Is Perceived Discrimination in Pregnancy Prospectively Linked to Postpartum Depression? Exploring the Role of Education

Štěpáníková, Irena; Kukla, Lubomír

doi:10.1007/s10995-016-2259-7

Cited by 20 publications

(13 citation statements)

References 66 publications

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“…We identified perceived discrimination as a strong predictor of depressive symptoms during pregnancy. This finding is consistent with previous research conducted among pregnant women in the Czech Republic which showed that perceived discrimination was associated with increased odds of postpartum depression [37]. Similarly, a population-based study of young (ages [18][19][20] women in the Midwest region of the U.S. found a positive association between discrimination and depressive symptoms [38].…”

Section: Plos Onesupporting

confidence: 91%

Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis

et al. 2020

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Pregnant women who experience psychosocial stressors, such as stressful life events, poor neighborhood quality, and financial hardship, are at an increased risk for adverse pregnancy outcomes. Yet, few studies have examined associations between multiple stressors from different sources, which may be helpful to better inform causal pathways leading to adverse birth outcomes. Using path analysis, we examined associations between multiple selfreported stressor exposures during and before pregnancy in the Chemicals in Our Bodies-2 study (N = 510), a demographically diverse cohort of pregnant women in San Francisco. We examined associations between eight self-reported exposures to stressors and three responses to stress which were assessed via interview questionnaire at the 2 nd trimester. Stressors included: neighborhood quality, stressful life events, caregiving, discrimination, financial strain, job strain, food insecurity, and unplanned pregnancy. Perceived stress, depression, and perceived community status were included as indicators of self-reported stress response. Our model indicated that women who experienced discrimination and food insecurity had a 3.76 (95% confidence interval [CI] = 1.60, 5.85) and 2.67 (95% CI = 1.31, 4.04) increase in depression scale scores compared to women who did not experience discrimination and food insecurity, respectively. We additionally identified job strain and caregiving for an ill family member as strong predictors of increased depressive symptoms (β = 1.63, 95% CI = 0.29, 3.07; β = 1.48, 95% CI = 0.19, 2.70, respectively). Discrimination, food insecurity, and job strain also influenced depression indirectly through the mediating pathway of increasing perceived stress, although indirect effects were less precise. In our study population, women who experienced discrimination, food insecurity, job strain and caregiving for an ill family member had an increased number of depressive symptoms compared to women who did not experience these stressors. Results from our study highlight the complex relationships between stressors and stress responses and may help to identify possible mediating pathways leading to adverse pregnancy outcomes.

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Section: Plos Onesupporting

confidence: 91%

Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis

et al. 2020

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“…In a population of British women, it showed relative stability between pregnancy and years eight to eleven postpartum and a slight increase between years eleven and eighteen [35]. EPDS has been used in high-, middle-, and low-income countries, including the Czech Republic [36][37][38][39][40][41]. The present study used EPDS scores collected at baseline (midpregnancy), after delivery, at child age six months, eighteen months, three years, five years, seven years, and eleven years.…”

Section: Implications Of All the Available Evidencementioning

confidence: 99%

Gender discrimination and depressive symptoms among child-bearing women: ELSPAC-CZ cohort study

et al. 2020

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Background: Depression is approximately two-fold more prevalent among women than men. Social theories suggest that discrimination is a pathway through which gender inequalities affect women's lives, but data are lacking. This cohort study evaluates whether perceived gender discrimination is linked to depressive symptoms among child-bearing women. Methods: Data were obtained from 4,688 participants enrolled in pregnancy in 1991À92 in the European Longitudinal Cohort Study of Pregnancy and Childhood, Czech Republic. Perceived gender discrimination was assessed in mid-pregnancy, year seven, and year eleven. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale at eight time-points between mid-pregnancy and year eleven postdelivery. Linear mixed error-component models of depressive symptoms were estimated. Findings: Perceived gender discrimination, reported by 10.7% of women, was related to higher depressive symptoms, both in the unadjusted analysis (b = 0.15 [95% confidence interval (CI): 0.12, 0.19], p < 0.001) and in the fully adjusted model (b = 0.12 [95% CI: 0.09, 0.16], p < 0.001). Covariates linked to higher depressive symptoms included financial hardship (b = 0.12 [95% CI: 0.10, 0.14], p < 0.001), childhood emotional/physical neglect (b = 0.18 [95% CI: 0.14, 0.22], p < 0.001), and childhood sexual abuse (b = 0.04 [95% CI: 0.03, 0.06], p < 0.001); an inverse relationship was evident for social support (À0.05 [95% CI: À0.07, À0.04], p < 0.001) and having a partner who performs female-stereotypical household tasks (b=À0.03 [95% CI: À0.05, À0.01], p = 0.001). Interpretation: The findings provide the first evidence that perceived gender discrimination is associated with depressive symptoms among child-bearing women. Social intervention programs aimed at reducing gender discrimination can potentially contribute to better mental health of women. Funding: Bill and Melinda Gates Foundation.

