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Prenatal Depression in Latinas in the U.S. and Mexico

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Abstract

Objectives 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. Method 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). Results The prevalence of depressive symptoms was 32.4% for pregnant Latinas and 36.8% for Mexicans (CES-D ≥ 16), and 15.7% and 23.9% (CES-D ≥ 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 ≥ 16), and (2) second trimester, as compared to first, also predicted symptoms (CES-D ≥ 24). (3) History of suicidal thoughts predicted symptoms in Latinas in the U.S. (CES-D ≥ 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 ≥ 24) among pregnant Mexicans. Conclusions 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.

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Notes

  1. Major depression refers to a distinct clinical syndrome meeting diagnostic criteria (e.g., DSM-IV-TR) for which treatment is typically warranted. Depressive symptomatology is typically assessed by dimensional self-rating scales. High depressive symptoms measured by these scales can be impairing but usually less severe than major depression [10].

References

  1. Nicolson, P. (1999). Loss, happiness and postpartum depression: The ultimate paradox. Canadian Psychology, 40, 62–178. doi:10.1037/h0086834.

    Google Scholar 

  2. Stern, D. (1997). La Constelación Maternal. Barcelona, España: Editorial Paidos.

  3. Segre, L. S., Stuart, S., & O’Hara, W. (2004). Interpersonal psychotherapy for antenatal and postpartum depression. Primary Psychiatry, 11, 52–56.

    Google Scholar 

  4. Beck, C. T. (2001). Predictors of postpartum depression: An update. Nursing Research, 50, 275–285. doi:10.1097/00006199-200109000-00004.

    Article  PubMed  CAS  Google Scholar 

  5. O’Hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression: A meta-analysis. International Review of Psychiatry (Abingdon, England), 8, 37–54. doi:10.3109/09540269609037816.

    Article  Google Scholar 

  6. Kelly, R. H., Zatzick, D. F., & Anders, T. F. (2001). The detection and treatment of psychiatric disorders and substance use among pregnant women cared for in obstetrics. The American Journal of Psychiatry, 158, 213–219. doi:10.1176/appi.ajp. 158.2.213.

    Article  PubMed  CAS  Google Scholar 

  7. U.S. Census Bureau. Facts on the Hispanic or Latino Population. Retrieved on October 20, 2006, from http://www.census.gov/pubinfo/www/NEWhispML1.html

  8. Sáez-Santiago, E., & Bernal, G. B. (2003). Depression in ethnic minorities: Latinos and Latinas, African Americans, Asian Americans, and Native Americans. In G. Bernal, J. E. Trimble, A. K. Burlew & F. T. L. Leong (Eds.), Handbook of racial and ethnic minority psychology (pp. 401–428). Thousand Oaks, CA: Sage.

    Google Scholar 

  9. U.S. Department of Homeland Security. (2005). Yearbook of immigration statistics. Washington, DC: U.S. Department of Homeland Security, Office of Immigration Statistics. Retrieved December 1, 2006, from http://www.dhs.gov/xlibrary/assets/statistics/yearbook/2005/OIS_2005_Yearbook.pdf

  10. Gaynes, B. N., Gavin, N., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner, G., et al. (February 2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Evidence report/technology assessment No. 119. Prepared by the RTI-University of North Carolina Evidence-based Practice Center, under Contract No. 290-02-0016. AHRQ Publication No. 05-E006-2 Rockville, MD: Agency for Healthcare Research and Quality.

  11. Bennett, H. A., Einarson, A., Taddio, A., Koren, G., & Einarson, T. R. (2004). Depression during pregnancy. Overview of clinical factors. Clinical Drug Investigation, 24, 157–179. doi:10.2165/00044011-200424030-00004.

    Article  PubMed  Google Scholar 

  12. Holzman, C., Eyster, J., Tiedje, L. B., Roman, L. A., Seagull, E., & Rahbur, M. H. (2006). A life course perspective on depressive symptoms in mid- pregnancy. Maternal and Child Health Journal, 10, 127–138. doi:10.1007/s10995-005-0044-0.

    Article  PubMed  Google Scholar 

  13. Heilemann, M., Frutos, L., Lee, K., & Kury, F. S. (2004). Protective strength factors, resources, and risks in relation to depressive symptoms among childbearing women of Mexican descent. Health Care for Women International, 25, 88–106. doi:10.1080/07399330490253265.

