Nilam Shakeel1, Line Sletner2, Ragnhild Sørum Falk3, Kari Slinning4, Egil W Martinsen5, Anne Karen Jenum6, Malin Eberhard-Gran7. 1. General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway. Electronic address: nilam.shakeel@medisin.uio.no. 2. Department of Pediatrics and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway. Electronic address: line.sletner@medisin.uio.no. 3. Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Norway. Electronic address: rs@ous-hf.no. 4. Center for Child and Adolescent Mental Health Eastern and Southern Norway (R.BUP Oslo), Norway. Electronic address: kari.slinning@icloud.com. 5. Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: e.w.martinsen@medisin.uio.no. 6. General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway. Electronic address: a.k.jenum@medisin.uio.no. 7. Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway; Health Services Research Centre, Akershus University Hospital, Lørenskog; Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway. Electronic address: malin.eberhard-gran@fhi.no.
Abstract
BACKGROUND: Postpartum depression (PPD) may have adverse effects on both mother and child. The aims were to determine the prevalence of postpartum depressive symptoms, PPDS, identify associations with ethnicity and with the level of social integration. METHOD: Population-based, prospective cohort study of 643 pregnant women (58% ethnic minorities) attending primary antenatal care in Oslo. Questionnaires regarding demographics and health issues were collected through interviews. PPDS was defined as a sum score ≥ 10 by the Edinburgh Postnatal Depression Scale, used as the main outcome in logistic regression analyses, first with ethnicity, second with level of integration as main explanatory factors. RESULTS: The prevalence of PPDS was higher in ethnic minorities 12.7% (95% CI: 9.31-16.09) than in Western Europeans 4.8% (2.26-7.34). Adverse life events, lack of social support and depressive symptoms during the index pregnancy were other significant risk factors. Western European with PPDS were more likely to have had depressive symptoms also during pregnancy than women from ethnic minorities (72.2% versus 33.3%, p = 0.041). When replacing ethnicity with integration, a low level of integration was independently associated with PPDS (2.1 (1.11-3.95)). LIMITATIONS: Cases with PPDS were limited. Heterogeneity in the ethnic groups is a concern. CONCLUSION: Both point prevalence and new onset of PPDS was higher among ethnic minorities than among Western Europeans. Low level of integration was associated with PPDS. Our findings suggest that clinicians should be aware of the increased risk of new cases of PPDS among ethnic minorities compared to Western European women and offer evidence-based care accordingly.
BACKGROUND: Postpartum depression (PPD) may have adverse effects on both mother and child. The aims were to determine the prevalence of postpartum depressive symptoms, PPDS, identify associations with ethnicity and with the level of social integration. METHOD: Population-based, prospective cohort study of 643 pregnant women (58% ethnic minorities) attending primary antenatal care in Oslo. Questionnaires regarding demographics and health issues were collected through interviews. PPDS was defined as a sum score ≥ 10 by the Edinburgh Postnatal Depression Scale, used as the main outcome in logistic regression analyses, first with ethnicity, second with level of integration as main explanatory factors. RESULTS: The prevalence of PPDS was higher in ethnic minorities 12.7% (95% CI: 9.31-16.09) than in Western Europeans 4.8% (2.26-7.34). Adverse life events, lack of social support and depressive symptoms during the index pregnancy were other significant risk factors. Western European with PPDS were more likely to have had depressive symptoms also during pregnancy than women from ethnic minorities (72.2% versus 33.3%, p = 0.041). When replacing ethnicity with integration, a low level of integration was independently associated with PPDS (2.1 (1.11-3.95)). LIMITATIONS: Cases with PPDS were limited. Heterogeneity in the ethnic groups is a concern. CONCLUSION: Both point prevalence and new onset of PPDS was higher among ethnic minorities than among Western Europeans. Low level of integration was associated with PPDS. Our findings suggest that clinicians should be aware of the increased risk of new cases of PPDS among ethnic minorities compared to Western European women and offer evidence-based care accordingly.
Authors: Maria Marti-Castaner; Camila Hvidtfeldt; Sarah Fredsted Villadsen; Bjarne Laursen; Trine Pagh Pedersen; Marie Norredam Journal: Eur J Public Health Date: 2022-02-01 Impact factor: 4.424