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Course of Depressive Symptoms across Pregnancy in African American Women
Author(s) -
Wilusz Matthew J.,
Peters Rosalind M.,
CassidyBushrow Andrea E.
Publication year - 2013
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/jmwh.12057
Subject(s) - depression (economics) , medicine , center for epidemiologic studies depression scale , african american , pregnancy , depressive symptoms , antenatal depression , obstetrics , demography , mental health , epidemiology , third trimester , gestation , psychiatry , anxiety , sociology , biology , economics , macroeconomics , history , ethnology , genetics
Although African American women are at increased risk for antenatal depression, less is known regarding the course of antenatal depression symptoms among African American women. Because pregnancy is a state of rapid physical and mental changes, we examined if depression symptoms changed between the second and third trimesters in a sample of pregnant African American women. Methods A nonprobability sample of women was recruited from obstetrics clinics within a large Midwestern health system. African American women in their second trimester (N = 189) completed an initial study visit; a convenience sample of 37 women (19.6%) completed a second identical study visit during their third trimester. The 20‐item Center for Epidemiological Studies Depression Scale (CES‐D) was used to measure depressive symptoms; a CES‐D score of 16 or higher equates with clinical depression and a CES‐D score of 23 or higher indicates major depression. Paired t tests and correlation coefficients were used to estimate change in depression symptoms. Results Mean (SD) second‐ and third‐trimester CES‐D scores were not statistically significantly different (15.3 [10.6] and 15.1 [10.3], respectively; P = .87) and were moderately and significantly correlated ( r = 0.65; P <.001). Prevalence of CES‐D scores of 16 or higher was 43.2% (n = 16) in the second trimester and 37.8% (n = 14) in the third trimester, which was not significantly different ( P = .77). Between the 2 visits, 67.6% (n = 25) were classified identically with a CES‐D scores of 16 or higher with only fair agreement between the 2 measures (kappa = 0.33). Prevalence of CES‐D scores of 23 or higher was 27.0% (n = 10) and 21.6% (n = 8) in the second and third trimesters, respectively, and was not significantly different ( P = .69). Between the 2 visits, 83.8% (n = 31) were classified identically with CES‐D scores of 23 or higher, with moderate agreement between the 2 measures (kappa = 0.56). Discussion Depression symptoms were relatively constant across the latter 2 trimesters of pregnancy. The second trimester may be an appropriate time to screen women for antenatal depression, as it is less likely to be affected by early‐pregnancy somatic events yet is early enough that intervention may impart positive health benefits for mother and child.