Maternal and Child Health Journal

, Volume 13, Issue 3, pp 318–325 | Cite as

Acculturation and Depressive Symptoms Among Pregnant and Postpartum Latinas

  • Marivel Davila
  • Stephanie L. McFall
  • Diana Cheng
Article

Abstract

Objectives Among childbearing Latinas, higher acculturation has been found to be significantly associated with increased risk for mental health problems (Acevado (Child Abuse Neglect, 24:11–127, 2000)), although these findings have been inconsistent (Beck (Maternal Child Nurs, 31(2), 114–120, 2006)). The aims of this study are to assess and compare the prevalence of elevated depressive symptoms among pregnant and postpartum U.S.- and Mexican-born Latinas, and to describe the relation of elevated depressive symptoms and acculturation indicators. Methods A convenience sample of 439 pregnant and postpartum Latinas attending Public Health Clinics in San Antonio, Texas was screened for depressive symptoms using the Center for Epidemiologic Studies Depression (CES-D) Scale. Women with a score of 21 or greater were classified as having elevated depressive symptoms. Sociodemographic data, including birth country and language of interview, were collected as indicators of acculturation. Results 21% of the sample had moderate depressive symptoms; 15% met the threshold for high depressive symptoms. Bivariate analysis showed Latinas who were U.S.-born, single, preferred English or were pregnant were more likely to express elevated levels of depressive symptoms. Being U.S.-born, pregnant and single was significantly associated with moderate levels of depressive symptoms in logistic regression analyses controlling for other variables in the model. Controlling for other variables, being pregnant and single was significantly associated with high levels of depressive symptoms. Conclusions Higher acculturation, pregnancy and single status were positively associated with elevated depressive symptoms. Screening for depression during pregnancy is important for this population group, given Latinas’ high rates of fertility and births to single women, particularly among more acculturated, U.S.-born Latinas.

Keywords

Depression Perinatal period Hispanic American Mexican-American Acculturation Postpartum depression 

