Lau Elizabeth, Adams Yenupini Joyce
MCN Am J Matern Child Nurs. 2023;48(6):326-333. doi: 10.1097/NMC.0000000000000955.
To evaluate the predictors of postpartum depression and to examine the effects of maternal racial identity on postpartum depression among women with low incomes in the United States.
We conducted a secondary data analysis using baseline data from the Baby's First Years study, including postpartum women living below the federal poverty line who were recruited from four diverse communities in the United States. Postpartum depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were performed to identify associations between pre-identified postpartum depression risk factors and postpartum depression among participants, followed by predictive margins analyses to elaborate on probability of postpartum depression across different racial identity groups in the sample.
The sample included 1,051 postpartum women. Almost one-half of participants identified as Black (45.9%), followed by White (20.7%), American Indian (1.8%), and Asian (1.3%). Prevalence of postpartum depression in the sample was 24%. Financial insecurity and alcohol use were positively associated with postpartum depression, whereas level of education and reported physical health were negatively associated with postpartum depression. Mothers who identified as Black had an 8.3% higher probability of postpartum depression than that of White mothers in the sample.
Nurses working with populations with low income should assess social determinants of health to provide holistic mental health care. Women with low incomes should be referred to resources which account for their financial burden. Racial disparities exist in perinatal care, and birth and postpartum mental health outcomes. It is crucial to address the systemic racism faced by Black mothers experiencing postpartum depression.
评估产后抑郁的预测因素，并研究在美国低收入女性中，母亲的种族身份对产后抑郁的影响。
我们使用了“宝宝的第一年”研究中的基线数据进行二次数据分析，该研究对象包括从美国四个不同社区招募的、生活在联邦贫困线以下的产后女性。产后抑郁症状采用流行病学研究中心抑郁量表（CES-D）进行评估。进行逻辑回归分析，以确定预先确定的产后抑郁风险因素与参与者产后抑郁之间的关联，随后进行预测边际分析，以详细阐述样本中不同种族身份群体产后抑郁的概率。
样本包括1051名产后女性。几乎一半的参与者被认定为黑人（45.9%），其次是白人（20.7%）、美国印第安人（1.8%）和亚洲人（1.3%）。样本中产后抑郁的患病率为24%。经济不安全和饮酒与产后抑郁呈正相关，而教育水平和报告的身体健康状况与产后抑郁呈负相关。在样本中，认定为黑人的母亲产后抑郁的概率比白人母亲高8.3%。
为低收入人群提供护理的护士应评估健康的社会决定因素，以提供全面的心理健康护理。低收入女性应被转介到考虑到其经济负担的资源处。围产期护理、分娩和产后心理健康结果方面存在种族差异。解决产后抑郁的黑人母亲所面临的系统性种族主义至关重要。
