Czech Katherine A, Hamil Jaime, Taple Bayley J, Ciolino Jody D, Kan Ann, Letkiewicz Allison M, Diebold Alicia, Tandon S Darius
Department of Psychology, University of Denver, 2155 S Race St, Denver, CO, 80210, USA.
Institute for Public Health and Medicine, Center for Community Health, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr, Chicago, IL, 60611, USA.
BMC Pregnancy Childbirth. 2025 Aug 21;25(1):870. doi: 10.1186/s12884-025-08009-w.
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.
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.
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.
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.
在种族和民族多样化以及低收入人群中，意外怀孕与围产期抑郁症之间的关联研究较少。本研究包括对一个低收入且70%为种族和民族少数群体样本的数据进行二次分析，以检验意外怀孕与围产期抑郁症状之间的关联，并探讨社会因素的潜在调节作用。
808名孕妇参与了一项评估产后抑郁症预防干预效果的更大规模研究，并在产前和产后12周使用16项抑郁症状快速量表收集自我报告的抑郁症状。多元线性回归分析了意外怀孕与母亲抑郁症状之间的关系，以及意外怀孕与（1）种族/民族、（2）教育水平、（3）初为人父母状况和（4）产前心理保健利用情况之间的潜在相互作用。分析在整个样本以及种族/民族亚组中进行。
虽然双变量回归显示意外怀孕与产前抑郁症状之间存在显著关联（β = 0.88，95%置信区间[0.27, 1.49]，p = 0.005），但在全样本的调整模型中，意外怀孕与产前或产后抑郁症并无显著关联。分析表明种族/民族亚组存在不同趋势。具体而言，与计划怀孕的人相比，拉丁裔亚组中认可产前心理保健利用且意外怀孕的人产前抑郁症状更高（β = 4.59，95%置信区间[0.60, 8.59]，p = 0.025）。此外，在拉丁裔样本中，与计划怀孕的人相比，意外怀孕的人在产后12周时抑郁症状也更高（β = 1.06；95%置信区间[0.10, 2.03]，p = 0.031）。在任何其他种族/民族亚组的调整模型中，未发现意外怀孕与产前抑郁症状有关联。
这项来自更大规模研究的二次分析表明，意外怀孕与围产期抑郁症状之间的关联在种族/民族亚组中可能存在重要差异。未来的研究在评估种族/民族亚组之间的结果差异时，应认识到低收入且种族和民族多样化的围产期人群所经历的众多压力源和保护因素。
