Mother-infant interaction, life events and prenatal and postpartum depressive symptoms among urban minority women in primary care.
OBJECTIVE
Prenatal and postpartum depression are significant mental health problems that can have negative effects on mother-infant interactions. We examined the relationships among mother-infant interactions, depressive symptoms, life events, and breastfeeding of low-income urban African American and Hispanic women in primary care settings.


METHODS
Participants were 89 African American and Hispanic women who were part of a larger mental health intervention study conducted in community health centers. Questionnaire data on depression, as well as negative and positive life events, were collected during pregnancy and at three-months postpartum, while mother-infant interaction observations and breastfeeding practice were only collected at three-months postpartum.


RESULTS
The ratings of maternal behavior for 'depressed' mothers did not differ from 'nondepressed' mothers. Except for gaze aversion behavior, infants' behavior while interacting with their mothers did not differ by maternal depression level. Hierarchical regression analyses revealed that maternal positive life events positively predicted infant interactional summary ratings, while maternal negative life events were inversely associated with maternal interactional summary ratings.


CONCLUSIONS
To improve services in primary care, perinatal screenings for depression can help identify those women most at risk. When follow-up use of structured diagnostic instruments is not possible or cost-effective, clinician assessment of severity of depression will determine women with clinical levels of depression. Reducing negative life events is beyond the control of women or clinicians but cognitive interventions to help women focus on positive life events can reduce the deleterious effects of depression on mothers and their infants.
Boyd
Rhonda C
RC
Department of Psychiatry, Children's Hospital of Philadelphia, Pennsylvania 19104, USA. rboyd@mail.med.upenn.edu
Zayas
Luis H
LH
McKee
M Diane
MD
D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000208:ethnology; D003151:Community Health Centers / Q000706:statistics & numerical data; D019052:Depression, Postpartum / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008016:Life Change Events; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D009034:Mother-Child Relations / Q000208:ethnology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology*; D011295:Prenatal Care; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D014481:United States; D014504:Urban Health