    Article  PubMed  Google Scholar 

  14. Rich-Edwards, J. W., Kleinman, J., Abrams, A., Harlow, B., McLaughlin, T. J., & Joffe, J. (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology and Community Health, 60, 221–227. doi:10.1136/jech.2005.039370.

    Article  PubMed  Google Scholar 

  15. Ortega, L., Lartigue, T., & Figueroa, M. E. (2001). Prevalencia de depresión, a través de la Escala de Depresión Perinatal de Edinburgh (EPDS). Perinatologia y Reproduccion Humana, 15, 11–20.

    Google Scholar 

  16. Lara, M. A., Navarro, C., Navarrete, L., Cabrera, M., Almanza, J., Morales, F., et al. (2006). Síntomas depresivos en el embarazo y factores asociados en pacientes de tres instituciones de salud de la Ciudad de México. Salud Mental, 29, 55–62.

    Google Scholar 

  17. Canaval, G. E., González, M. C., Martínez-Schallmoser, L., Tovat, M. C., & Valencia, C. (2000). Depresión posparto, apoyo social y calidad de vida en mujeres de Cali, Colombia. Colombia Médica, 31, 4–10.

    Google Scholar 

  18. Falcone, V. M., Hader, C. V., Nascimento, C. F., Santos, J. M., & de Nobrega, F. J. (2005). Multiprofessional care and mental health in pregnant women. Revista de Saude Publica, 39, 612–618. doi:10.1590/S0034-89102005000400015.

    PubMed  Google Scholar 

  19. Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Women’s Health, 12, 373–380. doi:10.1089/154099903765448880.

    Article  PubMed  Google Scholar 

  20. Kitamura, T., Sugawara, M., Sugawara, K., Toda, M. A., & Shima, S. (1996). Psychosocial study of depression in early pregnancy. The British Journal of Psychiatry, 168, 732–738.

    Article  PubMed  CAS  Google Scholar 

  21. Kitamura, T., Shima, S., Sugawara, M., & Toda, M. A. (1993). Psychological and social correlates of the onset of affective disorders among pregnant women. Psychological Medicine, 23, 967–975.

    PubMed  CAS  Google Scholar 

  22. O’Hara, M. W. (1986). Social support, life events, and depression during pregnancy and the puerperium. Archives of General Psychiatry, 43, 569–573.

    PubMed  Google Scholar 

  23. Bernazzani, O., Saucier, J. F., David, H., & Borgeat, F. (1997). Psychosocial factors related to emotional disturbances during pregnancy. Journal of Psychosomatic Research, 42, 391–402. doi:10.1016/S0022-3999(96)00371-6.

    Article  PubMed  CAS  Google Scholar 

  24. Alderete, E., Vega, W. A., Kolody, B., & Aguilar-Gaxiola, S. (1999). Depressive symptomatology: Prevalence and psychosocial risk factors among Mexican migrant farm workers in California. Journal of Community Psychology, 27, 457–471. doi:10.1002/(SICI)1520-6629(199907)27:4≤457::AID-JCOP7≥3.0.CO;2-D.

    Article  Google Scholar 

  25. Kahn, R. S., Wise, P. H., Kennedy, B. P., & Kawachi, I. (2000). State income inequality, household income, and maternal mental and physical health: Cross sectional national survey. BMJ (Clinical Research Ed.), 321, 1311–1315. doi:10.1136/bmj.321.7272.1311.

    Article  CAS  Google Scholar 

  26. Yonkers, K. A., Ramin, S. M., Rush, A. J., Navarrete, C. A., Carmody, T., March, D., et al. (2001). Onset and persistence of postpartum depression in an inner-city maternal health clinic system. The American Journal of Psychiatry, 158, 1856–1863. doi:10.1176/appi.ajp. 158.11.1856.

    Article  PubMed  CAS  Google Scholar 

  27. Allister, L., Lester, B. M., Carr, S., & Liu, J. (2001). The effects of maternal depression on fetal heart rate response to vibroacoustic stimulation. Developmental Neuropsychology, 20, 639–651.

    PubMed  CAS  Google Scholar 

  28. Robertson, E., Grace, S., Wallington, T., & Stewart, D. E. (2004). Antenatal risk factors for postpartum depression: A synthesis of recent literature. General Hospital Psychiatry, 26, 289–295. doi:10.1016/j.genhosppsych.2004.02.006.

