Mukherjee Soumyadeep, Trepka Mary Jo, Pierre-Victor Dudith, Bahelah Raed, Avent Tenesha
Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
Matern Child Health J. 2016 Sep;20(9):1780-97. doi: 10.1007/s10995-016-1989-x.
Objectives More than 10 % of pregnant women in the United States (U.S.) suffer from depression, which has far-reaching consequences on maternal and fetal well-being. There is conflicting evidence regarding the prevalence of antenatal depression among different race and ethnic groups. This systematic review aimed to summarize the existing literature concerning racial/ethnic disparities in the prevalence and correlates of antenatal depression in the U.S. Methods PubMed, CINAHL and PsycINFO databases were searched online for research studies published in English in peer-reviewed journals until March 2015, using a pre-designed search strategy. Eligibility was determined using pre-specified criteria; and quality was assessed. Results Forty-one (41) articles met the criteria; 13 were cross-sectional, and 21 were longitudinal studies. Overall, the prevalence of antenatal depression was 10-30 %; it was higher among non-Hispanic blacks (NHBs) and Hispanics, compared to non-Hispanic whites (NHWs). Few studies looked at the correlates of depression by race/ethnicity. Among employed women, higher depression scores were observed among NHBs, compared to NHWs; while there was no racial difference among unemployed women. Racial difference and race-employment interaction disappeared once discrimination was accounted for. In another study, higher parity, higher stress, and lower self-esteem were significant correlates of depression among NHBs, while less satisfaction with social support, and higher stress predicted higher depression scores among NHWs and Hispanics respectively. Conclusions The findings of our review suggest that not only is antenatal depression a major public health issue that needs to be addressed, but different racial/ethnic groups seem to differ in their vulnerability and risk factors.
目标 在美国，超过10%的孕妇患有抑郁症，这对母婴健康有着深远影响。关于不同种族和族裔群体中产前抑郁症的患病率，证据存在冲突。本系统评价旨在总结美国现有关于产前抑郁症患病率及相关因素的种族/族裔差异的文献。方法 采用预先设计的检索策略，在PubMed、CINAHL和PsycINFO数据库中在线检索截至2015年3月在同行评审期刊上发表的英文研究。使用预先指定的标准确定纳入标准；并评估质量。结果 41篇文章符合标准；13篇为横断面研究，21篇为纵向研究。总体而言，产前抑郁症的患病率为10% - 30%；与非西班牙裔白人（NHW）相比，非西班牙裔黑人（NHB）和西班牙裔中的患病率更高。很少有研究按种族/族裔探讨抑郁症的相关因素。在就业女性中，与NHW相比，NHB的抑郁得分更高；而失业女性中不存在种族差异。一旦考虑到歧视，种族差异和种族 - 就业交互作用就消失了。在另一项研究中，较高的产次、较高的压力和较低的自尊是NHB中抑郁症的显著相关因素，而对社会支持的较低满意度和较高压力分别预测了NHW和西班牙裔中较高的抑郁得分。结论 我们的综述结果表明，产前抑郁症不仅是一个需要解决的主要公共卫生问题，而且不同种族/族裔群体在其易感性和风险因素方面似乎存在差异。
