Is screening for depression in the perinatal period enough? The co-occurrence of depression, substance abuse, and intimate partner violence in culturally diverse pregnant women.
BACKGROUND
The perinatal period provides unique opportunities to identify and intervene with the co-occurrence of perinatal depression, intimate partner violence (IPV), and substance use problems. Psychosocial screening recommended for women seen in maternal child health settings tends to target single rather than multiple risk factors; there is limited research examining the co-occurrence of these issues especially in racially and ethnically diverse women across the perinatal period. These analyses explore the relationships of sociodemographic, psychosocial, and behavioral characteristics in a large, diverse sample of women.


METHODS
Women receiving perinatal services at routinely scheduled visits, including the 6-week postpartum visit, were recruited from 10 community obstetric/gynecologic clinics. Data were collected on perinatal depression, IPV, maternal substance use, and sociodemographic characteristics by bilingual, bicultural research assistants.


RESULTS
A total of 1868 women were screened, 1526 (82%) Latina, 1099 (58.8%) interviewed in Spanish; 20.4% (n=382) screened positive for depressive symptoms based on an Edinburgh Postnatal Depression Scale score of 10 or above, 20.9% reported harmful drinking, 4.3% reported drug use, 23% reported substance use problems, and 3.5% reported current or recent IPV. Women who were Black, Asian, Pacific Islander, or other race/ethnicity had greater odds for depressive symptoms relative to women who were Hispanic or Latino (odds ratio [OR]=1.81, p=0.005). Women reporting substance use problems (OR=2.37, p<0.0001) and IPV (OR=3.98, p<0.0001) had higher odds for depressive symptoms.


CONCLUSIONS
In a predominately Latina sample, 1 in 5 mothers (20.4%) screened positive for depressive symptoms and over one third (36.7%) reported one or more psychosocial issues during the perinatal period. Screening for multiple risk factors rather than just one can help clinicians tailor interventions for the successful management of psychosocial issues.
1 University of San Diego Hahn School of Nursing and Health Science , San Diego, California.
Cynthia D
CD
Connelly
Andrea L
AL
Hazen
Mary J
MJ
Baker-Ericzén
John
J
Landsverk
Sarah McCue
SM
Horwitz
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D015897:Comorbidity; D003469:Culture; D003863:Depression / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods; D018743:Perinatal Care; D011247:Pregnancy; D037841:Pregnant People / Q000208:ethnology* / Q000523:psychology; D012747:Sexual Partners; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000208:ethnology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications / Q000208:ethnology*; D011795:Surveys and Questionnaires; D055815:Young Adult