East Carolina University, Greenville, NC, USA.
Matern Child Health J. 2013 Sep;17(7):1277-87. doi: 10.1007/s10995-012-1123-7.
This study examines the potential racial disparity in postpartum depression (PPD) symptoms among a cohort of non-Hispanic white and African American women after taking into consideration the influence of socioeconomic status (SES). Participants (N = 299) were recruited from maternity clinics serving rural counties, with oversampling of low SES and African Americans. The Edinburgh Postnatal Depression Scale (EPDS) was administered 1 and 6 months postpartum, and subjective SES scale at 6 months postpartum. Demographic information was collected during enrollment and 1 month postpartum, with updates at 6 months postpartum. Separate logistic regressions were conducted for 1 and 6 month time points for minor-major PPD (EPDS ≥ 10) and major PPD (EPDS > 12); with marital status, poverty, education, subjective SES, and race predictors entered in block sequence. After including all other predictors, race was not a significant predictor of minor-major or major PPD at 1 or 6 months postpartum. Subjective SES was the most consistent predictor of PPD, being significantly associated with minor-major PPD and major PPD at 6 months postpartum, with higher subjective SES indicating lower odds of PPD, even after accounting for all other predictors. This study shows that significant racial disparities were not observed for minor-major or major PPD criteria at 1 or 6 months postpartum. The most consistent and significant predictor of PPD was subjective SES. Implications of these findings for future research, as well as PPD screening and intervention are discussed.
本研究考察了考虑社会经济地位(SES)影响后,非西班牙裔白人和非裔美国女性产后抑郁症(PPD)症状潜在的种族差异。参与者(N=299)是从服务于农村县的妇产科诊所招募的,对 SES 较低和非裔美国人进行了超额抽样。产后 1 个月和 6 个月时使用爱丁堡产后抑郁量表(EPDS)进行评估,6 个月时使用主观 SES 量表进行评估。人口统计学信息在入组时和产后 1 个月收集,并在产后 6 个月更新。分别对产后 1 个月和 6 个月的轻度-重度 PPD(EPDS≥10)和重度 PPD(EPDS>12)进行逻辑回归分析;将婚姻状况、贫困、教育、主观 SES 和种族预测因素按顺序依次输入。在纳入所有其他预测因素后,种族并不是产后 1 个月或 6 个月时轻度-重度或重度 PPD 的显著预测因素。主观 SES 是 PPD 最一致的预测因素,与产后 6 个月时的轻度-重度 PPD 和重度 PPD 显著相关,主观 SES 越高,PPD 的可能性越低,即使考虑了所有其他预测因素。本研究表明,产后 1 个月或 6 个月时,轻度-重度或重度 PPD 标准没有观察到显著的种族差异。PPD 最一致和最显著的预测因素是主观 SES。讨论了这些发现对未来研究以及 PPD 筛查和干预的意义。