Associação entre toxoplasmose e depressão pré e pós-parto em mulheres residentes no município de Santa Cruz-RN

Abstract

Toxoplasmosis is a disease caused by the protozoan Toxoplasma gondii. This zoonosis has a worldwide geographic distribution and its clinical manifestations are usually mild or subclinical. However, this parasite can cause severe clinical signs in immunocompromised individuals and can also be transmitted vertically, resulting in damage to the development of the fetus or newborn. Given that latent toxoplasmosis is associated with behavioral changes and neuropsychiatric disorders, the present study aimed to evaluate the relationship between T. gondii infection and depression before and after childbirth. To this end, a cohort study was conducted with women aged between 15 and 45 years living in the city of Santa Cruz, in the interior of Rio Grande do Norte state. The volunteers were approached at two times: at the end of the 3rd trimester of pregnancy and after childbirth. The pregnant women were initially approached at basic health units and contacted again for the second interview 30 days after the expected date of delivery. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess depressive symptoms. A questionnaire containing 15 questions was used to identify the serological profile and epidemiological aspects related to toxoplasmosis, which covered personal data, economic and housing situation, and educational and health/disease aspects. Of the 78 volunteers analyzed in the first interview, 24 (30.8%) had positive serology for toxoplasmosis and 54 (69.2%) had negative serology, indicating a large percentage of women susceptible to infection by the protozoan. The result of the EPDS scale showed that 12.8% of the volunteers were predisposed to depression before delivery. It was observed that this percentage increased to 19.1% during the postpartum period, with an incidence of 33.3%. To verify the association between depression and infection by T. gondii, Pearson's chi-square test (X2) was performed. In our study, an association was observed between the predisposition to develop postpartum depression and infection by the protozoan T. gondii (p=0.046), but this factor is not the only factor responsible for the disorder. An association was also observed between the use of licit drugs and the predisposition to depression during pregnancy (p=0.004). Therefore, further studies on mental disorders associated with the influence of pathogens are necessary to determine risk factors related to the development of depressive symptoms in pregnant women and in the puerperium. In addition, the frequency of toxoplasmosis in the study population was consistent with previous studies, revealing the need for actions to control, prevent and monitor infection by T. gondii and the sequelae of the disease both during pregnancy and in live births.