Abstract
Objectives
Data are scarce regarding the prevalence and predictors of perinatal mood and anxiety disorders (PMADs) among Black women. The purpose of this study was to examine the prevalence and predictors of symptoms of PMADS among Black women.
Methods
Black women completed a paper survey between August 2019 and October 2019. Binomial logistic regression was employed to examine predictors of PMAD symptoms.
Results
The prevalence of symptoms of PMADs was 56%. A higher proportion of women with PMADs had experienced depression (16% vs. 32%, p = 0.006); physical (18% vs. 31%, p = 0.030), emotional (35% vs. 61%, p = 0.000), or sexual abuse (12% vs. 29%, p = 0.002); and symptoms of depression or anxiety before pregnancy (18% vs. 46%, p = 0.000). After adjusting for socio-demographics in multivariate analysis, experiencing symptoms of depression or anxiety before pregnancy (adjusted odds ratio [aOR] = 3.445, p = 0.001) was positively associated with experiencing symptoms of PMADs, whereas higher levels of self-esteem (aOR = 0.837, p = 0.000) were negatively associated with experiencing symptoms of perinatal mood and anxiety disorders.
Conclusions for Practice
The prevalence of PMAD symptoms among this sample of Black women was alarmingly high. Women who experienced PMADs were more likely to report adverse childhood experiences (e.g., physical, emotional, and/or sexual abuse). By understanding the prevalence of PMADs and the factors associated with these disorders, healthcare professionals can improve diagnosis and treatment rates among this understudied and underserved population.
This is a preview of subscription content, log in via an institution to check access.
References
Atzl, V. M., Narayan, A. J., Rivera, L. M., & Lieberman, A. F. (2019). Adverse childhood experiences and prenatal mental health: Type of ACEs and age of maltreatment onset. Journal of Family Psychology, 33(3), 304–314. https://doi.org/10.1037/fam0000510
Berber Çelik, Ç., & Odacı, H. (2020). Does child abuse have an impact on self-esteem, depression, anxiety and stress conditions of individuals? International Journal of Social Psychiatry, 66(2), 171–178. https://doi.org/10.1177/0020764019894618
Byrnes, L. (2018). Perinatal mood and anxiety disorders. The Journal for Nurse Practitioners, 14(7), 507–513. https://doi.org/10.1016/j.nurpra.2018.03.010
Carrington, C. H. (2006). Clinical depression in African American women: Diagnoses, treatment, and research. Journal of Clinical Psychology, 62(7), 779–791. https://doi.org/10.1002/jclp.20289
Chaudron, L. H., Szilagyi, P. G., Tang, W., Anson, E., Talbot, N. L., Wadkins, H. I. … Wisner, K. L. (2010). Accuracy of depression screening tools for identifying postpartum depression among urban mothers. Pediatrics, 125(3), e609–e617. https://doi.org/10.1542/peds.2008-3261
Chao, R. C. L., Vidacovich, C., & Green, K. E. (2017). Rasch analysis of the Rosenberg Self-Esteem Scale with African Americans. Psychological Assessment, 29(3), 329–342. https://doi.org/10.1037/pas0000347
Choi, K. W., Sikkema, K. J., Vythilingum, B., Geerts, L., Faure, S. C., Watt, M. H. … Stein, D. J. (2017). Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism. Journal of Affective Disorders, 211, 107–115. https://doi.org/10.1016/j.jad.2017.01.004
Centers for Disease Control and Prevention [CDC]. (2009). Behavioral risk factor surveillance system survey questionnaire. Atlanta, GA: U.S. Department of Health and Human Services
Edge, D. (2011). “It’s leaflet, leaflet, leaflet then, ‘see you later’”: Black Caribbean women’s perceptions of perinatal mental health care. British Journal of General Practice, 61(585), 256–262. https://doi.org/10.3399/bjgp11X567063
Evans, M. G., Phillippi, S., & Gee, R. E. (2015). Examining the screening practices of physicians for postpartum depression: implications for improving health outcomes. Women’s Health Issues, 25(6), 703–710. https://doi.org/10.1016/j.whi.2015.07.003
