Prenatal Depression in Latinas in the U.S. and Mexico
ABSTRACT The study aimed to investigate the prevalence of depressive symptoms and their associated risk factors during pregnancy in Latinas in the United States (U.S.) and Mexico.
The sample included 108 women in the U.S. whose data were obtained from medical chart reviews in a community clinic in Washington, D.C., and 117 women in Mexico who participated in face-to-face interviews in the waiting rooms of primary care community centers in Mexico City. Variables, chosen to match in both countries for comparisons, were: socio-demographics, pregnancy gestation and order, social support, depressive symptoms, personal history of depression, family psychiatric history, and suicidal thoughts. Depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale (CES-D).
The prevalence of depressive symptoms was 32.4% for pregnant Latinas and 36.8% for Mexicans (CES-D > or = 16), and 15.7% and 23.9% (CES-D > or = 24), respectively, with no differences between groups. Separate multiple logistic regression analyses showed that for U.S. Latinas: (1) being more educated predicted depressive symptoms (CES-D > or = 16), and (2) second trimester, as compared to first, also predicted symptoms (CES-D > or /= 24). (3) History of suicidal thoughts predicted symptoms in Latinas in the U.S. (CES-D > or = 24) and in Mexico (using both definitions of high symptoms), and (4) living with a partner but not formally married and multi-parous condition predicted symptoms (CES-D > or /= 24) among pregnant Mexicans.
A high prevalence of depressive symptoms and significant risk factors during pregnancy were found in Latinas in U.S. and Mexico, suggesting increased risk for postpartum major depression. Implications for screening and interventions are discussed.
- SourceAvailable from: Rita Pickler
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- "The rates of depressive symptomatology reported from this study are congruent with the literature on the prevalence of depression in Hispanic women (Davila and McFall 2009; Lara et al. 2009). The findings reported from this study are also consistent with higher depressive symptoms during pregnancy (Zayas et al. 2003). "
ABSTRACT: We examined the effects of acculturation, depressive symptoms, progesterone, and estriol (E3) as predictors of preterm birth (PTB) in pregnant Hispanic women. This cross-sectional study recruited a sample of 470 Hispanic women between 22- and 24-week gestation from physician practices and community clinics. We used the CES-D to measure maternal depressive symptoms. We measured acculturation by English proficiency on the Bidimensional Acculturation Scale, residence index by years in the USA minus age, nativity, and generational status. Serum progesterone and E3 were analyzed by EIA. Ultrasound and medical records determined gestational age after delivery. In χ (2) analysis, there were a significantly greater percentage of women with higher depressive scores if they were born in the USA. In a structural equation model (SEM), acculturation (English proficiency, residence index, and generational status) predicted the estriol/progesterone ratio (E/P), and the interaction of depressive symptoms with the E/P ratio predicted PTB. Undiagnosed depressive symptoms during pregnancy may have biological consequences increasing the risk for PTB.Archives of Women s Mental Health 02/2012; 15(1):57-67. DOI:10.1007/s00737-012-0258-2 · 1.96 Impact Factor
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- "Most studies conducted in the U.S. on depression among pregnant Latinas have focused on Mexican Americans(Davila et al., 2009, Lara et al., 2009), with only a few focusing on other Latina subgroups(Zayas et al., 2002, Zayas et al., August 2003), and none of them comparing Latina subgroups among pregnant women. Our findings that Puerto Rican Latinas tended to be more likely to experience elevated levels of depressive symptoms compared to non-Puerto Rican Latinas deserves discussion due to the effect size of the association and the unique nature of the results. "
ABSTRACT: Latinas experience high rates of poverty, household food insecurity and prenatal depression. To date, only one USA study has examined the relationship between household food insecurity and prenatal depression, yet it focused primarily on non-Latina white and non-Latina black populations. Therefore, this study examined the independent association of household food insecurity with depressive symptoms among low-income pregnant Latinas. This cross-sectional study included 135 low income pregnant Latinas living in Hartford, Connecticut. Women were assessed at enrolment for household food security during pregnancy using an adapted and validated version of the US Household Food Security Survey Module. Prenatal depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. A cut-off of ≥21 was used to indicate elevated levels of prenatal depressive symptoms (EPDS). Multivariate backwards stepwise logistic regression was used to identify risk factors for EPDS. Almost one third of participants had EPDS. Women who were food insecure were more likely to experience EPDS compared to food secure women (OR = 2.59; 95% CI = 1.03-6.52). Being primiparous, experiencing heartburn and reporting poor/fair health during pregnancy, as well as having a history of depression were also independent risk factors for experiencing EPDS. Findings from this study suggest the importance of assessing household food insecurity when evaluating depression risk among pregnant Latinas.Maternal and Child Nutrition 10/2011; 7(4):421-30. DOI:10.1111/j.1740-8709.2010.00266.x · 2.97 Impact Factor
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ABSTRACT: Perinatal depression is increasingly recognized as a significant public mental health problem; consequently, there is a major interest in developing strategies to prevent postpartum depression that may help reduce its detrimental consequences. However, the unique experiences associated with the perinatal period make it more difficult to recruit participants at this stage and to retain them over time when assessing prevention interventions. The aim of the study is to examine retention rates and predictors of retention in a longitudinal, randomized controlled trial (RCT) to prevent postnatal depression. Method Participants: Pregnant women (N=377) at risk of depression were randomized to intervention or usual care condition and assessed during pregnancy and at 6 weeks and 4-6 months postpartum. Intervention: The intervention was designed by modifying a previously evaluated one and includes information on normal pregnancy and the postpartum period, from psychoanalytic and risk factors perspectives. It attempts to reduce depression levels by increasing positive thinking and pleasant activities, improving self-esteem, increasing self-care, learning skills to strengthen social support, and exploring unrealistic expectations about pregnancy and motherhood. It is delivered in eight two-hour weekly group sessions during pregnancy. Measures: Depressive symptoms were measured using the second edition of the Beck Depression Inventory (BDI-II); anxiety symptoms with the corresponding subscale of the Hopkins Symptoms Checklist (SCL-90) and social support with the Social Support Apgar (SSA). A short form of 12 items representing potential stressors was used as a measurement of stressful life events and the Abbreviated Version of the Dyadic Adjustment Scale (A-DAS) measured partner relationship.