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“…Previous research, mainly from Western countries (the US, Europe or New-Zealand), showed that discrimination is associated with increased risk of health problems during pregnancy and after birth [26], including postpartum depression (PPD) [27–29]. PPD is a serious public health issue faced by almost one fifth of new mothers in Western countries [30] and up to two thirds in non-Western countries [31].…”

Section: Introductionmentioning

confidence: 99%

Multiple forms of discrimination and postpartum depression among indigenous Palestinian-Arab, Jewish immigrants and non-immigrant Jewish mothers

et al. 2019

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BackgroundWhile discrimination takes multiple forms, racial or ethnic discrimination is a root cause of this health-damaging social phenomenon. We drew on intersectionality theory, which offers an account of discrimination’s multiple effects, to consider associations between women’s experiences of discrimination and postpartum depression (PPD) using four measures: single forms of discrimination (SFD); multiple forms of discrimination (MFD); ethnic discrimination combined with MFD (E-MFD); and a composite MFD that interacted with women’s identity (C-MFD).MethodsWe interviewed a stratified sample of 1128 mothers face to face in 2014–2015 during mothers’ visits to maternal and child health clinics. The mothers belonged to three groups in Israel: Palestinian-Arab minority, Jewish immigrant, and non-immigrant Jewish. We conducted unadjusted and adjusted logistic regressions for PPD, measured on the Edinburgh Postnatal Depression Scale, in associations with SFD (experiencing discrimination based on any of the following: age, sex, class, ethno-national identity, religiosity level and skin color); MFD (experiencing 0,1, 2 or ≥ 3 of SFD); E-MFD (ethnic discrimination combined with other MFD); and finally, C-MFD (interaction between MFD and women’s identity).ResultsPalestinian-Arab mothers had higher PPD and reported higher SFD (based on ethnicity, religiosity level, and socioeconomic status), as well as higher MFD and E-MFD. This was followed by Jewish immigrant mothers, and lastly by non-immigrant Jewish mothers. However, both MFD and E-MFD had a strong association with PPD among non-immigrant Jewish mothers reporting 2MFD and ≥ 3MFD, and Palestinian-Arab mothers reporting ≥3MFD, but no significant association among immigrant Jewish mothers. When we used C-MFD, we found a dose-response association in which Palestinian-Arab mothers experiencing more MFD (2MFD and ≥ 3MFD) were more likely to experience PPD. This was followed by immigrant Jewish mothers (reporting 2MFD and ≥ 3MFD), and lastly by non-immigrant Jewish mothers.ConclusionsMFD should be considered in relation to women’s identity (being part of a minority, immigrant, or non-immigrant majority group) in maternal mental health research and practice. Otherwise, we risk underestimating the effects of MFD on PPD, especially in minority and immigrant mothers, who are more likely to face interlocking forms of discrimination.

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Is Perceived Discrimination in Pregnancy Prospectively Linked to Postpartum Depression? Exploring the Role of Education

Cited by 20 publications

References 66 publications

Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis

Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis

Gender discrimination and depressive symptoms among child-bearing women: ELSPAC-CZ cohort study

Multiple forms of discrimination and postpartum depression among indigenous Palestinian-Arab, Jewish immigrants and non-immigrant Jewish mothers

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