References

  1. 1.
    Gavin, N., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics, 106(5), 1071–1083.Google Scholar
  2. 2.
    U.S. Census Bureau News. U.S. Department of Commerce. Washington, D.C. 20233. Available at: www.census.gov/Press-Release/www/releases/archives/population/011910.html. Accessed June 16, 2008.
  3. 3.
    Hamilton, B. E., Martin, J. A., & Ventura, S. J. Births. Preliminary data for 2005. National Vital Statistics Reports; Vol. 55. Hyattsville, MD: National Center for Health Statistics, Tables 1, 5. Available at www.cdc.gov/nchs/products/pubs/pubd/hestats/prelimbirths05.htm#ref02. Accessed June 16, 2008.
  4. 4.
    Escobar, J. I., Nervi, C. H., & Gara, M. A. (2000). Immigration and mental health: Mexican-americans in the united states. Harvard Review of Psychiatry, 8, 64–72. doi:10.1093/hrp/8.2.64.PubMedCrossRefGoogle Scholar
  5. 5.
    Cuellar, I., Harris, L. C., & Jasso, R. (1980). An acculturation scale for Mexican American normal and clinical populations. Hispanic Journal of Behavioral Sciences, 2(3), 199–217.Google Scholar
  6. 6.
    Martinez-Schallmoser, L., Telleen, S., & MacMullen, N. J. (2003). The effect of social support and acculturation on postpartum depression in Mexican American women. Journal of Transcultural Nursing, 14(4), 329–338. doi:10.1177/1043659603257162.PubMedCrossRefGoogle Scholar
  7. 7.
    Odegaard, O. (1946). A statistical investigation of the incidence of mental disorder in norway. The Psychiatric Quarterly, 20, 382–383.Google Scholar
  8. 8.
    Malzberg, B. (1964). Mental disease among native and foreign born whites in New York state. Mental Hygiene, 48, 478–499.PubMedGoogle Scholar
  9. 9.
    Strole, L., Langner, T. S., Michael, S. T., Kirkpatrick, P., Opler, M. K., & Rennie, T. A. C. (1962). Mental health in the metropolis: the midtown manhattan study. New York: McGraw-Hill.CrossRefGoogle Scholar
  10. 10.
    Moscicki, E. K., Locke, B. Z., Rae, D. S., & Boyd, J. H. (1989). Depressive symptoms among mexican americans: The Hispanic health and nutrition examination survey. American Journal of Epidemiology, 130(2), 348–360.PubMedGoogle Scholar
  11. 11.
    Ortega, A. N., Rosenheck, R., Alegria, M., & Desai, R. A. (2000). Acculturation and the lifetime risk of psychiatric and substance use disorders among Hispanics. The Journal of Nervous and Mental Disease, 188(11), 728–735. doi:10.1097/00005053-200011000-00002.PubMedCrossRefGoogle Scholar
  12. 12.
    Beck, C. T. (2006). Acculturation: Implications for perinatal research. MCN. The American Journal of Maternal Child Nursing, 31(2), 114–120. doi:10.1097/00005721-200603000-00011.PubMedCrossRefGoogle Scholar
  13. 13.
    Zhihuan, J. H., Wong, F. Y., Ronzio, C. R., & Yu, S. M. (2007). Depressive symptomatology and mental health-seeking patterns of U.S.- and foreign-born mothers. Maternal and Child Health Journal, 11, 257–267. doi:10.1007/s10995-006-0168-x.CrossRefGoogle Scholar
  14. 14.
    Kuo, W. H., Wilson, T. E., Holman, S., Fuentes-Afflick, E., O’Sullivan, M. J., & Minkoff, H. (2004). Depressive symptoms in the immediate postpartum period among Hispanic women in three U.S. cities. Journal of Immigrant Health, 6(4), 145–153. doi:10.1023/B:JOIH.0000045252.10412.fa.PubMedCrossRefGoogle Scholar
  15. 15.
    Chaudron, L. H., Kitzman, H. J., Peifer, K., Morrow, S., Perez, L., & Newman, M. (2005). Prevalence of maternal depressive symptoms in low-income Hispanic women. The Journal of Clinical Psychiatry, 66(4), 418–423.PubMedCrossRefGoogle Scholar
  16. 16.
    Heilemann, M., Frutos, L., Lee, K., & Kury, F. S. (2004). Protective strength factors, resources, and risks in relation to depressive symptoms among childbearing women of mexican descent. Health Care for Women International, 25(1), 88–106. doi:10.1080/07399330490253265.PubMedCrossRefGoogle Scholar
  17. 17.
    Burnam, M. A., Hough, R. L., Karno, M., Escobar, J. I., & Telles, C. A. (1987). Acculturation and lifetime prevalence of psychiatric disorders among Mexican Americans in Los Angeles. Journal of Health and Social Behavior, 28(1), 89–102. doi:10.2307/2137143.PubMedCrossRefGoogle Scholar
  18. 18.
    Escobar, J. I., & Vega, W. A. (2000). Mental health and immigration’s AAAs: Where are we and where do we go from here? The Journal of Nervous and Mental Disease, 188(11), 736–740. doi:10.1097/00005053-200011000-00003.PubMedCrossRefGoogle Scholar
  19. 19.
    U.S. Census Bureau. (2001). The Hispanic Population (Census 2000 Brief). Washington, DC: U.S. Department of Commerce.Google Scholar
  20. 20.
