title: Course of depressive symptoms across pregnancy in African American women.
abstract: BACKGROUND
  Although African American women are at increased risk for antenatal depression, less is known regarding the course of antenatal depression symptoms among African American women. Because pregnancy is a state of rapid physical and mental changes, we examined if depression symptoms changed between the second and third trimesters in a sample of pregnant African American women.
  
  
  METHODS
  A nonprobability sample of women was recruited from obstetrics clinics within a large Midwestern health system. African American women in their second trimester (N = 189) completed an initial study visit; a convenience sample of 37 women (19.6%) completed a second identical study visit during their third trimester. The 20-item Center for Epidemiological Studies Depression Scale (CES-D) was used to measure depressive symptoms; a CES-D score of 16 or higher equates with clinical depression and a CES-D score of 23 or higher indicates major depression. Paired t tests and correlation coefficients were used to estimate change in depression symptoms.
  
  
  RESULTS
  Mean (SD) second- and third-trimester CES-D scores were not statistically significantly different (15.3 [10.6] and 15.1 [10.3], respectively; P = .87) and were moderately and significantly correlated (r = 0.65; P .001). Prevalence of CES-D scores of 16 or higher was 43.2% (n = 16) in the second trimester and 37.8% (n=14) in the third trimester, which was not significantly different (P =.77). Between the 2 visits, 67.6% (n=25) were classified identically with a CES-D scores of 16 or higher with only fair agreement between the 2 measures (kappa = 0.33). Prevalence of CES-D scores of 23 or higher was 27.0% (n = 10) and 21.6% (n = 8) in the second and third trimesters, respectively, and was not significantly different (P = .69). Between the 2 visits, 83.8% (n = 31) were classified identically with CES-D scores of 23 or higher, with moderate agreement between the 2 measures (kappa = 0.56).
  
  
  CONCLUSIONS
  Depression symptoms were relatively constant across the latter 2 trimesters of pregnancy. The second trimester may be an appropriate time to screen women for antenatal depression, as it is less likely to be affected by early-pregnancy somatic events yet is early enough that intervention may impart positive health benefits for mother and child.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Wilusz
authors.forename: Rosalind M
authors.initials: RM
authors.lastname: Peters
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cassidy-Bushrow
mesh_terms: D000328:Adult; D001741:Black or African American; D003863:Depression / Q000150:complications* / Q000208:ethnology; D003866:Depressive Disorder / Q000150:complications* / Q000208:ethnology; D003865:Major Depressive Disorder / Q000150:complications* / Q000208:ethnology; D005260:Female; D006801:Humans; D015146:Midwestern United States; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology / Q000523:psychology*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D037841:Pregnant People / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult