Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice

Abstract

Objective: Data are scarce regarding the sociodemographic predictors of antenatal and postpartum depression. This study investigated whether race/ethnicity, age, finances, and partnership status were associated with antenatal and postpartum depressive symptoms. Setting: 1662 participants in Project Viva, a US cohort study. Design: Mothers indicated mid-pregnancy and six month postpartum depressive symptoms on the Edinburgh postpartum depression scale (EPDS). Associations of sociodemographic factors with odds of scoring .12 on the EPDS were estimated. Main results: The prevalence of depressive symptoms was 9% at mid-pregnancy and 8% postpartum. Black and Hispanic mothers had a higher prevalence of depressive symptoms compared with nonHispanic white mothers. These associations were explained by lower income, financial hardship, and higher incidence of poor pregnancy outcome among minority women. Young maternal age was associated with greater risk of antenatal and postpartum depressive symptoms, largely attributable to the prevalence of financial hardship, unwanted pregnancy, and lack of a partner. The strongest risk factor for antenatal depressive symptoms was a history of depression (OR = 4.07; 95% CI 3.76, 4.40), and the strongest risk for postpartum depressive symptoms was depressive symptoms during pregnancy (6.78; 4.07, 11.31) or a history of depression before pregnancy (3.82; 2.31, 6.31). Conclusions: Financial hardship and unwanted pregnancy are associated with antenatal and postpartum depressive symptoms. Women with a history of depression and those with poor pregnancy outcomes are especially vulnerable to depressive symptoms during the childbearing year. Once these factors are taken in account, minority mothers have the same risk of antenatal and postpartum depressive symptoms as white mothers.

Depression during pregnancy: prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil

“…Consistent with the extant literature, we found an association between antenatal major depression and a previous history of depression 5,6,7,14,18,19,27 as well as previous psychiatric treatment 10, 23,24 . Since major depressive disorder is often a recurrent condition, it is not surprising that a prior depressive episode is a significant risk factor for depression during pregnancy.…”

“…Table 4 The multivariate model of risk factor for depression in 331 pregnant women attending a public health clinic in Rio de Janeiro, Brazil. An association between an unplanned pregnancy and depression during pregnancy has been well-documented 5,8,19,27 . In Brazil, women of lower socio-economic status (low education and low income) report more unplanned pregnancies than those of higher socio-economic status.…”

“…Overall 27 ). The lower prevalence in these countries might have resulted from high quality antenatal care, better nutrition during pregnancy, and less stressful life events such as financial difficulties 58,59 .…”

“…Thus, prevalence rates of depression during pregnancy were significantly higher in low-income countries. The main risk factors associated with these differences are past history of psychiatric disorders, poor antenatal care, poor nutrition, stressful life events, economic deprivation and gender based violence, which are more prevalent in developing countries 4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29 .…”

Impact of socioeconomic deprivation on maternal perinatal mental illnesses presenting to UK general practice

“…While an association between mental illness and greater socioeconomic deprivation in the general population has been well documented, 9 fewer studies have assessed this in the perinatal period and results are inconsistent. [10][11][12][13] Furthermore, evidence that impacts of material deprivation may vary with age 14 has not been assessed in pregnant women.…”