Fairbrother, N., Young, A., Antony, M., & Tucker, E. (2015). Depression and anxiety during the
perinatal period.BMC Psychiatry, 15(206). https://doi.org/10.1186/s12888-015-0526-6
Goodman, S. H., Dimidjian, S., & Williams, K. G. (2013). Pregnant African American women’s attitudes toward perinatal depression prevention. Cultural Diversity and Ethnic Minority Psychology, 19(1), 50–57. https://doi.org/10.1037/a0030565
Hall, J. C., Crutchfield, J., & Jones, A. E. (2019). Self-esteem, problem solving, and family coping responses: Determinants and consequences for Black women. Health & Social Work, 44(1), 39–47
Hernandez, N. D., Dorsey, J., Glass, D. M., Pope, E., Worthy, N., Blasingame, E. … Dotson, Y. (2019). Community-engaged approaches to address the ethical concerns of maternal mental health disparities research. Journal of Health Care for the Poor and Underserved, 30(4 Suppl), 12
Howell, E. A., Mora, P. A., Horowitz, C. R., & Leventhal, H. (2005). Racial and ethnic differences in factors associated with early postpartum depressive symptoms. Obstetrics and Gynecology, 105(6), 1442–1450. https://doi.org/10.1097/01.AOG.0000164050.34126.37
Karakuş, Ö. (2012). Relation between childhood abuse and self esteem in adolescence. Journal of Human Sciences, 9(2), 753–763. https://www.j-humansciences.com/ojs/index.php/IJHS/article/view/2348
Kendig, S., Keats, J. P., Hoffman, M. C., Kay, L. B., Miller, E. S., Simas, T. A. M. … Lemieux, L. (2017). Consensus bundle on maternal mental health: Perinatal depression and anxiety. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46(2), 272–281. https://doi.org/10.1016/j.jogn.2017.01.001
Kim, H. G., Kuendig, J., Prasad, K., & Sexter, A. (2020). Exposure to racism and other adverse childhood experiences among perinatal women with Moderate to severe mental illness. Community Mental Health Journal, 56(5), 867–874. https://doi.org/10.1007/s10597-020-00550-6
Kozhimannil, K. B., Trinacty, C. M., Busch, A. B., Huskamp, H. A., & Adams, A. S. (2011). Racial and ethnic disparities in postpartum depression care among low-income women. Psychiatric Services, 62(6), 619–625. https://doi.org/10.1176/appi.ps.62.6.619
Lacey, K. K., Parnell, R., Mouzon, D. M., Matusko, N., Head, D., Abelson, J. M., & Jackson, J. S. (2015). The mental health of US Black women: The roles of social context and severe intimate partner violence. BMJ Open, 5. https://doi.org/10.1136/bmjopen-2015-008415
Lekan, D. (2009). Sojourner syndrome and health disparities in African American women. Advances in Nursing Science, 32(4), 307–321
Ley, C. E., Copeland, V. C., Flint, C. S., White, J. S., & Wexler, S. (2009). Community-based perinatal depression services for African American women: The Healthy Start model. Social Work in Public Health, 24(6), 568–583. https://doi.org/10.1080/19371910802679622
Liu, C. H., & Tronick, E. (2014). Prevalence and predictors of maternal postpartum depressed mood and anhedonia by race and ethnicity. Epidemiology and Psychiatric Sciences, 23(2), 201–209. https://doi.org/10.1017/S2045796013000413
McDonnell, C. G., & Valentino, K. (2016). Intergenerational effects of childhood trauma: evaluating pathways among maternal ACEs, perinatal depressive symptoms, and infant outcomes. Child Maltreatment, 21(4), 317–326. https://doi.org/10.1177/1077559516659556
McKee, K. S., Admon, L. K., Winkelman, T. N., Muzik, M., Hall, S., Dalton, V. K., & Zivin, K. (2020). Perinatal mood and anxiety disorders, serious mental illness, and delivery-related health outcomes, United States, 2006–2015. BMC Women’s Health, 23(20), 150. https://doi.org/10.1186/s12905-020-00996-6
Melville, J. L., Gavin, A., Guo, Y., Fan, M. Y., & Katon, W. J. (2010). Depressive disorders during pregnancy: Prevalence and risk factors in a large urban sample. Obstetrics and Gynecology, 116(5), 1064–1070. https://doi.org/10.1097/AOG.0b013e3181f60b0a
