Risk factors for prenatal depressive symptoms among Hispanic women.

Prior studies of risk factors for depressive symptoms during pregnancy are sparse and the majority have focused on non-Hispanic white women. Hispanics are the largest minority group in the US and have the highest birth rates. We examined associations between pre and early pregnancy factors and depressive symptoms in early pregnancy among 921 participants in Proyecto Buena Salud, an ongoing cohort of pregnant Puerto Rican and Dominican women in Western Massachusetts. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (mean=13 weeks gestation) by bilingual interviewers who also collected data on sociodemographic, acculturation, behavioral, and psychosocial factors. A total of 30% of participants were classified as having depressive symptoms (EPDS scores>12) with mean+SD scores of 9.28+5.99. Higher levels of education (college/graduate school vs. <high school: RR=0.60, 95% CI 0.41-0.86), household income (Ptrend=0.02), and living with a spouse/partner (0.80; 95% CI 0.63-1.00) were independently associated with lower risk of depressive symptoms. There was the suggestion that failure to discontinue cigarette smoking with the onset of pregnancy (RR=1.32; 95% CI 0.97-1.71) and English language preference (RR=1.33; 95% CI 0.96-1.70) were associated with higher risk. Single marital status, second generation in the U.S., and higher levels of alcohol consumption were associated with higher risk of depressive symptoms in univariate analyses, but were attenuated after adjustment for other risk factors. Findings in the largest, fastest-growing ethnic minority group can inform intervention studies targeting Hispanic women at risk of depression in pregnancy.