Abstract
Objectives
Immigrant women present high prevalence of depressive symptoms during pregnancy, the early postpartum period and as mothers of young children. We compared mental health of immigrant and Canadian native-born women during pregnancy according to length of stay and region of origin, and we assessed the role of economics and social support in antenatal depressive symptomatology.
Methods
Data originated from the Montreal study on socio-economic differences in prematurity; 3,834 Canadian-born and 1,495 foreign-born women attending Montreal hospitals for antenatal care were evaluated for depression at 24–26 weeks of pregnancy using the Center for Epidemiologic Studies Depression scale by fitting logistic regressions with staggered entry of possible explanatory variables.
Results
Immigrant women had a higher prevalence of depressive symptomatology independently of time since immigration. Region of origin was a strong predictor of depressive symptomatology: women from the Caribbean, South Asia, Maghreb, Sub-Saharan Africa and Latin America had the highest prevalence of depressive symptomatology compared to Canadian-born women. The higher depression odds in immigrant women are attenuated after adjustment for lack of social support and money for basic needs. Time trends of depressive symptoms varied across origins. In relation to length of stay, depressive symptoms increased (European, Southeast Asian), decreased (Maghrebian, Sub-Saharan African, Middle Eastern, East Asian) or fluctuated (Latin American, Caribbean).
Conclusion
Depression in minority pregnant women deserves more attention, independently of their length of stay in Canada. Social support favouring integration and poverty reduction interventions could reduce this risk of antenatal depression.
Key words: Pregnancy, depression, immigration, socio-economic factors, social support, region of origin
Résumé
Objectifs
Les immigrantes affichent une prévalence élevée de symptômes dépressifs durant la grossesse, au début de la période post-partum et en tant que mères de jeunes enfants. Nous avons comparé la santé mentale d’immigrantes et de Canadiennes de souche durant la grossesse selon la longueur du séjour et la région d’origine, puis évalué le rôle des facteurs économiques et du soutien social dans la symptomatologie dépressive prénatale.
Méthode
Nos données proviennent de l’étude montréalaise sur les différences socioéconomiques dans la prématurité; 3834 Canadiennes de souche et 1495 femmes nées à l’étranger recevant des soins prénatals dans les hôpitaux de Montréal ont été évaluées à 24–26 semaines de grossesse selon l’échelle de dépression du Centre des études épidémiologiques en agençant des régressions logistiques avec l’introduction échelonnée de variables explicatives possibles.
Résultats
Les immigrantes avaient une prévalence accrue de symptomatologie dépressive, indépendamment de leur date d’immigration. La région d’origine était un solide prédicteur de symptomatologie dépressive: les femmes originaires des Caraïbes, d’Asie du Sud, du Maghreb, d’Afrique subsaharienne et d’Amérique latine présentaient la plus forte prévalence comparativement aux Canadiennes de souche. Les probabilités de dépression accrues chez les immigrantes s’atténuent lorsqu’on tient compte de leur manque de soutien social et d’argent pour répondre à leurs besoins fondamentaux. Les tendances temporelles des symptômes dépressifs variaient selon les origines. Par rapport à la durée du séjour, les symptômes dépressifs pouvaient s’accentuer (femmes originaires d’Europe et d’Asie du Sud-Est), diminuer (femmes du Maghreb, d’Afrique subsaharienne, du Moyen-Orient et d’Asie de l’Est) ou fluctuer (femmes d’Amérique latine et des Caraïbes).
Conclusion
La dépression chez les femmes enceintes des minorités mérite qu’on s’y attache, indépendamment de la durée de leur séjour au Canada. Un soutien social favorisant l’intégration et la réduction de la pauvreté pourrait réduire le risque de dépression prénatale.
Mots clés: grossesse, dépression, émigration et immigration, facteurs socioéconomiques, soutien social, région d’origine
Footnotes
Acknowledgements: Supported by the Perinatal Epidemiological Research Initiative Program Grant No. 20-FYO4-38 from the March of Dimes Birth Defects Foundation, the Canadian Institutes of Health Research (CIHR) and Institut de Recherche en Santé Publique de l’Université de Montréal (IRSPUM).
Conflict of Interest: None to declare.
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