Depressive and Anxiety Symptoms in Pregnancy:Associations with maternal characteristics and infant birth weight among American Indians in the Northern Plains

American Indian;mental health;pregnancy;birth outcomes;Public Health Studies

Around Him, Deana MarieDiener-West, Marie ;

Johns Hopkins University

关键词: American Indian;    mental health;    pregnancy;    birth outcomes;    Public Health Studies;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/60292/AROUNDHIM-DISSERTATION-2014.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Objective:A growing body of research suggests that poor mental health in pregnancy may have consequences for birth outcomes.Data on the mental health of pregnant American Indian women is limited; however, studies of non-pregnant women suggest higher rates of depression and anxiety related disorders than for White women.American Indian women in the Northern Plains face health and social challenges in everyday life and often begin childbearing at a young age.The objective of this dissertation was to identify maternal characteristics associated with symptoms of depression and anxiety in pregnancy, and explore the relation of these symptoms with birth outcomes among American Indian women in the Northern Plains.This research also compared these relations with those for White women from the same region.Methods:This study was conducted with Safe Passage Study data from 4,003 pregnant American Indian and White women recruited at health facilities in three urban and two American Indian reservations in the Northern Plains between 2007 and 2013.Statistical analyses included descriptive statistics, factor analysis of the Edinburgh Postnatal Depression Scale (EPDS) and Spielberger State-Trait Anxiety Inventory (STAI), and multivariable logistic and linear regression.Results:American Indian women had significantly higher rates of depressive, state anxiety, and trait anxiety symptoms than White women; however, after adjustment for socio-demographic characteristics, pre-pregnancy health, reproductive history, and behavior in pregnancy, being American Indian was only significantly associated with an increase in the odds of state anxiety symptoms.Characteristics associated with increased odds of mental health symptoms among American Indian women included:having a history of depression, smoking in pregnancy, being in a partnered versus married relationship, being multiparous, living in a crowded home, having two or more moves in the last 12 months, and having less than a high school education.Similar characteristics were also significant for White women, and the associations for maternal age and history of anemia were significantly different across race.For the association between mental health symptoms and birth weight, depressive, state anxiety, and trait anxiety symptoms experienced during pregnancy were associated with a non-significant decrease in mean birth weight for American Indians and Whites; however, state anxiety symptoms were associated with a significant increase in mean birth weight among American Indians with one or more prior pregnancy losses.The association of state anxiety symptoms and birth weight differed significantly for American Indians and Whites.Additional maternal characteristics significantly associated with infant birth weight among American Indians included:pre-pregnancy body mass index, prior high birth weight delivery (>4,000g), prior preterm and/or low birth weight delivery (<2,500g), maternal age, and maternal education.Similar characteristics were also significant for Whites.Conclusions:Variation in mental health symptoms between pregnant American Indians and Whites in the Northern Plains is mostly accounted for by differences in characteristics other than race.Decreases in mean birth weight associated with mental health symptoms tended to not be significant, although future studies with improved data and validated instruments are needed.This study is the first to describe the associations of interest among pregnant American Indians in the Northern Plains.Advisor:Donna Strobino, Ph.D.