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Racial/Ethnic Disparities in Antenatal Depression in the United States: A Systematic Review

Abstract

Objectives More than 10 % of pregnant women in the United States (U.S.) suffer from depression, which has far-reaching consequences on maternal and fetal well-being. There is conflicting evidence regarding the prevalence of antenatal depression among different race and ethnic groups. This systematic review aimed to summarize the existing literature concerning racial/ethnic disparities in the prevalence and correlates of antenatal depression in the U.S. Methods PubMed, CINAHL and PsycINFO databases were searched online for research studies published in English in peer-reviewed journals until March 2015, using a pre-designed search strategy. Eligibility was determined using pre-specified criteria; and quality was assessed. Results Forty-one (41) articles met the criteria; 13 were cross-sectional, and 21 were longitudinal studies. Overall, the prevalence of antenatal depression was 10–30 %; it was higher among non-Hispanic blacks (NHBs) and Hispanics, compared to non-Hispanic whites (NHWs). Few studies looked at the correlates of depression by race/ethnicity. Among employed women, higher depression scores were observed among NHBs, compared to NHWs; while there was no racial difference among unemployed women. Racial difference and race-employment interaction disappeared once discrimination was accounted for. In another study, higher parity, higher stress, and lower self-esteem were significant correlates of depression among NHBs, while less satisfaction with social support, and higher stress predicted higher depression scores among NHWs and Hispanics respectively. Conclusions The findings of our review suggest that not only is antenatal depression a major public health issue that needs to be addressed, but different racial/ethnic groups seem to differ in their vulnerability and risk factors.

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Acknowledgments

The authors would like to gratefully acknowledge the valuable inputs regarding search terms and databases from Barbara M. Sorondo, the Health Sciences Librarian at Florida International University.

Funding

There was no funding involved in the conduct and writing of this systematic review.

Author Contributions

Study concept: Mukherjee, Trepka. Database search and data extraction: Mukherjee, Pierre-Victor, Bahelah, Avent. Quality assessment and compilation of the results: Mukherjee, Pierre-Victor, Bahelah, Avent. Interpretation of results and drafting of the manuscript: Mukherjee, Trepka. Critical revision of the manuscript: Trepka, Mukherjee, Pierre-Victor, Bahelah.

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Correspondence to Soumyadeep Mukherjee.

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Mukherjee, S., Trepka, M.J., Pierre-Victor, D. et al. Racial/Ethnic Disparities in Antenatal Depression in the United States: A Systematic Review. Matern Child Health J 20, 1780–1797 (2016). https://doi.org/10.1007/s10995-016-1989-x

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Keywords

  • Antenatal depression
  • Racial/ethnic disparities
  • Systematic review
  • Prevalence
  • Correlates