The Feasibility of Recruiting and Retaining Perinatal Latinas in a Biomedical Study Exploring Neuroendocrine Function and Postpartum Depression

An Erratum to this article was published on 01 October 2016


This study evaluates the feasibility of enrolling and retaining perinatal immigrant and U.S.-born Latinas in a laboratory-based study that includes the collection of biomarkers implicated in the development of postpartum depression. This prospective study followed Latinas from third trimester of pregnancy to 12 weeks postpartum. Women were enrolled during pregnancy and interviewed at 4, 8 and 12 weeks postpartum. Demographic information, depression status and breastfeeding practices were ascertained using validated Spanish- and English-measures. Blood samples were collected at the 8-week postpartum laboratory visit during infant feeding and pain testing. Feasibility was demonstrated with 85 % retention of the original 34 prenatal women enrolled in the study. The majority (88 %) of women enrolled attended the 8-week laboratory visit regardless of depression status. This is the first study to demonstrate feasibility of enrolling and retaining depressed and nondepressed perinatal immigrant and U.S.-born Latinas in biomedical research.

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  1. 1.

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). Arlington: American Psychiatric Publishing; 2013.

    Google Scholar 

  2. 2.

    Kuo WH, et al. Depressive symptoms in the immediate postpartum period among Hispanic women in three U.S. cities. J Immigr Health. 2004;6(4):145–53.

    PubMed  Google Scholar 

  3. 3.

    Zayas LH, Jankowski KRB, McKee DM. Prenatal and postpartum depression among low-income Dominican and Puerto Rican women. Hisp J Behav Sci. 2003;25(3):370–85.

    Google Scholar 

  4. 4.

    Liu CH, Tronick E. Rates and predictors of postpartum depression by race and ethnicity: results from the 2004 to 2007 New York City PRAMS Survey (Pregnancy Risk Assessment Monitoring System). Matern Child Health J. 2013;17(9):1599–610.

    PubMed  Google Scholar 

  5. 5.

    Goodkind JR, et al. The Hispanic women’s social stressor scale—understanding the multiple social stressors of US- and Mexico-born Hispanic women. Hisp J Behav Sci. 2008;30(2):200–29.

    Google Scholar 

  6. 6.

    Plaza A, et al. Childhood sexual abuse and hypothalamus-pituitary-thyroid axis in postpartum major depression. J Affect Disord. 2010;122(1):159–63.

    CAS  PubMed  Google Scholar 

  7. 7.

    Schatzberg AF, et al. A corticosteroid/dopamine hypothesis for psychotic depression and related states. J Psychiatr Res. 1985;19(1):57–64.

    CAS  PubMed  Google Scholar 

  8. 8.

    Skrundz M, et al. Plasma oxytocin concentration during pregnancy is associated with development of postpartum depression. Neuropsychopharmacology. 2011;36(9):1886–93.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Stuebe AM, Grewen K, Meltzer-Brody S. Association between maternal mood and oxytocin response to breastfeeding. J Women’s Health. 2013;22(4):352–61.

    Google Scholar 

  10. 10.

    Lara-Cinisomo S, Wisner KL, Meltzer-Brody S. Advances in science and biomedical research on postpartum depression do not include meaningful numbers of Latinas. J Immigr Minor Health. 2015;17(6):1593–6.

    PubMed  Google Scholar 

  11. 11.

    Levkoff S, Sanchez H. Lessons learned about minority recruitment and retention from the Centers on Minority Aging and Health Promotion. Gerontologist. 2003;43(1):18–26.

    PubMed  Google Scholar 

  12. 12.

    Moreno-John G, et al. Ethnic minority older adults participating in clinical research: developing trust. J Aging Health. 2004;16(5 suppl):93S.

    PubMed  Google Scholar 

  13. 13.

    Giuliano AR, et al. Participation of minorities in cancer research: the influence of structural, cultural, and linguistic factors. Ann Epidemiol. 2000;10(8):22–34.

    Google Scholar 

  14. 14.

    Preloran HM, Browner CH, Lieber E. Strategies for motivating Latino Couples’ participation in qualitative health research and their effects on sample construction. Am J Public Health. 2001;91(11):1832–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Magiakou MA, et al. Hypothalamic corticotropin-releasing hormone suppression during the postpartum period: implications for the increase in psychiatric manifestations at this time. J Clin Endocrinol Metab. 1996;81(5):1912–7.

    CAS  PubMed  Google Scholar 

  16. 16.

    Glynn LM, Davis EP, Sandman CA. New insights into the role of perinatal HPA-axis dysregulation in postpartum depression. Neuropeptides. 2013;47(6):363–70.

    CAS  PubMed  Google Scholar 

  17. 17.

    Jolley SN, et al. Dysregulation of the hypothalamic-pituitary-adrenal axis in postpartum depression. Biol Res Nurs. 2007;8(3):210–22.

    CAS  PubMed  Google Scholar 

  18. 18.

    Gill H. Latino migration experience in North Carolina: new roots in the Old North State. Chapel Hill: University of North Carolina Press; 2010.

    Google Scholar 

  19. 19.

    Scalza R. Hispanic births reach 50% at UNC, in Herald-Sun (Durham, NC). Sacramento: McClatchy-Tribune Information Services; 2008.

