundation, and the Stanley Center for Psychiatric Research. MBR received funds from WPA Congress Mexico City 2018, Guayaquil CEPAM 2019, Asunción X CONGRESO LATINOAMERICANO DE LA FLAPB 2018, Guayaquil 2019 (Bago), and Lancet Psychiatry, London (commission on Violence against women) 2019. SS declares no potential conflict of interest.

BACKGROUND: Suicide is a leading cause of maternal death globally, and suicide prevalence rates have been shown to be increased in those with migraine. No previous study has examined the association between migraine and suicidal ideation during pregnancy. OBJECTIVE: To examine the association between migraine and suicidal ideation among a cohort of pregnant women. METHODS: A cross-sectional study was conducted among 3372 pregnant women attending prenatal care clinics in Lima, Peru. Suicidal ideation and depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale during early pregnancy. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders-III beta criteria. Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Sui...

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

Abstract BACKGROUND: The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. METHODS: A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach's alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. RESULTS: The reliability of t...

Background: Previous studies suggest sleep quality and obstructive sleep apnea (OSA) may be associated with psychiatric symptoms, including depression, anxiety, and posttraumatic stress disorder (PTSD). However, few studies have examined the relationship between sleep quality and OSA with maternal psychiatric symptoms during pregnancy, a state of vulnerability to these disorders. Objective: The objective of our study is to examine the association between poor sleep quality and sleep apnea with antepartum depression, anxiety, and PTSD among pregnant women. Methods: A cross-sectional study was conducted among women seeking prenatal care in Lima, Peru. Sleep quality was measured using the Pittsburgh Sleep Quality Index, and the Berlin questionnaire was used to identify women at high risk for OSA. Depression, generalized anxiety, and PTSD symptoms were measured using the Patient Health Quest...

Background: Physiological changes during pregnancy are often accompanied by reduced sleep quality, sleep disruptions, and insomnia. Studies conducted among men and non-pregnant women have documented psychiatric disorders as common comorbidities of insomnia and other sleep disorders. However, no previous study has examined the association between stress-related sleep disturbances and psychiatric disorders among pregnant women. Methods: This cross-sectional study included a total of 2051 pregnant women in Peru. The Spanish-language version of the Ford Insomnia Response to Stress Test (FIRST-S) was used to assess sleep disruptions due to stressful situations. Symptoms of antepartum depression, generalized anxiety disorder, and posttraumatic stress disorder (PTSD) were examined using the Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7 and PTSD Checklist – Civilian Vers...

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

bgelaye@hsph.harvard.edu

We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen's kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation...