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Maternal and Child Health Journal

Erschienen in:

14.03.2018

Material Hardship and Mental Health Symptoms Among a Predominantly Low Income Sample of Pregnant Women Seeking Prenatal Care

verfasst von: Jennifer Katz, Hugh F. Crean, Catherine Cerulli, Ellen L. Poleshuck

Erschienen in: Maternal and Child Health Journal | Ausgabe 9/2018

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Abstract

Introduction Although poverty is an established correlate of poorer mental health for pregnant women, limited research has examined the mental health effects of material hardship (i.e., difficulties meeting basic needs such as for food, transportation, or stable housing) during pregnancy. Methods The current research examined rates of material hardship among pregnant women seeking prenatal care and the relationships of both income and material hardship with depression and anxiety during pregnancy. Pregnant women (N = 892) responded to self-report measures of mental health symptoms, annual household income, and current material hardship in the waiting areas of community-based obstetrics/gynecology practices serving primarily financially disadvantaged patients. Results About 56% of the sample reported some form of material hardship. About 19% of the sample reported elevated depression, and 17% reported elevated anxiety. Both depression and anxiety were uniquely associated with lower income and greater material hardship, even after controlling for age, race/ethnicity, relationship status, and number of children in the home. Furthermore, material hardship partially mediated the effect of income on mental health symptoms. Discussion The physical, emotional, and social effects of deprivation of basic daily needs may contribute to pregnant women’s experiences of mental health symptoms. These results converge with the broader literature focused on the social determinants of physical and mental health. When symptoms of depression and anxiety reflect distress related to material hardship, addressing unmet social needs may be more effective than mental health treatment.

American College of Obstetricians and Gynecologists. (2015). ACOG Committee Opinion No. 630. Screening for perinatal depression. Obstetrics and Gynecology, 125, 1268–1271. Retrieved February 1, 2018 from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Screening-for-Perinatal-Depression.

American College of Obstetricians and Gynecologists. (2018). ACOG Committee Opinion No. 729. Importance of social determinants of health and cultural awareness in the delivery of reproductive health care. Obstetrics and Gynecology, 131, e43–e48. Retrieved February 1, 2018 from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Importance-of-Social-Determinants-of-Health-and-Cultural-Awareness-in-the-Delivery-of-Reproductive.

Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C., & Braveman, P. A. (2010). Socioeconomic disparities in adverse birth outcomes: A systematic review. American Journal of Preventive Medicine, 39, 263–272. https://doi.org/10.1016/j.amepre.2010.05.012.CrossRefPubMed

Bödecs, T., Szilagyi, E., Cholnoky, P., Sándor, J., Gonda, X., Rihmer, Z., & Horváth, B. (2013). Prevalence and psychosocial background of anxiety and depression emerging during the first trimester of pregnancy: Data from a Hungarian population-based sample. Psychiatria Danubina, 25, 352–358.PubMed

Bourgois, P., Holmes, S. M., Sue, K., & Quesada, J. (2017). Structural vulnerability: Operationalizing the concept to address health disparities in clinical care. Academic Medicine, 92, 299–307. https://doi.org/10.1097/ACM.0000000000001294.CrossRefPubMedPubMedCentral

Boushey, H., Brocht, C., Gundersen, B., & Bernstein, J. (2001). Hardships in America: The real story of working families. Accessed January 26, 2017, from http://www.epinet.org/books/hardships.pdf.

Butterworth, P., Cherbuin, N., Sachdev, P., & Anstey, K. J. (2012). The role of hardship in the association between socio-economic position and depression. Australian and New Zealand Journal of Psychiatry, 46, 364–373. https://doi.org/10.1177/0004867411433215.CrossRefPubMed

Butterworth, P., Rodgers, B., & Windsor, T. D. (2009). Financial hardship, socio-economic position and depression: Results from the PATH through life survey. Social Science & Medicine, 69, 229–237. https://doi.org/10.1016/j.socscimed.2009.05.008.CrossRef

Crosier, T., Butterworth, P., & Rodgers, B. (2007). Mental health problems among single and partnered mothers: The role of financial hardship and social support. Social Psychiatry and Psychiatric Epidemiology, 42, 6–13. https://doi.org/10.1007/s00127-006-0125-4.CrossRefPubMed

CSDH. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Final report of the commission on social determinants of health. Geneva: World Health Organization. Accessed January 26, 2017, http://www.who.int/social_determinants/thecommission/finalreport/en/.

