Ringenary Haley L, Froelich Jessilyn M, Njoroge Wanjikũ F M, Gerstein Emily D
Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Matern Child Health J. 2025 Feb;29(2):183-193. doi: 10.1007/s10995-025-04055-0. Epub 2025 Jan 18.
Development of postpartum depressive symptoms (PDS) is influenced by many social determinants of health, including income, discrimination, and other stressful life experiences. Early recognition of PDS is essential to reduce its long-term impact on mothers and their children, but postpartum checkups are highly underutilized. This study examined how stressful life experiences and race-based discrimination influence PDS development and whether or not a women has a postpartum checkup.
Pregnancy Risk Assessment Monitoring System (2016-2022) was used for secondary data analysis of mothers from 9 sites (n = 8,851). Stressful life experiences prior to birth, race-based discrimination, PDS, and postpartum checkup data were collected using the PRAMS questionnaire. Covariates were collected using primarily birth certificate data.
Women of multiple races and ethnicities were significantly more likely to experience PDS if they reported a greater number of stressful life experiences. Women of multiple races and ethnicities were more likely to experience PDS if they reported experiencing race-based discrimination, with Asian women having nearly 8 times greater odds. Black and Hispanic women were less likely to have a postpartum checkup if they reported a greater number of stressors. Black women were less likely to have a postpartum checkup if they had previously experienced race-based discrimination.
The influence of race-based discrimination was seen across a diverse group of races and ethnicities. Findings highlight the need to expand questionnaires focused on social determinants of health, specifically discrimination, in PRAMS to all 50 states to better assess their significant consequences for maternal wellbeing.
产后抑郁症状（PDS）的发展受到许多健康的社会决定因素的影响，包括收入、歧视和其他压力性生活经历。早期识别PDS对于减少其对母亲及其子女的长期影响至关重要，但产后检查的利用率极低。本研究调查了压力性生活经历和基于种族的歧视如何影响PDS的发展，以及女性是否进行产后检查。
使用妊娠风险评估监测系统（2016 - 2022年）对来自9个地点的母亲（n = 8851）进行二次数据分析。使用PRAMS问卷收集出生前的压力性生活经历、基于种族的歧视、PDS和产后检查数据。协变量主要使用出生证明数据收集。
如果多种族和族裔的女性报告有更多压力性生活经历，她们患PDS的可能性显著更高。如果多种族和族裔的女性报告经历过基于种族的歧视，她们患PDS的可能性更大，亚洲女性的患病几率几乎高出8倍。如果黑人和西班牙裔女性报告有更多压力源，她们进行产后检查的可能性较小。如果黑人女性以前经历过基于种族的歧视，她们进行产后检查的可能性较小。
在不同种族和族裔群体中都发现了基于种族的歧视的影响。研究结果强调需要将PRAMS中侧重于健康的社会决定因素，特别是歧视的问卷扩展到所有50个州，以更好地评估其对孕产妇健康的重大影响。
