Unplanned pregnancy and perinatal depression: secondary exploratory analyses from a racially and ethnically diverse, low-income sample of birthing people in the United States.

BACKGROUND

The association between unplanned pregnancy and perinatal depression is understudied in racially and ethnically diverse and low-income populations. The present study was compromised of a secondary analysis of data from a low-income and 70% racially and ethnically minoritized sample to examine associations between unplanned pregnancy and perinatal depressive symptoms and to explore potential moderation by social factors.

METHODS

Pregnant individuals (n = 808) were enrolled in a larger study evaluating the effectiveness of a preventative intervention for postpartum depression, and self-reported depressive symptoms were collected prenatally and at 12 weeks postpartum using the 16-item Quick Inventory of Depressive Symptomatology. Multiple linear regression examined the relationship between unplanned pregnancy and maternal depressive symptoms, and the potential interactions between unplanned pregnancy and (1) race/ethnicity (2), education level (3), first-time parent status, and (4) a prenatal mental healthcare utilization. Analyses were conducted both within the sample as a whole and within racial/ethnic subgroups.

RESULTS

While bivariate regression revealed a significant association between unplanned pregnancy and prenatal depressive symptoms (β = 0.88, 95% CI [0.27, 1.49], p = 0.005), unplanned pregnancy was not significantly associated with prenatal or postpartum depression in adjusted models in the full sample. Analyses suggested different trends in racial/ethnic subgroups. Specifically, endorsing prenatal mental healthcare utilization and unplanned pregnancy was associated with higher prenatal depressive symptoms in the Latine subgroup compared to those whose pregnancies were planned (β = 4.59, 95% CI [0.60, 8.59], p = 0.025). Additionally, unplanned pregnancy was associated with higher depressive symptoms at 12 weeks postpartum compared to those with planned pregnancy also in the Latine sample (β = 1.06; 95% CI [0.10, 2.03], p = 0.031). Unplanned pregnancy was not found to be associated with prenatal depressive symptoms in the adjusted models of any other racial/ethnic subgroups.

CONCLUSIONS

These secondary analyses from a larger study suggest potentially important differences in the association between unplanned pregnancy and perinatal depressive symptoms by racial/ethnic subgroups. Future research should acknowledge the myriad stressors and protective factors experienced by low-income and racially and ethnically diverse perinatal populations when evaluating differences in outcomes among racial/ethnic subgroups.