Rates and predictors of prenatal depression in women living with and without HIV

Abstract

Depression is a significant mental health and public health concern, and women living with HIV are at increased risk for depression. This risk may be especially elevated during pregnancy; however, few studies have attempted to identify rates and predictors of depression in pregnant, HIV-infected women. The purpose of the present study was to investigate rates and predictors of prenatal depression, such as history of depression, childhood sexual abuse (CSA), and social support among HIV-infected and HIV-uninfected women in Philadelphia, Pennsylvania. It was hypothesized that pregnant women with HIV will have higher rates of depressive symptoms and will exhibit a greater number of mood disorder diagnoses as compared to HIV-uninfected pregnant women. It was also hypothesized that HIV status, history of depression, CSA, and inadequate social support will emerge as predictors of depressive symptoms. A sample of 163 women, 31% (n=50) of whom were HIV-infected and 69% (n=113) of whom were HIV-uninfected, were recruited from an obstetrics/gynecology clinic affiliated with an urban university hospital. The Center for Epidemiological Studies-Depression Scale (CES-D) was used to identify depressive symptoms, and Modules A and D of the Structured Clinical Interview for DSM-IV (SCID) confirmed the presence of a mood disorder. Findings demonstrated that rates of depressive symptoms and mood disorder diagnoses during pregnancy did not differ according to HIV serostatus. History depression, CSA, and inadequate social support predicted depressive symptoms during pregnancy in this sample. Due to their association with depressive symptoms, history of depression, CSA, and inadequate social support may be important to identify during pregnancy.

Perinatal Depression and Anxiety in Women with and without Human Immunodeficiency Virus Infection

“…In the same population as the present study, risk factors significantly related to prenatal depression in women with HIV were childhood sexual abuse and a history of depression (Bonacquisti et al, 2014). However, in the present study, a self-reported history of depression did not predict postpartum depression symptoms, whereas childhood sexual abuse predicted postpartum depressive symptoms only in women with HIV infection.…”

“…Childhood sexual abuse remains a critical experience to study among women with HIV, given its demonstrated relationship to depressive symptoms and its inherent link to trauma, including such responses as posttraumatic stress disorder and symptoms (Villar-Loubet et al, 2014). In addition, women with HIV have been found to perceive lower levels of emotional support when compared with women without HIV (Bonacquisti et al, 2014). However, in this study, perceived emotional support did not have a relationship with depressive and anxiety symptoms in the prenatal and postpartum period among women with and without HIV, when controlling for other factors.…”

“…Social support is a heterogeneous concept that has been measured in a variety of ways in the current literature, with varying degrees of attention paid to the amount, duration, quality, and type of support. In the current study, perceptions of emotional support from family/friends was conceptualized as an indicator of overall support, and in a previous publication using these same study data, inadequate emotional support from family and friends emerged as significant predictor of prenatal depression (Bonacquisti, Geller & Aaron, 2014).…”

History of childhood sexual abuse and risk of prenatal and postpartum depression or depressive symptoms: an epidemiologic review

“…Six postpartum depression studies had information suitable and sufficient for meta-analysis and thus were meta-analyzed. Two studies (Robertson-Blackmore et al 2013; Bonacquisti et al 2014) were counted twice as the authors observed women in both the prenatal and postpartum periods.…”

“…The seven original articles reporting on the association between maternal history of CSA and prenatal depression or depressive symptoms (Benedict et al 1999; Lang et al 2006; Lev-Wiesel and Daphna-Tekoah 2010; Bublitz and Stroud 2012; Robertson-Blackmore et al 2013; Bonacquisti et al 2014; Leeners et al 2014) were based on cross-sectional data. Five studies were from the USA, one from Germany, and one from Israel.…”