Skip to main content

Advertisement

Log in

Disparities in Self-Reported Postpartum Depression among Asian, Hawaiian, and Pacific Islander Women in Hawaii: Pregnancy Risk Assessment Monitoring System (PRAMS), 2004–2007

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Postpartum depression affects 10–20% of women and causes significant morbidity and mortality among mothers, children, families, and society, but little is known about postpartum depression among the individual Asian and Pacific Islander racial/ethnic groups. This study sought to indentify the prevalence of postpartum depression among common Asian and Pacific Islander racial/ethnic groups. Data from the Hawaii Pregnancy Risk Assessment and Monitoring System (PRAMS), a population-based surveillance system on maternal behaviors and experiences before, during, and after the birth of a live infant, were analyzed from 2004 through 2007 and included 7,154 women. Questions on mood and interest in activities since giving birth were combined to create a measure of Self-reported Postpartum Depressive Symptoms (SRPDS). A series of generalized logit models with maternal race or ethnicity adjusted for other sociodemographic characteristics evaluated associations between SRPDS and an intermediate level of symptoms as possible indicators of possible SRPDS. Of all women in Hawaii with a recent live birth, 14.5% had SRPDS, and 30.1% had possible SRPDS. The following Asian and Pacific Islander racial or ethnic groups were studied and found to have higher odds of SRPDS compared with white women: Korean (adjusted odds ratio [AOR] = 2.8;95% confidence interval [CI]: 2.0–4.0), Filipino (AOR = 2.2;95% CI: 1.7–2.8), Chinese (AOR = 2.0;95% CI: 1.5–2.7), Samoan (AOR = 1.9;95% CI: 1.2–3.2), Japanese (AOR = 1.6;95% CI: 1.2–2.2), Hawaiian (AOR = 1.7;95% CI: 1.3–2.1), other Asian (AOR = 3.3;95% CI: 1.9–5.9), other Pacific Islander (AOR = 2.2;95% CI: 1.5–3.4), and Hispanic (AOR = 1.9;95% CI: 1.1–3.4). Women who had unintended pregnancies (AOR = 1.4;95% CI: 1.2–1.6), experienced intimate partner violence (AOR = 3.7;95% CI: 2.6–5.5), smoked (AOR = 1.5;95% CI: 1.2–2.0), used illicit drugs (AOR = 1.9;95% CI: 1.3–3.9), or received Women, Infant, and Children (WIC) benefits during pregnancy (AOR = 1.4;95% CI: 1.2–2.6) were more likely to have SRPDS. Several groups also were at increased risk for possible SRPDS, although this risk was not as prominent as seen with the risk for SRPDS. One in seven women reported SRPDS, and close to a third reported possible SRPDS. Messages about postpartum depression should be incorporated into current programs to improve screening, treatment, and prevention of SRPDS for women at risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., et al. (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA, 289(23), 3095–3105.

    Article  PubMed  Google Scholar 

  2. Bromberger, J. T. (2004). A psychosocial understanding of depression in women: For the primary care physician. Journal of the American Medical Women’s Association, 59(3), 198–206.

    PubMed  Google Scholar 

  3. Ingram, R., Scott, W., & Siegle, G. (1999). Depression: Social and cognitive aspects. In T. Millon, P. H. Blaney, & R. D. Davis (Eds.), Oxford textbook of psychopathology (pp. 203–226). New York: Oxford University.

    Google Scholar 

  4. Desai, H. D., & Jann, M. W. (2000). Major depression in women: A review of the literature. Journal of the American Pharmaceutical Association, 40(4), 525–537.

    CAS  PubMed  Google Scholar 

  5. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.

    Article  PubMed  Google Scholar 

  6. Kornstein, S. G. (2001). The evaluation and management of depression in women across the life span. Journal of Clinical Psychiatry, 62(Suppl 24), 11–17.

    PubMed  Google Scholar 

  7. Josefsson, A., Berg, G., Nordin, C., & Sydsjo, G. (2001). Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstetricia et Gynecologica Scandinavica, 80(3), 251–255.

