Understanding Depressive Symptoms among High-Risk, Pregnant, African-American Women

Abstract

Purpose Depression has been shown to be a risk factor of poor pregnancy outcomes among African-American women. The goal of this study was to examine both risk and protective factors of depressive symptoms among urban, high-risk African-American, pregnant women. Methods Data were drawn from a larger randomized controlled trial, Health Outcomes of Pregnancy Education that was a part of the National Institutes of Health–DC Initiative to Reduce Infant Mortality in Minority Populations in the District of Columbia. For purposes of the present study, a sample of African-American pregnant women ( n = 1,044) were recruited from six urban prenatal care clinics. Baseline depressive symptoms were assessed using the Hopkins Symptom Checklist-Depression Scale. Results Forty-four percent of women were confirmed as moderately to severely depressed at baseline. In multivariate linear regression analysis among the total sample, maternal age, intimate partner violence, illicit drug and alcohol use during pregnancy, and reproductive history (no live birth/only loss; no live birth/no loss) were associated with increased depressive symptoms. Being very happy about the pregnancy, having emotional support from others, and reporting more positive expectancies about the ability to regulate negative moods were associated with decreased depressive symptoms. Conclusion Results highlight the importance of attending to the context of high-risk, African-American, pregnant women, paying attention to both risk and protective factors of poor psychological well-being. Implications for future research in this area are discussed.