Risk of prenatal depression: differences by race

Abstract

Background: Approximately 20 million adults suffer from depressive illnesses each year and women are at least twice as likely as men to experience depressive disorders and symptoms. Empirical results have been mixed regarding racial differences in depression prevalence. Given that depression has negative effects on maternal outcomes, little has been explored in regard to prenatal depression across racial/ethnic groups.

Methods: This was a cross-sectional study. Data were abstracted from the 2006 National Inpatient Sample. A total of 877,579 women who delivered in a hospital in 2006 were identified. Presentation of depression at admission was the dependent variable. The independent variable was race/ethnicity that was categorized as White, African American, Hispanic, or other race. Patients' demographics, health insurance status, income level, and hospital characteristics were covariates.

Results: A little more than one percent (1.15%) of the women in the sample had depression as a comorbidity before the delivery. As compared with White women, African American women were much less likely to have the depression presentation (odds ratio (OR) [95% confidence interval (CI)] 0.43 [0.39, 0.47]), as were Hispanic women (OR [CI] 0.27 [0.25, 0.29]) and women of other races (OR [CI] 0.26 [0.23, 0.30]). Moreover, interactive effects between race/ethnicity and insurance status on the depression risk were also observed.

Conclusion: Counterintuitive findings that all minority women had lower depression risk as opposed to that of White women may indicate potential under-diagnosed depression and other mental illnesses among minority women. Further research is needed to examine whether the under-reporting or under-identification exists.