    CAS  PubMed  Google Scholar 

  8. Miller, L. J. (2002). Postpartum depression. JAMA, 287(6), 762–765.

    Article  PubMed  Google Scholar 

  9. Dietz, P. M., Williams, S. B., Callaghan, W. M., Bachman, D. J., Whitlock, E. P., & Hornbrook, M. C. (2007). Clinically identified maternal depression before, during, and after pregnancies ending in live births. American Journal of Psychiatry, 164(10), 1515–1520.

    Article  PubMed  Google Scholar 

  10. Chung, E. K., McCollum, K. F., Elo, I. T., Lee, H. J., & Culhane, J. F. (2004). Maternal depressive symptoms and infant health practices among low-income women. Pediatrics, 113(6), e523–e529.

    Article  PubMed  Google Scholar 

  11. Minkovitz, C. S., Strobino, D., Scharfstein, D., Hou, W., Miller, T., Mistry, K. B., et al. (2005). Maternal depressive symptoms and children’s receipt of health care in the first 3 years of life. Pediatrics, 115(2), 306–314.

    Article  PubMed  Google Scholar 

  12. Brown, C., Schulberg, H. C., Sacco, D., Perel, J. M., & Houck, P. R. (1999). Effectiveness of treatments for major depression in primary medical care practice: A post hoc analysis of outcomes for African American and white patients. Journal of Affective Disorders, 53(2), 185–192.

    Article  CAS  PubMed  Google Scholar 

  13. Gaynes, B. N., Gavin, N., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner, G., et al. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Evidence Report/Technology Assessment (Summary), 119, 1–8.

    Google Scholar 

  14. Rollman, B. L., Gilbert, T., Lowe, H. J., Kapoor, W. N., & Schulberg, H. C. (1999). The electronic medical record: Its role in disseminating depression guidelines in primary care practice. International Journal of Psychiatry in Medicine, 29(3), 267–286.

    Article  CAS  PubMed  Google Scholar 

  15. Whooley, M. A., & Simon, G. E. (2000). Managing depression in medical outpatients. New England Journal of Medicine, 343(26), 1942–1950.

    Article  CAS  PubMed  Google Scholar 

  16. Population Division, U.S. Census Bureau. (2008). Annual estimates of the population by sex, race, and Hispanic origin: April 1, 2000 to July 1, 2007. Available online at http://quickfacts.census.gov [accessed June 26, 2009].

  17. Reeves, T. & Bennett, C. (2003). The Asian and Pacific Islander Population in the United States: March 2002. In: Current Population Reports, P20-540. Washington, DC: U.S. Census Bureau.

  18. Reeves, T.J., & Bennett, C.E. (2004). We the people: Asians in the United States. In Census 2000 brief, CENSR-17. U.S. Census Bureau.

  19. Bostock, J., Marsen, M., Sarwar, Z., & Stoltz, S. (1996). Postnatal depression in Asian women. Community Nurse, 2(10), 34–36.

    CAS  PubMed  Google Scholar 

  20. Goyal, D., Murphy, S. O., & Cohen, J. (2006). Immigrant Asian Indian women and postpartum depression. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35(1), 98–104.

    Article  PubMed  Google Scholar 

  21. Hau, F. W., & Levy, V. A. (2003). The maternity blues and Hong Kong Chinese women: An exploratory study. Journal of Affective Disorders, 75(2), 197–203.

    Article  PubMed  Google Scholar 

  22. Hearn, G., Iliff, A., Jones, I., Kirby, A., Ormiston, P., Parr, P., et al. (1998). Postnatal depression in the community. The British Journal of General Practice, 48(428), 1064–1066.

    CAS  PubMed  Google Scholar 

  23. Huang, Z. J., Wong, F. Y., Ronzio, C. R., & Yu, S. M. (2007). Depressive symptomatology and mental health help-seeking patterns of U.S.- and foreign-born mothers. Maternal and Child Health Journal, 11(3), 257–267.

    Article  PubMed  Google Scholar 

  24. Berg, A. O. (2002). Screening for depression: Recommendations and rationale. The American Journal of Nursing, 102(7), 77–80.

    PubMed  Google Scholar 

  25. Corson, K., Gerrity, M. S., & Dobscha, S. K. (2004). Screening for depression and suicidality in a VA primary care setting: 2 items are better than 1 item. The American Journal of Managed Care, 10((11 Pt 2)), 839–845.

    PubMed  Google Scholar 

  26. Li, C., Friedman, B., Conwell, Y., & Fiscella, K. (2007). Validity of the Patient Health Questionnaire 2 (PHQ-2) in identifying major depression in older people. Journal of the American Geriatrics Society, 55(4), 596–602.

    Article  PubMed  Google Scholar 

  27. Lowe, B., Kroenke, K., & Grafe, K. (2005). Detecting and monitoring depression with a two-item questionnaire (PHQ-2). Journal of Psychosomatic Research, 58(2), 163–171.

    Article  PubMed  Google Scholar 

  28. Whooley, M. A., Avins, A. L., Miranda, J., & Browner, W. S. (1997). Case-finding instruments for depression. Two questions are as good as many. Journal of General Internal Medicine, 12(7), 439–445.

    Article  CAS  PubMed  Google Scholar 

  29. Sorenson, C. A., Wood, B., & Prince, E. W. (2003). Race and ethnicity data: Developing a common language for public health surveillance in Hawaii. Californian Journal of Health Promotion, 1((Special Issue: Hawaii)), 91–104.

    Google Scholar 

  30. Centers for Disease Control and Prevention. (2008). Prevalence of self-reported postpartum depressive symptoms—17 states, 2004–2005. Morbidity and Mortality Weekly Report, 57(14), 361–366.

    Google Scholar 

  31. Carroll, J. C., Reid, A. J., Biringer, A., Midmer, D., Glazier, R. H., Wilson, L., et al. (2005). Effectiveness of the Antenatal Psychosocial Health Assessment (ALPHA) form in detecting psychosocial concerns: A randomized controlled trial. Canadian Medical Association Journal, 173(3), 253–259.

    Article  PubMed  Google Scholar 

  32. Abbott, M. W., & Williams, M. M. (2006). Postnatal depressive symptoms among Pacific mothers in Auckland: Prevalence and risk factors. The Australian and New Zealand Journal of Psychiatry, 40(3), 230–238.

    PubMed  Google Scholar 

  33. Leung, W. C., Kung, F., Lam, J., Leung, T. W., & Ho, P. C. (2002). Domestic violence and postnatal depression in a Chinese community. International Journal of Gynaecology and Obstetrics, 79(2), 159–166.

    Article  CAS  PubMed  Google Scholar 

  34. Blackmore, E. R., Carroll, J., Reid, A., Biringer, A., Glazier, R. H., Midmer, D., et al. (2006). The use of the Antenatal Psychosocial Health Assessment (ALPHA) tool in the detection of psychosocial risk factors for postpartum depression: a randomized controlled trial. Journal of Obstetrics and Gynaecology Canada, 28(10), 873–878.

    PubMed  Google Scholar 

  35. Tiwari, A., Chan, K. L., Fong, D., Leung, W. C., Brownridge, D. A., Lam, H., et al. (2008). The impact of psychological abuse by an intimate partner on the mental health of pregnant women. BJOG, 115(3), 377–384.

    Article  CAS  PubMed  Google Scholar 

  36. Bacchus, L., Mezey, G., & Bewley, S. (2003). Experiences of seeking help from health professionals in a sample of women who experienced domestic violence. Health & Social Care in the Community, 11(1), 10–18.

    Article  Google Scholar 

  37. Hamilton, B. E., & Ventura, S. J. (2007). Characteristics of births to single- and multiple-race women: California, Hawaii, Pennsylvania, Utah, and Washington, 2003. National Vital Statistics Reports, 55(15), 1–20.

    Google Scholar 

  38. Affonso, D. (2008). Summary report of analyses conducted on clients enrolled in the Malama Ho’opili Pono from 1999-2005. Report prepared for the Family Health Services Division, Hawaii Department of Health.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Donald K. Hayes.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hayes, D.K., Ta, V.M., Hurwitz, E.L. et al. Disparities in Self-Reported Postpartum Depression among Asian, Hawaiian, and Pacific Islander Women in Hawaii: Pregnancy Risk Assessment Monitoring System (PRAMS), 2004–2007. Matern Child Health J 14, 765–773 (2010). https://doi.org/10.1007/s10995-009-0504-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-009-0504-z

Keywords

Navigation