Flach Katherine, Gressler Nathália Gewehr, Marcolino Miriam Allein Zago, Levandowski Daniela Centenaro
Post-Graduation Program of Health Sciences of Federal University of Health Sciences of Porto Alegre, UFCSPA, RS Porto Alegre, Brazil.
Federal University of Health Sciences of Porto Alegre, UFCSPA, RS Porto Alegre, Brazil.
Trends Psychol. 2022 Jan 10:1-35. doi: 10.1007/s43076-021-00112-z.
This study sought to identify the factors associated with the development and prevention of complicated grief in women who have lost a baby. This is a systematic review of scientific articles in the main mental health databases: MEDLINE (PubMed), EMBASE, Latin American and Caribbean Health Sciences Literature (LILACS), and APA Databases (PsycINFO). The selection and data extraction processes occurred independently and blindly by two authors, considering the eligibility criteria. The analysis included publications from 2013 to 2021 of observational studies with adult women who had experienced losing a baby (during pregnancy up to 2 years of life) and that employed standardized instruments to evaluate grief. From the 8,200 records found, 23 articles were selected for analysis. As risk factors, we identified the presence of mother's psychopathology, history of gestational loss, and social pressure for a new pregnancy, while as protective factors, we identified the presence of another child other than the deceased one, the quality of specialized healthcare, and the social support provided by either a partner, community, or spiritual activities. Furthermore, the studies pointed to the event of losing a baby as an opportunity for posttraumatic growth. Although complicated grief is often associated with other mental health conditions, such as anxiety, depression, or posttraumatic stress, it is necessary to differentiate it for a clearer understanding of the complicated grief as a singular condition, to enable access to appropriate care for bereaved mothers and families, as well as to promote public policies which provide support to them.
本研究旨在确定与失去婴儿的女性发生和预防复杂性悲伤相关的因素。这是一项对主要心理健康数据库中科学文章的系统综述：MEDLINE（PubMed）、EMBASE、拉丁美洲和加勒比健康科学文献数据库（LILACS）以及美国心理学会数据库（PsycINFO）。两位作者根据纳入标准独立且盲法进行筛选和数据提取过程。分析纳入了2013年至2021年发表的观察性研究，研究对象为经历过失去婴儿（孕期至婴儿2岁）的成年女性，且研究采用了标准化工具来评估悲伤。从检索到的8200条记录中，选取了23篇文章进行分析。作为风险因素，我们确定了母亲存在精神病理学问题、有过流产史以及来自新怀孕的社会压力；作为保护因素，我们确定了除已故婴儿外还有其他孩子、专业医疗保健的质量以及伴侣、社区或精神活动提供的社会支持。此外，研究指出失去婴儿这一事件是创伤后成长的契机。尽管复杂性悲伤通常与其他心理健康状况相关，如焦虑、抑郁或创伤后应激障碍，但有必要对其进行区分，以便更清楚地将复杂性悲伤作为一种独特状况来理解，从而使丧亲母亲及其家庭能够获得适当的护理，并推动制定为他们提供支持的公共政策。
