title: A prospective cohort study of depression in pregnancy, prevalence and risk factors in a multi-ethnic population.
abstract: BACKGROUND
  Depression in pregnancy increases the risk of complications for mother and child. Few studies are done in ethnic minorities. We wanted to identify the prevalence of depression in pregnancy and associations with ethnicity and other risk factors.
  
  
  METHODS
  Population-based, prospective cohort of 749 pregnant women (59% ethnic minorities) attending primary antenatal care during early pregnancy in Oslo between 2008 and 2010. Questionnaires covering demographics, health problems and psychosocial factors were collected through interviews. Depression in pregnancy was defined as a sum score ≥ 10 by the Edinburgh Postnatal Depression Scale (EPDS) at gestational week 28.
  
  
  RESULTS
  The crude prevalence of depression was; Western Europeans: 8.6% (95% CI: 5.45-11.75), Middle Easterners: 19.5% (12.19-26.81), South Asians: 17.5% (12.08-22.92), and other groups: 11.3% (6.09-16.51). Median EPDS score was 6 in Middle Easterners and 3 in all other groups. Middle Easterners (OR = 2.81; 95% CI (1.29-6.15)) and South Asians (2.72 (1.35-5.48)) had significantly higher risk for depression than other minorities and Western Europeans in logistic regression models. When adjusting for socioeconomic position and family structure, the ORs were reduced by 16-18% (OR = 2.44 (1.07-5.57) and 2.25 (1.07-4.72). Other significant risk factors were the number of recent adverse life events, self-reported history of depression and poor subjective health three months before conception.
  
  
  CONCLUSIONS
  The prevalence of depression in pregnancy was higher in ethnic minorities from the Middle East and South Asia. The increased risk persisted after adjustment for risk factors.
authors.affiliation: University of Oslo Institue for health and society, departement of general practice, Norway, Avdeling for allmennmedisin, institutt for helse og samfunn, Universitetet i Oslo, Norge, Postboks 1130 Blindern, Oslo, 0318, Norway. nilam.shakeel@medisin.uio.no.
authors.forename: Nilam
authors.initials: N
authors.lastname: Shakeel
authors.affiliation: Department of Psychosomatics and Health Behaviour, Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway. malin.eberhard-gran@fhi.no.|Health Services Research Center, Akershus University Hospital, Lørenskog, Norway. malin.eberhard-gran@fhi.no.|Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway. malin.eberhard-gran@fhi.no.
authors.forename: Malin
authors.initials: M
authors.lastname: Eberhard-Gran
authors.affiliation: Department of Child and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway. line.sletner@medisin.uio.no.
authors.forename: Line
authors.initials: L
authors.lastname: Sletner
authors.affiliation: The Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway. kari.slinning@icloud.com.|Department of psychology, University of Oslo, Oslo, Norway. kari.slinning@icloud.com.
authors.forename: Kari
authors.initials: K
authors.lastname: Slinning
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. e.w.martinsen@medisin.uio.no.
authors.forename: Egil W
authors.initials: EW
authors.lastname: Martinsen
authors.affiliation: Oslo University Hospital Ullevål, departement of Biostatic, Epidemiology and Health economics, Oslo, Norway. ingar.holme@nih.no.
authors.forename: Ingar
authors.initials: I
authors.lastname: Holme
authors.affiliation: Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. a.k.jenum@medisin.uio.no.|Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway. a.k.jenum@medisin.uio.no.
authors.forename: Anne Karen
authors.initials: AK
authors.lastname: Jenum
mesh_terms: D000328:Adult; D044466:Asian People / Q000523:psychology / Q000706:statistics & numerical data; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult