Advertisement

Canadian Journal of Public Health

, Volume 101, Issue 5, pp 358–364 | Cite as

Contributions of Immigration to Depressive Symptoms Among Pregnant Women in Canada

  • Malgorzata MiszkurkaEmail author
  • Lise Goulet
  • Maria Victoria Zunzunegui
Quantitative Research
  • 1 Downloads

Abstract

Objectives

Immigrant women present high prevalence of depressive symptoms during pregnancy, the early postpartum period and as mothers of young children. We compared mental health of immigrant and Canadian native-born women during pregnancy according to length of stay and region of origin, and we assessed the role of economics and social support in antenatal depressive symptomatology.

Methods

Data originated from the Montreal study on socio-economic differences in prematurity; 3,834 Canadian-born and 1,495 foreign-born women attending Montreal hospitals for antenatal care were evaluated for depression at 24–26 weeks of pregnancy using the Center for Epidemiologic Studies Depression scale by fitting logistic regressions with staggered entry of possible explanatory variables.

Results

Immigrant women had a higher prevalence of depressive symptomatology independently of time since immigration. Region of origin was a strong predictor of depressive symptomatology: women from the Caribbean, South Asia, Maghreb, Sub-Saharan Africa and Latin America had the highest prevalence of depressive symptomatology compared to Canadian-born women. The higher depression odds in immigrant women are attenuated after adjustment for lack of social support and money for basic needs. Time trends of depressive symptoms varied across origins. In relation to length of stay, depressive symptoms increased (European, Southeast Asian), decreased (Maghrebian, Sub-Saharan African, Middle Eastern, East Asian) or fluctuated (Latin American, Caribbean).

Conclusion

Depression in minority pregnant women deserves more attention, independently of their length of stay in Canada. Social support favouring integration and poverty reduction interventions could reduce this risk of antenatal depression.

Key words

Pregnancy depression immigration socio-economic factors social support region of origin 

Résumé

Objectifs

Les immigrantes affichent une prévalence élevée de symptômes dépressifs durant la grossesse, au début de la période post-partum et en tant que mères de jeunes enfants. Nous avons comparé la santé mentale d’immigrantes et de Canadiennes de souche durant la grossesse selon la longueur du séjour et la région d’origine, puis évalué le rôle des facteurs économiques et du soutien social dans la symptomatologie dépressive prénatale.

Méthode

Nos données proviennent de l’étude montréalaise sur les différences socioéconomiques dans la prématurité; 3834 Canadiennes de souche et 1495 femmes nées à l’étranger recevant des soins prénatals dans les hôpitaux de Montréal ont été évaluées à 24–26 semaines de grossesse selon l’échelle de dépression du Centre des études épidémiologiques en agençant des régressions logistiques avec l’introduction échelonnée de variables explicatives possibles.

Résultats

Les immigrantes avaient une prévalence accrue de symptomatologie dépressive, indépendamment de leur date d’immigration. La région d’origine était un solide prédicteur de symptomatologie dépressive: les femmes originaires des Caraïbes, d’Asie du Sud, du Maghreb, d’Afrique subsaharienne et d’Amérique latine présentaient la plus forte prévalence comparativement aux Canadiennes de souche. Les probabilités de dépression accrues chez les immigrantes s’atténuent lorsqu’on tient compte de leur manque de soutien social et d’argent pour répondre à leurs besoins fondamentaux. Les tendances temporelles des symptômes dépressifs variaient selon les origines. Par rapport à la durée du séjour, les symptômes dépressifs pouvaient s’accentuer (femmes originaires d’Europe et d’Asie du Sud-Est), diminuer (femmes du Maghreb, d’Afrique subsaharienne, du Moyen-Orient et d’Asie de l’Est) ou fluctuer (femmes d’Amérique latine et des Caraïbes).

Conclusion

La dépression chez les femmes enceintes des minorités mérite qu’on s’y attache, indépendamment de la durée de leur séjour au Canada. Un soutien social favorisant l’intégration et la réduction de la pauvreté pourrait réduire le risque de dépression prénatale.

Mots clés

grossesse dépression émigration et immigration facteurs socioéconomiques soutien social région d’origine 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Marcus SM, Flynn HA, Blow FC, Barry KL. Depressive symptoms among pregnant women screened in obstetrics settings. J Women’s Health 2003;12(4):373–80.Google Scholar
  2. 2.
    Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for post-partum depression: A synthesis of recent literature. Gen Hospital Psychiatry 2004;26(4):289–95.Google Scholar
  3. 3.
    Stewart AL, Dean ML, Gregorich SE, Brawarsky P, Haas JS. Race/ethnicity, socioeconomic status and the health of pregnant women. J Health Psychol 2007;12(2):285–300.PubMedGoogle Scholar
  4. 4.
    Zelkowitz P, Schinazi J, Katofsky L, Saucier JF, Valenzuela M, Westreich R, et al. Factors associated with depression in pregnant immigrant women. Transcultural Psychiatry 2004;41(4):445–64.PubMedGoogle Scholar
  5. 5.
    Dennis C-LE, Janssen PA, Singer J. Identifying women at-risk for postpartum depression in the immediate postpartum period. Acta Psychiatrica Scandinav-ica 2004;110(5):338–46.Google Scholar
  6. 6.
    Liamputtong P, Naksook C. Life as a mother in a new land: The experience of motherhood among Thai women in Australia. Health Care Women Int 2003;24(7):650–68.PubMedGoogle Scholar
  7. 7.
    Horwitz S, Briggs-Gowan M, Storfer-Isser A, Carter A. Prevalence, correlates, and persistence of maternal depression. J Women’s Health 2007;16(5):678–91.Google Scholar
  8. 8.
    Bhugra D. Migration and mental health. Acta Psychiatrica Scandinavica 2004;109(4):243–58.PubMedGoogle Scholar
  9. 9.
    Bhugra D. Cultural identities and cultural congruency: A new model for evaluating mental distress in immigrants. Acta Psychiatrica Scandinavica 2005;111(2):84–93.PubMedGoogle Scholar
  10. 10.
    Rogler LH. International migrations. A framework for directing research. Am Psychologist 1994;49(8):701–8.Google Scholar
  11. 11.
    Llácer A, Amo JD, García-Fulgueiras A, Ibáñez-Rojo V, García-Pino R, Jarrín I, et al. Discrimination and mental health in Ecuadorian immigrants in Spain. J Epidemiol Community Health 2009;63(9):766–72.PubMedGoogle Scholar
  12. 12.
    Beiser M. Influences of time, ethnicity, and attachment on depression in Southeast Asian refugees. Am J Psychiatry 1988;145(1):46–51.PubMedGoogle Scholar
  13. 13.
    Zelkowitz P. Childbearing and women’s mental health. Transcultural Psychiatry 1996;33(4):391–412.Google Scholar
  14. 14.
    Orr ST, Blazer DG, James SA. Racial disparities in elevated prenatal depressive symptoms among black and white women in eastern North Carolina. Ann Epidemiol 2006;16(6):463–68.PubMedGoogle Scholar
  15. 15.
    Canady RB, Bullen BL, Holzman C, Broman C, Tian Y. Discrimination and symptoms of depression in pregnancy among African American and White women. Women’s Health Issues 2008;18(4):292–300.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Vissandjee B, Desmeules M, Cao Z, Abdool S, Kazanjian A. Integrating ethnicity and migration as determinants of Canadian women’s health. BMC Women’s Health 2004;4(Suppl 1):S32.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Kramer MS, Goulet L, Lydon J, Séguin L, McNamara H, Dassa C, et al. Socio-economic disparities in preterm birth: Causal pathways and mechanisms. Pediatr Perinatal Epidemiol 2001;Suppl 2:104–23.Google Scholar
  18. 18.
    Radloff LS. The CES-D Scale: A self-report depression scale for research in the general population. Appl Psycholog Measurement 1977;1(3):385–401.Google Scholar
  19. 19.
    Stahl D, Sum CF, Lum SS, Liow PH, Chan YH, Verma S, et al. Screening for depressive symptoms: Validation of the Center for Epidemiologic Studies Depression Scale (CES-D) in a multiethnic group of patients with diabetes in Singapore. Diabetes Care 2008;31(6):1118–19.PubMedGoogle Scholar
  20. 20.
    2001 Census Analysis Series, Canada’s Ethnocultural Portrait — The Changing Mosaic. Ottawa, ON: Statistics Canada. Available at: https://doi.org/www12.statcan.ca/ (Accessed January 2009).
  21. 21.
    Canadian Community Health Survey Mental Health and Well-being. Available at: https://doi.org/www.statcan.gc.ca/pub/82-617-x/index-eng.htm (Accessed May 25, 2009).
  22. 22.
    Reitz J. Immigrant employment success in Canada, Part I: Individual and contextual causes. J Int Migration Integration 2007;8(1):11–36.Google Scholar
  23. 23.
    Smith KLW, Matheson FI, Moineddin R, Glazier RH. Gender, income and immigration differences in depression in Canadian urban centres. Can J Public Health 2007;98(2):149–53.PubMedGoogle Scholar
  24. 24.
    Battaglini A, Gravel S, Boucheron L, Fournier M, Brodeur J-M, Poulin C, et al. Quand migration et maternité se croisent: perspectives des intervenantes et des mères immigrantes. Service social 2002;49(1):35–69.Google Scholar
  25. 25.
    Bina R. The impact of cultural factors upon postpartum depression: A literature review. Health Care Women Int 2008;29(6):568–92.PubMedGoogle Scholar
  26. 26.
    Ahmed A, Stewart D, Teng L, Wahoush O, Gagnon A. Experiences of immigrant new mothers with symptoms of depression. Arch Women’s Mental Health 2008;11(4):295–303.Google Scholar
  27. 27.
    Kramer MS, Wilkins R, Goulet L, Séguin L, Lydon J, Kahn SR, et al. Investigating socio-economic disparities in preterm birth: Evidence for selective study participation and selection bias. Paediatr Perinat Epidemiol 2009;23(4):301–9.PubMedGoogle Scholar
  28. 28.
    Ding H, Hargraves L. Stress-associated poor health among adult immigrants with a language barrier in the United States. J Immigrant Minority Health 2009;11(6):446–52.Google Scholar
  29. 29.
    Stewart DE, Gagnon A, Saucier JF, Wahoush O, Dougherty G. Postpartum depression symptoms in newcomers. Can J Psych 2008;53:121–24.Google Scholar
  30. 30.
    Simich L, Beiser M, Stewart M, Mwakarimba E. Providing social support for immigrants and refugees in Canada: Challenges and directions. J Immigrant Health 2005;7(4):259–68.Google Scholar

Copyright information

© The Canadian Public Health Association 2010

Authors and Affiliations

  • Malgorzata Miszkurka
    • 1
    Email author
  • Lise Goulet
    • 1
    • 2
  • Maria Victoria Zunzunegui
    • 1
    • 2
  1. 1.Département de médecine sociale et préventivel‘Université de MontréalLavalCanada
  2. 2.Institut de Recherche en Santé Publiquel’Université de Montréal (IRSPUM)MontréalCanada

Personalised recommendations