Perinatal Distress and Depression in Culturally and Linguistically Diverse (CALD) Australian Women: The Role of Psychosocial and Obstetric Factors.

Sabrina Naz,Janette Perz,John Eastwood,Kingsley Agho,Sarah Khanlari,Felix Ogbo,Mansi Dhami,Jane Ussher,Anne McKenzie,Andrew Page,Osita Kingsley Ezeh

doi:10.3390/ijerph16162945

Abstract

Perinatal distress and depression can have significant impacts on both the mother and baby. The present study investigated psychosocial and obstetric factors associated with perinatal distress and depressive symptoms among culturally and linguistically diverse (CALD) Australian women in Sydney, New South Wales. The study used retrospectively linked maternal and child health data from two Local Health Districts in Australia (N = 25,407). Perinatal distress was measured using the Edinburgh Postnatal Depression Scale (EPDS, scores of 10–12) and depressive symptoms, with EPDS scores of 13 or more. Multivariate multinomial logistic regression models were used to investigate the association between psychosocial and obstetric factors with perinatal distress and depressive symptoms. The prevalence of perinatal distress and depressive symptoms among CALD Australian women was 10.1% for antenatal distress; 7.3% for antenatal depressive symptoms; 6.2% for postnatal distress and 3.7% for postnatal depressive symptoms. Antenatal distress and depressive symptoms were associated with a lack of partner support, intimate partner violence, maternal history of childhood abuse and being known to child protection services. Antenatal distress and depressive symptoms were strongly associated with postnatal distress and depressive symptoms. Higher socioeconomic status had a protective effect on antenatal and postnatal depressive symptoms. Our study suggests that current perinatal mental health screening and referral for clinical assessment is essential, and also supports a re-examination of perinatal mental health policy to ensure access to culturally responsive mental health care that meets patients’ needs.

Highlights

Worldwide, depression is one of the leading causes of health loss, in terms of disability-adjusted life years
Australian mental health services usually do not adequately capture information on culturally and linguistically diverse (CALD) subgroups [29,30], and generalities of perinatal depression evidence can mask specifics, with the potential for policy-makers and practitioners to design interventions that may not meet patients’ needs. To address these gaps in knowledge, the present study aimed to investigate the psychosocial and obstetric factors related to perinatal distress and depression among Australian CALD women in Sydney, New South Wales
The study investigated the prevalence and psychosocial and obstetric determinants of perinatal distress and depressive symptoms among CALD Australian women who resided in Sydney, Australia between 2014 and 2016

Summary

Introduction

Depression is one of the leading causes of health loss, in terms of disability-adjusted life years. In 2017, depression was the second leading cause of disability-adjusted life years (after low back pain) among Australian women aged 15–49 years [1]. Perinatal depression (the occurrence of depression from conception to 12 months old postpartum) is a major mental health issue among women as it can have substantial health effects on both the mother and baby [1]. Evidence indicates that perinatal depression is associated with low birth weight, behavioural and cognitive problems, as well as delays in childhood language acquisition [2,3,4,5,6]. The effects of perinatal depression may include non-adherence to antenatal care schedule, insomnia, poor appetite and weight gain, and poor social-emotional interaction with other family members. Low risk of suicidal ideation and suicide has been documented in some women who reported perinatal depression [2,3,4,5]

Methods

Results

Discussion

Conclusion