The healthy migrant effect and predictors of perinatal depression

Abstract

ProblemAlthough prenatal depression is a risk factor for postpartum depression, current screening tools for prenatal depression fail to predict postpartum depression in some marginalized populations. BackgroundThe assessment of other risk factors along with prenatal depression may be needed to improve prediction of postpartum depression and these risk factors may be specific to immigrants. AimsWe investigated the predictive utility of several measures in relation to postpartum depressive symptoms in: recent immigrants, less recent immigrants and Canadian-born women. MethodsMeasures pertaining to psychosocial risk factors, generalized anxiety, perinatal somatic and depressive symptoms were administered. Data were collected at 4 time-points: 12–14 weeks and 24–28 weeks gestation as well as 1-week and 8-weeks postpartum. Perinatal factors were entered into 3 different regression models to predict postpartum depressive symptoms at the last time-point. FindingsCanadian-born women reported significantly more psychosocial risk factors compared to immigrant women. The best predictors of postpartum depressive symptoms at 8-weeks among Canadian-born women included psychosocial risk, prenatal anxiety and depressive symptoms as well as early postpartum depressive symptoms. Prenatal somatic symptoms predicted postpartum depressive symptoms among recent immigrants. Depressive symptoms at 1-week postpartum and the lack of an emotionally supportive partner were significant predictors of postpartum depressive symptoms for both Canadian-born and immigrant women. DiscussionThere appears to be both overlapping and distinct predictors of postpartum depressive symptoms for immigrant and Canadian-born women. ConclusionThe findings from this research will help guide routine screening options and patient-centered approaches to management of perinatal depression for diverse populations.