    Article  PubMed  Google Scholar 

  29. Alvarado, R., Perucca, E., Neves, E., Rojas, M., Monardes, J., Olea, E., et al. (1993). Cuadros depresivos durante el embarazo y factores asociados. Revista Chilena de Obstetricia y Ginecología, 58, 135–141.

    PubMed  CAS  Google Scholar 

  30. Morales-Carmona, F., Luque-Coqui, M., & Barroso-Aguirre, J. (2002). Alteraciones emocionales en una muestra de mujeres mexicanas con eventos ginecoobstétricos. Perinatologia y Reproduccion Humana, 16, 157–162.

    Google Scholar 

  31. Jadresic, M., Jara, V. C., & Araya, B. R. (1993). Depresión en el embarazo y el puerperio: estudio de factores de riesgo. Revista Médica del Cobre, 2, 105–108.

    Google Scholar 

  32. Bonari, L., Bennett, H., Einarson, A., & Koren, G. (2004). Risk of untreated depression during pregnancy. Canadian Family Physician Medecin de Famille Canadien, 50, 37–39.

    PubMed  Google Scholar 

  33. Diego, M. A., Fueld, T., Hernández-Reif, M., Cullen, C., Schanberg, S., & Kuhn, C. (2004). Prepartum, postpartum, and chronic depression effects on newborns. Psychiatry, 67, 63–80.

    PubMed  Google Scholar 

  34. Zambrana, R. E., Scrimshaw, S. C. M., Collins, N., & Dunkel-Schetter, C. (1997). Prenatal health behaviors and psychosocial risk factors in pregnant women of Mexican origin: The role of acculturation. American Journal of Public Health, 87, 1022–1026.

    Article  PubMed  CAS  Google Scholar 

  35. O’Hara, M. W., Stuart, S., Gorman, L. L., & Wenzel, A. (2000). Efficacy of interpersonal psychotherapy for postpartum depression. Archives of General Psychiatry, 57, 1039–1045. doi:10.1001/archpsyc.57.11.1039.

    Article  PubMed  Google Scholar 

  36. Lara, M. A., Acevedo, M., Luna, S., Weckmann, C., Villarreal, A. L., & Pego, C.( 1997). ¿Es difícil ser mujer? Una guía sobre depresión. Mexico: Editorial Pax, pp. 15–183.

  37. Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306.

    Article  Google Scholar 

  38. Beeghly, M., Weinberg, M. K., Olson, K. L., Kernan, H., Riley, J., & Tronick, E. Z. (2002). Stability and change in level of maternal depressive symptomatology during the first postpartum year. Journal of Affective Disorders, 71, 169–180. doi:10.1016/S0165-0327(01)00409-8.

    Article  PubMed  Google Scholar 

  39. Orr, S. T., Blazer, D. G., James, S. A., & Reiter, J. P. (2007). Depressive symptoms and indicators of maternal health status during pregnancy. Journal of Women’s Health, 12(4), 373–380.

    Google Scholar 

  40. Flynn, H. A., Walton, M. A., Chermack, S. T., Cunningham, R. M., & Marcus, S. M. (2007). Brief detection and co-occurrence of violence, depression and alcohol risk in prenatal care settings. Archives of Women’s Mental Health, 10(4), 155–161. doi:10.1007/s00737-007-0188-6.

    Article  PubMed  CAS  Google Scholar 

  41. Le, H. N., Muñoz, R. F., Soto, J., Delucchi, K., & Ghosh Ippen, C. (2004). Identification of risk for onset of major depressive episodes during pregnancy and postpartum. Hispanic Journal of Behavioral Sciences, 26, 463–482. doi:10.1177/0739986304269165.

    Article  Google Scholar 

  42. SPSS. (2006). Statistical package for the social sciences for Windows, Version 15.01. Chicago, EU: SPSS, Inc. (Software for computer).

  43. Zayas, L. H., Jankowski, K. R., & McKee, M. D. (2003). Prenatal and postpartum depression among low-income Dominican and Puerto Rican women. Hispanic Journal of Behavioral Sciences, 25, 370–385. doi:10.1177/0739986303256914.

    Article  Google Scholar 

  44. Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the Edinburgh postnatal depression scale. The British Journal of Psychiatry, 150, 782–786.

    Article  PubMed  CAS  Google Scholar 

  45. Ross, L. E., Sellers, E. M., Gilbert Evans, S. E., & Romach, M. K. (2004). Mood changes during pregnancy and the postpartum period: development of a biopsychosocial model. Acta Psychiatrica Scandinavica, 109, 457–466. doi:10.1111/j.1600-0047.2004.00296.x.

