Fatores nutricionais e psicológicos associados com a ocorrência da picamalácia em gestantes

Abstract

Introduction: The etiology of pica seems to be complex. Various causes (environmental, nutritional, socioeconomic, physiological, cultural and psychiatric) have been recognized. But there are few studies on nutritional and psychological factors associated with the occurrence of pica during pregnancy. Objective: Assess the nutritional and psychological factors associated with the occurrence of pica in pregnant women in a public hospital in the city of Rio de Janeiro, Brazil. Methods: This is a descriptive study, exploratory, conducted with 13 women with a mean age of 28 years who carried out prenatal care at a public hospital in the city of Rio de Janeiro, between July and October 2013 and who practiced pica in the current pregnancy. It was considered in the study as a whole pica ingestion of inedible substances and atypical combinations of foods. During the prenatal visit, the women were invited to participate, as signed the consent form and underwent nutritional assessment (dietary assessment, anthropometric, clinical, biochemical, functional, socio-demographic and obstetric) and psychological (stress interview and assessment, anxiety and coping), the latter occurred only seven of the 13 pregnant participants. In both evaluations validated instruments or protocols developed for the study were utilized. Results: Overall, we observed the occurrence of some degree of stress and anxiety in pregnant women with pica (N = 07), as well as a comorbidity and digestive symptoms (n = 13). Thus, it was found that 84.61% complained of the presence of gastrointestinal symptoms such as heartburn, nausea, vomiting and constipation, and 69.2% had some type of comorbidity, such as type 2 diabetes mellitus, Diabetes Mellitus gestational; failure Urinary Tract Infection, Hypertension and; Hypothyroidism. All pregnant women who received psychological evaluation showed significant levels of stress (resistance phase: n = 05; exhaustion phase: n = 02) and anxiety (moderate level: n = 05), also revealed that pregnant women used as coping strategy (coping) to "search for religious practices" (42.8%) or "search for social support" (42.8%). The practice of pica was more that excessive consumption of ice (30.8 %) and fruit with salt (30.8%). Conclusions: Having in mind that pica may be associated with increased perinatal risk it is very important that this practice will be investigated during prenatal consultations, with the objective of to adopt a preventive approach to avoid various complications for mother and fetus.