Alterações fisiológicas da pele na gravidez: prevenção e assistência

Abstract

To investigate the perception of pregnant women about physiological changes in the skin during pregnancy; whether they have performed preventive care and have received guidance from professionals during prenatal care. To analyze the association between preventive practices and the reduction in the incidence of melasma and stretch marks. METHOD: Cross-sectional study, descriptive design, quantitative analytical approach and association between variables. Sample comprised 150 pregnant women, aged ≥ 18 years, gestational age ≥14 weeks, in high-risk prenatal care in the obstetric unit of the specialties outpatient clinic of a school hospital in the interior of São Paulo state. Data collection was performed in August/September 2021, in the waiting room, using a questionnaire with closed questions, prepared and applied individually by the researcher. The statistics were descriptive to describe the sample profile and inferential (Fisher's Test and Chi-square) to analyze the association between variables, considering p≤0.05 and critical Chi-square≥3.84. RESULTS: Most of the pregnant women were between 18 and 30 years old (53.3%), mean/SD (29.7/±6.18), were white (66.6%), literate (100%), attended complete high school (50.67%) and worked without payment (52.0%). The predominant gestational age was 26 to 30 weeks (30.0%) median (29 s), tertiparous (28.0%), nulliparous, and primiparous equals (31.0% each), never had an abortion (70%) and gained from 0 to 3 kg (32%). All pregnant women reported daily exposure to the sun, with a predominance of those who were exposed to < 15min/day (62.7%) They had hyperpigmentation (71.3%), melasma (21.3%), stretch marks (54.0%), edema (53.3%), varicose veins (18.7%), nail changes (22.0%) and bleeding gums (21.3%). They have not been performing preventive care for pigmentary changes (77.3%), for stretch marks (52.7%) and for vascular changes (89.3%). They were not oriented by professionals about specific care for pigmentary changes (98%), stretch marks (99%), vascular changes (94%), general skin care (68.7%) and those that were (31.3%), 87.2% received some type of guidance. There was a significant association between prevention practices and the reduction in the prevalence of stretch marks (p=0.0215 and RR=0.69), between sun exposure < 15min and reduction in the prevalence of melasma (p˂0.0005). There was a significant deviation between the expected frequency of melasma (70%) and the observed frequency (21%); critical chi-square=34.3. There was no significant association between general prevention practices and the reduction in the prevalence of melasma (p=0.9999). CONCLUSIONS: The pregnant women have noticed and identified the physiological changes in their skin; most did not perform preventive care and did not receive professional guidance during prenatal consultations. Pregnant women who prevented stretch marks had a 31% lower relative risk of developing them, and sun exposure ˂ 15min had an impact on reducing the prevalence of melisma. It is expected that the results obtained in this study will benefit pregnant women and professionals, since they allow the identification of skin alterations during pregnancy. Moreover, to review the practices used by health professionals, with the aim of helping them to improve comprehensive care in pregnancy, with broader actions of prevention and health education, avoiding psychological and social damage caused by the marks, since the skin is a highly visible organ, related to aesthetics and self-esteem.