Miller-Perrin, C. L., & Perrin, R. D. (2012). Child maltreatment: An introduction. Sage
Ranji, U., Gomez, I., & Salganicoff, A. (2019). Expanding postpartum Medicaid coverage. Washington DC: Henry J Kaiser Family Foundation Issue Brief
Rhodes, A. M., & Segre, L. S. (2013, August). Perinatal depression: A review of US legislation and law. Archives of Women’s Mental Health, 16(4), 259–270. https://doi.org/10.1007/s00737-013-0359-6
Rich-Edwards, J. W., Kleinman, K., Abrams, A., Harlow, B. L., McLaughlin, T. J., Joffe, H., & Gillman, M. W. (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology & Community Health, 60(3), 221–227. https://doi.org/10.1136/jech.2005.039370
Russell, K., Ashley, A., Chan, G., Gibson, S., & Jones, R. (2017). Maternal mental health—women’s voices. Royal College of Obstetricians and Gynaecologists
Sachs-Ericsson, N., Gayman, M. D., Kendall-Tackett, K., Lloyd, D. A., Medley, A., Collins, N. … Sawyer, K. (2010). The long-term impact of childhood abuse on internalizing disorders among older adults: The moderating role of self-esteem. Aging and Mental Health, 14(4), 489–501. https://doi.org/10.1080/13607860903191382
Shen, A. C. T. (2009). Self-esteem of young adults experiencing interparental violence and child physical maltreatment: Parental and peer relationships as mediators. Journal of Interpersonal Violence, 24(5), 770–794. https://doi.org/10.1177/0886260508317188
Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health, 15, 1745506519844044
Twenge, J. M., & Crocker, J. (2002). Race and self-esteem: meta-analyses comparing whites, blacks, Hispanics, Asians, and American Indians and comment on Gray-Little and Hafdahl (2000). Psychological Bulletin, 128(3), 371–408
van Heyningen, T., Honikman, S., Myer, L., Onah, M. N., Field, S., & Tomlinson, M. (2017). Prevalence and predictors of anxiety disorders amongst low-income pregnant women in urban South Africa: a cross-sectional study. Archives of Women’s Mental Health, 20(6), 765–775. https://doi.org/10.1007/s00737-017-0768-z
Ward, E. C., & Heidrich, S. M. (2009). African American women’s beliefs about mental illness, stigma, and preferred coping behaviors. Research in Nursing & Health, 32(5), 480–492. https://doi.org/10.1002/nur.20344
Wisner, K. L., Sit, D. K., McShea, M. C., Rizzo, D. M., Zoretich, R. A., Hughes, C. L. … Hanusa, B. H. (2013). Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry, 70(5), 490–498. https://doi.org/10.1001/jamapsychiatry.2013.87
Xiang, Y., Wang, W., & Guan, F. (2018). The relationship between child maltreatment and dispositional envy and the mediating effect of self-esteem and social support in young adults. Frontiers in Psychology, 9, 1054. https://doi.org/10.3389/fpsyg.2018.01054
Funding
Supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Significance
Based on recent literature, it is already known that untreated PMADs can have severe consequences for the health and well-being of the affected woman and her family, including long-term consequences for the cognitive, emotional, and behavioral development of her child. This study adds to the literature by providing new data on prevalence and risk factors for these disorders among Black women who are understudied. The prevalence of PMADs among this sample of women was higher than national estimates. This study provides practitioners with community-driven relevant data that may inform approaches to combat PMADs.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Hernandez, N.D., Francis, S., Allen, M. et al. Prevalence and predictors of symptoms of Perinatal Mood and anxiety Disorders among a sample of Urban Black Women in the South. Matern Child Health J 26, 770–777 (2022). https://doi.org/10.1007/s10995-022-03425-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-022-03425-2