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黑人女性在为人父母转变期的歧视经历与产后抑郁严重程度

Experiences of discrimination across the transition to parenthood and postpartum depression severity among Black women.

作者信息

Hipwell Alison, Magee Kelsey, Keenan Kate, Tung Irene, Hill Ashley, Stiller Ashley, Quick Allysa, Levine Michele, Strickland Sierra, Custodio Melanie

机构信息

Department of Psychiatry, https://ror.org/01an3r305University of Pittsburgh, Pittsburgh, PA, USA.

Department of Psychology, https://ror.org/04ehecz88University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Psychol Med. 2025 Jul 17;55:e193. doi: 10.1017/S003329172510113X.

Abstract

BACKGROUND

Postpartum depression is prevalent among Black women and associated with intersecting systemic factors and interpersonal discrimination. However, gaps remain in understanding pregnancy-related changes in discrimination experiences that influence postpartum mental health and could inform preventive interventions. We hypothesized that young Black women would experience increasing levels of discrimination across the transition to parenthood, heightening depression risk relative to non-pregnant peers.

METHODS

Participants comprised 335 Black primiparous women (ages 17-30 at delivery) and 335 age- and discriminationmatched non-pregnant controls from the Pittsburgh Girls Study. Self-reported discrimination experiences were collected at four timepoints: two years pre-pregnancy, one year pre-pregnancy, pregnancy, and one year postpartum for the childbearing sample, with corresponding data from the non-pregnant sample across the same interval (matched pairwise).

RESULTS

Linear increases in discrimination were observed for the nonpregnant participants ( = .480, SE = .090, <.001), while childbearing participants showed no overall changes, though younger age predicted greater increases over time. For childbearing participants, both baseline discrimination ( = .626, = .077, < .001) and increasing discrimination ( = 2.55, = .939, < .01) predicted postpartum depressive symptoms, controlling for pre-pregnancy depression. Among non-pregnant participants, only baseline discrimination predicted later depression ( = .912, = .081, < .001).

CONCLUSIONS

Experiencing increasing levels of interpersonal discrimination across the transition to parenthood may heighten postpartum depression risk among young Black women, indicating a need for interventions supporting well-being and promoting resilience before, during and after pregnancy.

摘要

背景

产后抑郁症在黑人女性中很普遍,且与相互交织的系统性因素和人际歧视有关。然而,在理解影响产后心理健康的歧视经历中与怀孕相关的变化方面仍存在差距,这些变化可为预防性干预措施提供依据。我们假设,年轻黑人女性在向为人父母的转变过程中会经历越来越多的歧视,相对于未怀孕的同龄人,这会增加抑郁风险。

方法

参与者包括335名黑人初产妇(分娩时年龄在17至30岁之间)和335名来自匹兹堡女孩研究的年龄和歧视情况相匹配的未怀孕对照者。在四个时间点收集自我报告的歧视经历:生育样本在怀孕前两年、怀孕前一年、怀孕期间和产后一年,未怀孕样本在相同时间段内有相应数据(成对匹配)。

结果

未怀孕参与者的歧视呈线性增加(β = 0.480,标准误 = 0.090,P < 0.001),而生育参与者总体上没有变化,不过年龄较小者随着时间推移增加幅度更大。对于生育参与者,在控制怀孕前抑郁的情况下,基线歧视(β = 0.626,标准误 = 0.077,P < 0.001)和歧视增加(β = 2.55,标准误 = 0.939,P < 0.01)均预测产后抑郁症状。在未怀孕参与者中,只有基线歧视预测后来的抑郁(β = 0.912,标准误 = 0.081,P < 0.001)。

结论

在向为人父母的转变过程中经历越来越多的人际歧视可能会增加年轻黑人女性产后抑郁的风险,这表明需要在怀孕前、怀孕期间和产后提供支持幸福感和促进复原力的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/281a/12315650/6921c7958de8/S003329172510113X_fig1.jpg

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