Risks and Resources Associated With Antepartum Risk for Depression Among Rural Southern Women

BACKGROUND: Seven to 13% of American women who are pregnant suffers from major depression and 11%-50% experience antepartum depressive symptoms. OBJECTIVE: To examine the prevalence of depressive symptoms in pregnancy and examine the biopsychosocial-spiritual risks and resources in low-income women of diverse racial/ethnic groups. METHODS: Prenatal interviews were conducted at 16-28 weeks gestation with 324 pregnant women from rural prenatal clinics in the southeastern United States; 43% were African American, 31% were Caucasian, and 26% were Hispanic. Multivariate logistic regression tested the contributions of psychosocial risks and psychosocial and spiritual resources to risk for depression (Beck Depression Inventory-II scores >or=16) for the aggregate and for each racial-ethnic group. RESULTS: Beck Depression Inventory-II scores indicating risk for depression were found in 33% of the women. There were no significant differences in symptom rates among African Americans, Caucasians, and Hispanics (37%, 25%, and 36%, respectively). African American race, abuse, more stress, less social support, less self-esteem, and less spirituality were associated with risk for depression, controlling for sociodemographic factors. DISCUSSION: A third of this diverse group of rural low-income women were at risk for depression in pregnancy. It is vital to screen for depressive symptoms in pregnancy and to identify psychosocial risks and resources associated with risk for depression in order to develop interventions for pregnant women with depressive symptoms.