Concentração de melatonina no leite humano, qualidade do sono e saúde mental materna: estudo transversal
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2024-03-05
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Universidade Federal de Goiás
Resumo
Oliveira FS. Melatonin Concentration in Human Milk, Sleep Quality, and Maternal
Mental Health: Cross-Sectional Study [thesis]. Goiânia: Faculdade de
Enfermagem/UFG; 2023. p. 196.
INTRODUCTION: Melatonin is an endogenous hormone present in human milk and
plays a crucial role in regulating the circadian rhythm. Its association with mood
disorders and sleep disturbances during the postpartum period is still underexplored.
OBJECTIVE: To investigate the association between melatonin concentration in
human milk and the quality of sleep, presence of depressive symptoms, anxiety, and
maternal stress in the postpartum period. METHODOLOGY: A cross-sectional study
was conducted with 84 women in the postpartum period in the public healthcare
system. Data collection took place between June 2021 and December 2022, with
participants approached in the postpartum ward of the maternity unit. Human milk
samples were collected through manual expression between 6 a.m. and 9 a.m. on day
14 postpartum. The samples were stored at -80°C and analyzed using an enzymelinked immunosorbent assay (ELISA). Sociodemographic, obstetric, and neonatal data
were collected, and questionnaires on postpartum depression (Edinburgh Postnatal
Depression Scale, EPDS), anxiety, stress (Depression, Anxiety, and Stress Scale,
DASS-21), and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were
administered. Statistical analysis included measures of central tendency and
dispersion, bivariate Poisson regression, and multivariate modeling, with p < 0.05
considered statistically significant. RESULTS: The median melatonin concentration
was 4.90 pg/ml (Q1: 2.78; Q3: 13.61). Depressive symptoms were reported by 22.6%
of the women, anxiety symptoms by 39.3%, stress symptoms by 38.1%, and sleep
disturbances by 63.1%. In the multivariate analysis, associations were found between
melatonin concentration ≤ 4.90 pg/ml, planned pregnancy (RP: 1.21; 95% CI: 1.04 -
1.42; p = 0.015), and anxiety symptoms (RP: 1.18; 95% CI: 1.02 - 1.37; p = 0.030).
Postpartum depressive symptoms were associated with paid employment (RP: 2.58;
95% CI: 1.20 - 5.52; p = 0.015), stress symptoms (RP: 3.84; 95% CI: 1.04 - 14.21; p =
0.044), and sleep disturbances (RP: 3.07; 95% CI: 1.13 - 8.33; p = 0.027). Significant
associations were also observed between stress symptoms and unplanned pregnancy
(RP: 3.06; 95% CI: 1.16 - 8.12; p = 0.024), anxiety symptoms (RP: 3.06; 95% CI: 2.06
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- 7.80; p < 0.001), and postpartum depressive symptoms (RP: 1.93; 95% CI: 1.12 -
3.33; p = 0.017). For anxiety symptoms, an association was found with stress
symptoms (RP: 1.19; 95% CI: 1.53 - 7.26; p = 0.002) and newborn weight (RP: 1.00;
95% CI: 1.00 - 1.01; p = 0.004). The presence of sleep disturbances was associated
with the number of people in the household (RP: 0.71; 95% CI: 0.54 - 0.94; p = 0.015).
CONCLUSION: Melatonin concentration in human milk was higher than the daytime
levels reported in the literature. The association between melatonin and anxiety
symptoms emphasizes the importance of identifying modifiable factors during the
perinatal period. The relationship between mood disorders and sleep disturbances
suggests a simultaneous or precedence interaction between these conditions.
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OLIVEIRA, F. S. oncentração de melatonina no leite humano, qualidade do sono e saúde mental materna: Estudo Transversal. 2024, 197 f. Tese (Doutorado em Enfermagem) - Faculdade de Enfermagem, Universidade Federal de Goiás, Goiânia, 2024.