Nwoke Chinenye Nmanma, Awosoga Oluwagbohunmi A, McDonald Sheila, Bonifacio Glenda T, Leung Brenda M Y
Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
Department of Pediatrics and Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
JMIR Form Res. 2023 Feb 20;7:e43800. doi: 10.2196/43800.
Although there is a significant body of evidence on maternal mental health, an inadequate focus has been placed on African immigrant women. This is a significant limitation given the rapidly changing demographics in Canada. The prevalence of maternal depression and anxiety among African immigrant women in Alberta and Canada, as well as the associated risk factors, are not well understood and remain largely unknown.
The purpose of this study was to investigate the prevalence and associated factors of maternal depression and anxiety among African immigrant women living in Alberta, Canada up to 2 years postpartum.
This cross-sectional study surveyed 120 African immigrant women within 2 years of delivery in Alberta, Canada from January 2020 to December 2020. The English version of the Edinburgh Postnatal Depression Scale-10 (EPDS-10), the Generalized Anxiety Disorder-7 (GAD-7) scale, and a structured questionnaire regarding associated factors were administered to all participants. A cutoff score of 13 on the EPDS-10 was indicative of depression, while a cutoff score of 10 on the GAD-7 scale was indicative of anxiety. Multivariable logistic regression was used to determine the factors significantly associated with maternal depression and anxiety.
Among the 120 African immigrant women, 27.5% (33/120) met the EPDS-10 cutoff score for depression and 12.1% (14/116) met the GAD-7 cutoff score for anxiety. The majority of respondents with maternal depression were younger (18/33, 56%), had a total household income of CAD $60,000 or more (US $45,000 or more; 21/32, 66%), rented their homes (24/33, 73%), had an advanced degree (19/33, 58%), were married (26/31, 84%), were recent immigrants (19/30, 63%), had friends in the city (21/31, 68%), had a weak sense of belonging in the local community (26/31, 84%), were satisfied with their settlement process (17/28, 61%), and had access to a regular medical doctor (20/29, 69%). In addition, the majority of respondents with maternal anxiety were nonrecent immigrants (9/14, 64%), had friends in the city (8/13, 62%), had a weak sense of belonging in the local community (12/13, 92%), and had access to a regular medical doctor (7/12, 58%). The multivariable logistic regression model identified demographic and social factors significantly associated with maternal depression (maternal age, working status, presence of friends in the city, and access to a regular medical doctor) and maternal anxiety (access to a regular medical doctor and sense of belonging in the local community).
Social support and community belonging initiatives may improve the maternal mental health outcomes of African immigrant women. Given the complexities immigrant women face, more research is needed on a comprehensive approach for public health and preventive strategies regarding maternal mental health after migration, including increasing access to family doctors.
尽管有大量关于孕产妇心理健康的证据，但对非洲移民女性的关注不足。鉴于加拿大人口结构的迅速变化，这是一个重大限制。艾伯塔省和加拿大的非洲移民女性中孕产妇抑郁和焦虑的患病率以及相关风险因素尚未得到充分了解，在很大程度上仍然未知。
本研究的目的是调查加拿大艾伯塔省产后两年内的非洲移民女性中孕产妇抑郁和焦虑的患病率及相关因素。
这项横断面研究在2020年1月至2020年12月期间对加拿大艾伯塔省分娩后两年内的120名非洲移民女性进行了调查。向所有参与者发放了爱丁堡产后抑郁量表10项版（EPDS - 10）的英文版本、广泛性焦虑障碍7项量表（GAD - 7）以及一份关于相关因素的结构化问卷。EPDS - 10的临界值为13分表示抑郁，GAD - 7量表的临界值为10分表示焦虑。采用多变量逻辑回归来确定与孕产妇抑郁和焦虑显著相关的因素。
在120名非洲移民女性中，27.5%（33/120）达到了EPDS - 10抑郁临界值，12.1%（14/116）达到了GAD - 7焦虑临界值。大多数患有孕产妇抑郁的受访者年龄较小（18/33，56%），家庭总收入为60,000加元或以上（45,000美元或以上；21/32，66%），租房居住（24/33，73%），拥有高等学位（19/33，58%），已婚（26/31，84%），是新移民（19/30，63%），在城市中有朋友（21/31，68%），在当地社区归属感较弱（26/31，84%），对定居过程满意（17/28，61%），并且能看普通医生（20/29，69%）。此外，大多数患有孕产妇焦虑的受访者不是新移民（9/14，64%），在城市中有朋友（8/13，62%），在当地社区归属感较弱（12/13，92%），并且能看普通医生（7/12，58%）。多变量逻辑回归模型确定了与孕产妇抑郁（产妇年龄、工作状况、在城市中有朋友以及能看普通医生）和孕产妇焦虑（能看普通医生和在当地社区的归属感）显著相关的人口统计学和社会因素。
社会支持和社区归属感倡议可能会改善非洲移民女性的孕产妇心理健康状况。鉴于移民女性面临的复杂性，需要更多关于移民后孕产妇心理健康的公共卫生和预防策略综合方法的研究，包括增加家庭医生的可及性。
