Influência dos fatores obstétricos e sociodemográficos na funcionalidade e incapacidade em gestantes

Abstract

Pregnancy is a period where the woman undergoes several changes that affect her life, which can cause her discomfort and pain. The International Classification of Functioning, Disability and Health (ICF) focuses on individuals and their needs, seeing the impact of the health condition on the person's functionality and daily life. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a questionnaire developed by the WHO and linked to the ICF that assesses functionality and disability. Objective article 1: To evaluate the relationship between sociodemographic factors and lifestyle factors and their impact on the functionality of pregnant women in the city of Santa Cruz/RN, evaluated using WHODAS 2.0. Objective article 2: To verify whether obstetric factors are related to the functionality and disability of pregnant women in northeastern Brazil, assessed using the WHODAS 2.0. Quantitative cross-sectional study, carried out between August/2018 and April/2020, where the sample of article 1 consisted of 124 pregnant women from Santa Cruz/RN who had data collected at the Basic Health Units, at the Faculty of Health Sciences of Trairi (FACISA /UFRN); and that of article 2 by 140 pregnant women in northeastern Brazil, with data also collected through Google Meet. Pregnant women with a single fetus participated who understood the questions; those who refused to answer any questions, had interrupted interviews or had difficulty understanding were excluded. An evaluation form was used to obtain sociodemographic data, life habits and obstetrics. Functioning and disability were measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), consisting of 36 items and six domains of daily activities: cognition, mobility, self-care, interpersonal relationships, life activities and participation. The power of the sample was 83.42% for article 1 and 100% for article 2. A significance of 5% (p<0.05) was adopted for both articles. Article 1: with regard to sociodemographic factors, a decrease in functionality was observed in the self-care domains (in relation to physical exercise, p=0.035), domestic activities (about paid work, p=0.022), school/work activities (about the number of years of schooling, p=0.03; and the skin color of the woman, p=0.047), and in the participation domain (education, p=0.03; paid work, p=0.009; and being alcoholics, p=0.041). Article 2: regarding obstetric factors, we obtained a decrease in the functionality of pregnant women in the self-care domains in relation to gestational age (p=0.007); interpersonal relationships with number of pregnancies (p=0.014) and number of deliveries (p=0.025); and in the school/work activities domain in relation to the number of pregnancies (p=0.047) and number of abortions (p=0.007). We verified that there is a decrease in the functionality of pregnant women evaluated with the WHODAS 2.0 in relation to the practice of physical exercise, paid work, their skin color, schooling, alcohol consumption, in addition to gestational age, number of pregnancies, number of deliveries and of abortions.