Social Stressors Associated With Antepartum Depressive Symptoms in Low-Income African American Women

Objectives: To describe depressive symptomatology and examine the relationship between social stressors and depressive symptoms in pregnant African American women. Design and Sample: Cross‐sectional study of 119 women receiving care at 2 prenatal clinics in Northern California. Measures: Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES‐D). Social stress variables included discrimination, trauma exposure, social conflict, and economic stress. Results: In this sample, mean CES‐D score was 15.88. Forty‐two percent of the women had CES‐D scores ≥16 (possible risk), and 23% had CES‐D scores ≥23 (probable risk). There were significantly positive relationships between the social stress variables (discrimination, trauma exposure, social conflict, economic stress) and CES‐D scores. Stepwise multiple regression analysis indicated that together discrimination and social conflict accounted for 36% of the variance in antepartum depressive symptoms. Conclusions: Discrimination and social conflict are considerable sources of stress that contribute to levels of antepartum depressive symptoms in African American women. While the results reinforce the importance of universal prenatal screening, comprehensive strategies are also needed to help ameliorate the impact that social stressors such as discrimination and social conflict have on the mental health of pregnant African American women.