    Article  PubMed  CAS  Google Scholar 

  46. Jomeen, J., & Martin, C. (2005). Edinburgh postnatal depression scale (EPDS) during early pregnancy. Journal of Reproductive and Infant Psychology, 23, 143–154. doi:10.1080/02646830500129297.

    Article  Google Scholar 

  47. Stuart, S., Couser, G., Schilder, K., O’Hara, M., & Gorman, L. (1998). Postpartum anxiety and depression: Onset and co-morbidity in a community sample. The Journal of Nervous and Mental Disease, 186(7), 420–424. doi:10.1097/00005053-199807000-00006.

    Article  PubMed  CAS  Google Scholar 

  48. Goldney, R., Fisher, L., Dal Grande, E., & Taylor, A. (2004). Subsyndromal depression: Prevalence, use of health services and quality of life in an Australian population. Social Psychiatry and Psychiatric Epidemiology, 39, 293–298. doi:10.1007/s00127-004-0745-5.

    Article  PubMed  Google Scholar 

  49. Solomon, A., Haaga, D., & Arnow, B. (2001). Is clinical depression distinct from subthreshold depressive symptoms? A review of the continuity issue in depression research. The Journal of Nervous and Mental Disease, 189, 498–506. doi:10.1097/00005053-200108000-00002.

    Article  PubMed  CAS  Google Scholar 

  50. Field, T., Hernandez-Reif, M., & Diego, M. (2006). Risk factors and stress variables that differentiate depressed from non-depressed pregnant women. Infant Behavior and Development, 29, 169–174.

    Article  PubMed  Google Scholar 

  51. Stewart, A. L., Dean, M. L., Gregorich, S. E., Brawarsky, P., & Haas, J. S. (2007). Race/ethnicity, socioeconomic status and the health of pregnant women. Journal of Health Psychology, 12, 285–300. doi:10.1177/1359105307074259.

    Article  PubMed  Google Scholar 

  52. Beck, A. T., Steer, R. A., Beck, J. S., & Newman, C. F. (1993). Hopelessness, depression, suicidal ideation and clinical diagnosis of depression. Suicide and Life-threatening Behavior, 23, 139–145.

    PubMed  CAS  Google Scholar 

  53. Cunningham, M., & Zayas, L. H. (2002). Reducing depression in pregnancy: Designing multimodal interventions. Social Work, 47, 114–123.

    PubMed  Google Scholar 

  54. Brown, S. L. (2000). The effect of union type on psychological well-being: Depression among cohabitors versus marrieds. Journal of Health and Social Behavior, 41, 241–255. doi:10.2307/2676319.

    Article  PubMed  CAS  Google Scholar 

  55. CONAPO. (2000). Cuadernos de Salud Reproductiva. Distrito Federal. México: Consejo Nacional de Población (CONAPO)

  56. Alducin, A., et al. (2004). Los valores de los mexicanos (pp. 15–150). México: tomo V Cambio y permanencia. Grupo Financiero Banamex.

    Google Scholar 

  57. Lindahl, V., Pearson, J. L., & Colpe, L. (2005). Prevalence of suicidality during pregnancy and the postpartum. Archives of Women’s Mental Health, 8, 77–87. doi:10.1007/s00737-005-0080-1.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

This work was supported by grants from the Health Resources and Services Administration/Maternal Child Health Bureau (R40 MC 02497) and the Consejo Nacional de Ciencia y Tecnología (CONACyT, Salud–2003-C01.021). Special thanks to Kathryn Schaefer, and the staff and participants at the Mary’s Center for Maternal and Child Care (U.S. site), and staff at Centro de Salud José Castro Villagrana and Casas de Salud (Mexico sites).

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  1. Instituto Nacional de Psiquiatría Ramón de la Fuente, Calzada México-Xochimilco 101. San Lorenzo Huipulco, Tlalpan, Mexico, DF, 14370, Mexico

    Ma. Asunción Lara & Gabriela Letechipia

  2. George Washington University, Washington, DC, USA

    Huynh-Nhu Le & Laila Hochhausen

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  1. Ma. Asunción Lara
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  2. Huynh-Nhu Le
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Lara, M.A., Le, HN., Letechipia, G. et al. Prenatal Depression in Latinas in the U.S. and Mexico. Matern Child Health J 13, 567–576 (2009). https://doi.org/10.1007/s10995-008-0379-4

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