    Google Scholar 

  20. 20.

    Fein SB, et al. Infant feeding practices study II: study methods. Pediatrics. 2008;122:S28–35.

    PubMed  Google Scholar 

  21. 21.

    Garcia-Esteve LS, et al. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers. J Affect Disord. 2003;75(1):71–6.

    PubMed  Google Scholar 

  22. 22.

    Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150(6):782–6.

    CAS  Google Scholar 

  23. 23.

    First MB, et al. Structured clinical interview for DSM-IV Axis I Disorders, Research Version, Non-Patient Edition (SCID-I, NP). New York: Biometrics Research, New York State Psychiatric Institute; 2002.

    Google Scholar 

  24. 24.

    Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Development of the Spanish edition of the State-Trait Anxiety Inventory. Revista Interamericana de Psicologia. 1971;5:145–58.

    Google Scholar 

  25. 25.

    Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press; 1983.

    Google Scholar 

  26. 26.

    Cuellar I, Arnold B, Maldonado R. Acculturation rating scale for Mexican Americans-II: a revision of the original ARSMA scale. Hisp J Behav Sci. 1995;17(3):275–304.

    Google Scholar 

  27. 27.

    Haack LM, Gerdes AC, Lawton KE. Conducting research with Latino families: examination of strategies to improve recruitment, retention, and satisfaction with an at-risk and underserved population. J Child Fam Stud. 2014;23(2):410–21.

    Google Scholar 

  28. 28.

    Steidel AGL, Contreras JM. A new familism scale for use with Latino populations. Hisp J Behav Sci. 2003;25(3):312–30.

    Google Scholar 

  29. 29.

    Goodkind JR, et al. The Hispanic Women’s Social Stressor Scale: understanding the multiple social stressors of U.S.- and Mexico-born Hispanic women. Hisp J Behav Sci. 2008;30(2):200–29.

    Google Scholar 

  30. 30.

    Oliver-Roig A, et al. The Spanish version of the Breastfeeding Self-Efficacy Scale-short form: reliability and validity assessment. Int J Nurs Stud. 2012;49(2):169–73.

    PubMed  Google Scholar 

  31. 31.

    Dennis CL, Faux S. Development and psychometric testing of the Breastfeeding Self-Efficacy Scale. Res Nurs Health. 1999;22(5):399–409.

    CAS  PubMed  Google Scholar 

  32. 32.

    Li R, et al. Why mothers stop breastfeeding: mothers’ self-reported reasons for stopping during the first year. Pediatrics. 2008;122(Supplement):S69–76.

    PubMed  Google Scholar 

  33. 33.

    Schwabe L, Haddad L, Schachinger H. HPA axis activation by a socially evaluated cold-pressor test. Psychoneuroendocrinology. 2008;33(6):890–5.

    CAS  PubMed  Google Scholar 

  34. 34.

    Leserman J, et al. Impact of sexual and physical abuse dimensions on health status: development of an abuse severity measure. Psychosom Med. 1997;59(2):152–60.

    CAS  PubMed  Google Scholar 

  35. 35.

    Reidy MC, Orpinas P, Davis M. Successful recruitment and retention of Latino study participants. Health Promot Pract. 2012;13(6):779–87.

    PubMed  Google Scholar 

  36. 36.

    Center PR. Demographic Profile of Hispanics in North Carolina, 2011. 2011.

  37. 37.

    Le H, Lara MA, Perry DF. Recruiting Latino women in the U.S. and women in Mexico in postpartum depression prevention research. Arch Women’s Ment Health. 2008;11:159–69.

    Google Scholar 

  38. 38.

    O’Connor E, et al. Primary care screening for and treatment of depression in pregnant and postpartum women: evidence report and systematic review for the us preventive services task force. JAMA. 2016;315(4):388–406.

    PubMed  Google Scholar 

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The authors wish to thank the mothers and their infants who participated in this groundbreaking study. This study could not have been possible without their impressive commitment to our work. The authors would also like to acknowledge the hard work of our impressive research assistants and technical staff: Kathryn McKenney, Sierra Pierce, Jayme Wood, Mala Elam, and Chihiro Christmas. The authors also wish to thank the National Institute of Mental Health (5T32MH093315-03; Drs. Girdler & Rubinow, PIs and MH085165-01A1; Dr. Meltzer-Brody), the Foundation of Hope for Research and Treatment of Mental Illness, and the North Carolina Translational and Clinical Sciences (NC TraCS) Institute for their support of this research. The project described here was also supported by Grants UL1TR000083, KL2TR000084, and TL1TR000085 from the National Center for Advancing Translational Sciences, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Correspondence to Sandraluz Lara-Cinisomo.

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Conflict of interest

Dr. Meltzer-Brody has received research Grant support from Sage Therapeutics.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the University of North Carolina at Chapel Hill Internal Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Lara-Cinisomo, S., Plott, J., Grewen, K. et al. The Feasibility of Recruiting and Retaining Perinatal Latinas in a Biomedical Study Exploring Neuroendocrine Function and Postpartum Depression. J Immigrant Minority Health 18, 1115–1123 (2016).

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  • Latina
  • Feasibility
  • Perinatal women
  • Postpartum depression
  • Biomedical study