    Barnes, G. E., & Prosen, H. (1984). Depression in Canadian general practice attenders. Canadian Journal of Psychiatry, 29, 2–10.Google Scholar
  21. 21.
    Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Journal of Applied Psychological Measures, 1, 385–401. doi:10.1177/014662167700100306.CrossRefGoogle Scholar
  22. 22.
    Naughton, M. J., & Wiklund, J. (1993). A critical review of dimension-specific measures of health-related quality of life in cross-cultural research. Quality of Life Research, 2, 397–432. doi:10.1007/BF00422216.PubMedCrossRefGoogle Scholar
  23. 23.
    Roberts, R. E., Vernon, S. W., & Rhodes, H. M. (1989). Effects of language and ethnic status on reliability and validity of the center for epidemiological studies-depression scale with psychiatric patients. The Journal of Nervous and Mental Disease, 177, 581–592. doi:10.1097/00005053-198910000-00001.PubMedCrossRefGoogle Scholar
  24. 24.
    Collins, N., Dunkel-Schetter, M., & Scrimshaw, S. (1993). Social support in pregnancy: Psychosocial correlates of birth outcomes and postpartum depression. Journal of Personality and Social Psychology, 65(6), 1243–1258. doi:10.1037/0022-3514.65.6.1243.PubMedCrossRefGoogle Scholar
  25. 25.
    Roberts, R. E. (1980). Reliability of the CES-D scale in different ethnic contexts. Psychiatry Research, 2, 125–134. doi:10.1016/0165-1781(80)90069-4.PubMedCrossRefGoogle Scholar
  26. 26.
    Orr, S. T., & Miller, C. A. (1995). Maternal depressive symptoms and the risk of poor pregnancy outcomes. Epidemiologic Reviews, 17(1), 165–171.PubMedGoogle Scholar
  27. 27.
    Orr, S. T., Blazer, D. G., & James, S. A. (2006). Racial disparities in elevated prenatal depressive symptoms among black and white women in eastern North Carolina. Annals of Epidemiology, 16(6), 463–468. doi:10.1016/j.annepidem.2005.08.004.PubMedCrossRefGoogle Scholar
  28. 28.
    Vega, W. A., Kolody, B., Valle, R., & Hough, R. (1986). Depressive symptoms and their correlates among immigrant Mexican women in the United States. Social Science, 22(6), 645–652.Google Scholar
  29. 29.
    Sribney, W. FAQ: A comparison of different tests for trend 1996. Available at: www.stata.com/support/faqs/test_trend.htm. Accessed June 13, 2008.
  30. 30.
    Rich-Edwards, J. W., Kleinman, K., Abrams, A., Harlow, B. L., McLaughlin, T. J., & Joffe, H. (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology, 60(3), 221–227.Google Scholar
  31. 31.
    Hunt, L. M., Schneider, S., & Comer, B. (2004). Should “acculturation” be a variable in health research? A critical review of research on us Hispanics. Social Science & Medicine, 59, 973–986. doi:10.1016/j.socscimed.2003.12.009.CrossRefGoogle Scholar
  32. 32.
    Zayas, L. H., Jankowski, K. R., & McKee, M. D. (2003). Prenatal and postpartum depression among low-income Dominican and Puerto Rican women. Hispanic Journal of Behavioral Sciences, 25, 370–385. doi:10.1177/0739986303256914.CrossRefGoogle Scholar
  33. 33.
    Yonkers, K. A., Ramin, S. M., Rush, A. J., Navarrete, C. A., Carmody, T., March, D., et al. (2001). Onset and persistence of postpartum depression in an inner-city maternal health clinic system. The American Journal of Psychiatry, 158(11), 1856–1863. doi:10.1176/appi.ajp. 158.11.1856.PubMedCrossRefGoogle Scholar
  34. 34.
    Le, H. N., Munoz, R. F., & Soto, J. A. (2004). Identifying risk for onset of major depressive episodes in low-income Latinas during pregnancy and postpartum. Hispanic Journal of Behavioral Sciences, 26(4), 463–482. doi:10.1177/0739986304269165.CrossRefGoogle Scholar
  35. 35.
    Federal Interagency Forum on Child and Family Statistics. (2007). America’s Children: Key National Indicators of Well-Being.Google Scholar
  36. 36.
    Hamilton, B. E., Martin, J. A., & Ventura, S. J. (2007). Births: Preliminary data for 2005. National vital statistics reports; vol 55 no 11. Hyattsville, MD: National Center for Health Statistics.Google Scholar
  37. 37.
    Acevado, M. C. (2000). The role of acculturation in explaining ethnic differences in the prenatal health-risk behaviors, mental health and parenting beliefs of Mexican-American and European American at-risk women. Child Abuse & Neglect, 24, 11–127.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Marivel Davila
    • 1
  • Stephanie L. McFall
    • 2
  • Diana Cheng
    • 3
  1. 1.Department of Family and Community MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioUSA
  2. 2.University of Texas, School of Public HealthSan AntonioUSA
  3. 3.Maryland Department of Health and Mental HygieneBaltimoreUSA

Personalised recommendations