Tan Nasya S, James Tyler G, McKee Kimberly S, Moore Simas Tiffany A, Smith Lauren D, McKee Michael M, Mitra Monika
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Arch Womens Ment Health. 2024 Sep 11. doi: 10.1007/s00737-024-01512-7.
This study aimed to investigate antenatal depression and drug use among deaf and hard-of-hearing (DHH) birthing parents who use American Sign Language (ASL), spoken English, or bilingually both ASL and English.
DHH participants in the United States responded to the Survey on Pregnancy Experiences of Deaf and Hard-of-Hearing Women. Respondents self-reported their antenatal depression diagnoses and drug use (i.e., pain relievers, cannabis, or illicit drugs) during their last pregnancy. Poisson regression models were used to estimate prevalence ratios, adjusting for age, race/ethnicity, education, marital status, and parity.
The average age of respondents (n = 587) was 35 years. Respondents were predominantly non-Hispanic white (80%), college educated (60%), and married (74%). Relative to DHH English-speakers, DHH ASL-users had lower prevalence of reporting antenatal depression diagnosis (aPR = 0.40, 95% CI: 0.23 to 0.72). DHH people who reported antenatal depression diagnosis had higher prevalence of reporting antenatal drug use (PR = 2.34, 95% CI: 1.65 to 3.33). There were no significant associations between preferred language and antenatal drug use.
DHH ASL-users are less likely to report receiving an antenatal depression diagnosis compared to DHH English-speakers. Given well-documented patient-provider communication barriers among DHH ASL-users, it is unclear if the lower prevalence observed in this study is the result of inadequate or inaccessible screening during pregnancy. Future work should consider universal use of linguistically appropriate screening tools for DHH birthing parents in both clinical and research settings.
本研究旨在调查使用美国手语(ASL)、英语口语或同时使用ASL和英语双语的失聪和听力障碍(DHH)生育父母的产前抑郁和药物使用情况。
美国的DHH参与者对《失聪和听力障碍女性怀孕经历调查》做出了回应。受访者自行报告了他们在上次怀孕期间的产前抑郁诊断和药物使用情况(即止痛药、大麻或非法药物)。使用泊松回归模型来估计患病率比,并对年龄、种族/族裔、教育程度、婚姻状况和产次进行了调整。
受访者(n = 587)的平均年龄为35岁。受访者主要是非西班牙裔白人(80%),受过大学教育(60%),且已婚(74%)。相对于说英语的DHH人群,使用ASL的DHH人群报告产前抑郁诊断的患病率较低(aPR = 0.40,95% CI:0.23至0.72)。报告产前抑郁诊断的DHH人群报告产前药物使用的患病率较高(PR = 2.34,95% CI:1.65至3.33)。首选语言与产前药物使用之间没有显著关联。
与说英语的DHH人群相比,使用ASL的DHH人群报告接受产前抑郁诊断的可能性较小。鉴于有充分记录表明DHH使用ASL人群存在医患沟通障碍,目前尚不清楚本研究中观察到的较低患病率是否是由于孕期筛查不足或无法进行筛查所致。未来的工作应考虑在临床和研究环境中普遍使用适合语言需求的筛查工具,用于DHH生育父母。