Faisal-Cury, A., & Menezes, P. R. (2007). Prevalence of anxiety and depression during pregnancy in a private setting sample. Archives of Women’s Mental Health, 10, 25–32. https://doi.org/10.1007/s00737-006-0164-6.CrossRefPubMed

Fellenzer, J. L., & Cibula, D. A. (2014). Intendedness of pregnancy and other predictive factors for symptoms of prenatal depression in a population based study. Maternal and Child Health, 18, 2426–2436. https://doi.org/10.1007/s10995-014-1481-4.CrossRef

Fisher, J., Tran, T., Tran, T. D., Dwyer, T., Nguyen, T., Casey, G. J., … Biggs, B. A. (2013). Prevalence and risk factors for symptoms of common mental disorders in early and late pregnancy in Vietnamese women: A prospective population-based study. Journal of Affective Disorders, 146, 213–219. https://doi.org/10.1016/j.jad.2012.09.007.CrossRefPubMed

Flynn, H. A., Sexton, M., Ratliff, S., Porter, K., & Zivin, K. (2011). Comparative performance of the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire-9 in pregnant and postpartum women seeking psychiatric services. Psychiatry Research, 187, 130–134. https://doi.org/10.1016/j.psychres.2010.10.022.CrossRefPubMed

Gottlieb, L., Sandel, M., & Adler, N. E. (2013). Collecting and applying data on social determinants of health in health care settings. JAMA Internal Medicine, 173, 1017–1020. https://doi.org/10.1001/jamainternmed.2013.560.CrossRefPubMed

Grote, N. K., Bridge, J. A., Gavin, A. R., Melville, J. L., Ivengar, S., & Katon, W. J. (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Archives of General Psychiatry, 67, 1012–1024. https://doi.org/10.1001/archgenpsychiatry.2010.111.CrossRefPubMedPubMedCentral

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press.

Heflin, C. M., Corcoran, M. E., & Siefert, K. A. (2007). Work trajectories, income changes, and food insufficiency in a Michigan welfare population. Social Service Review, 81, 3–25.CrossRef

Heflin, C. M., & Iceland, J. (2009). Poverty, material hardship, and depression. Social Science Quarterly, 90, 1051–1071. https://doi.org/10.1111/j.1540-6237.2009.00645.x.CrossRefPubMedPubMedCentral

Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., … Kendler, K. S. (1994). Lifetime and 12-month prevalence of DSM-III—R psychiatric disorders in the United States: Results from the national comorbidity study. Archives of General Psychiatry, 51, 8–19. https://doi.org/10.1001/archpsyc.1994.03950010008002.CrossRefPubMed

Koleva, H., Stuart, S., O’Hara, M. W., & Bowman-Reif, J. (2011). Risk factors for depressive symptoms during pregnancy. Archives of Women’s Mental Health, 14, 99–105. https://doi.org/10.1007/s00737-010-0184-0.CrossRefPubMed

Kroenke, K., Spitzer, R. L., Williams, J. B., Monahan, P. O., & Lowe, B. (2007). Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146, 317–325. https://doi.org/10.7326/0003-4819-146-5-200703060-00004.CrossRefPubMed

Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9—Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613. https://doi.org/10.1046/j1525-14972001016009606x.CrossRefPubMedPubMedCentral

Lynch, J., Smith, G. D., Harper, S., Hillemeier, M., Ross, N., Kaplan, G. A., & Wolfson, M. (2004). Is income inequality a determinant of population health? part 1. A systematic review. Milbank Quarterly, 82, 5–99. https://doi.org/10.1111/j.0887-378X.2004.00302.x.CrossRefPubMed

Lynch, J. W., Smith, G. D., Kaplan, G. A., & House, J. S. (2000). Income inequality and mortality: Importance to health of individual income, psychosocial environment, or material conditions. British Medical Journal, 320, 1200–1204. https://doi.org/10.1136/bmj.320.7243.1200.CrossRefPubMed

Målqvist, M., Clarke, K., Matsebula, T., Bergman, M., & Tomlinson, M. (2016). Screening for antepartum depression through community health outreach in Swaziland. Journal of Community Health, 41, 946–952. https://doi.org/10.1007/s10900-016-0175-9.CrossRefPubMedPubMedCentral

Marcus, S. M. (2009). Depression during pregnancy: Rates, risks and consequences—Mother risk Update 2008. Canadian Journal of Clinical Pharmacology, 16, e15–e22.PubMed

Mechanic, D. (2001). Rediscovering the social determinants of health. Health Affairs, 19, 269–276. https://doi.org/10.1377/hlthaff.19.3.269.CrossRef

Metzl, J. M., & Hansen, H. (2014). Structural competency: Theorizing a new medical engagement with stigma and inequality. Social Science & Medicine, 103, 126–133. https://doi.org/10.1016/j.socscimed.2013.06.032.CrossRef

Muntaner, C., Eaton, W. W., Miech, R., & O’Campo, P. (2004). Socioeconomic position and major mental disorders. Epidemiologic Review, 26, 53–62. https://doi.org/10.1093/epirev/mxh001.CrossRef

Norhayati, M. N., Hazlina, N. H. N., Asrenee, A. R., & Emilin, W. M. A. (2015). Magnitude and risk factors for postpartum symptoms: A literature review. Journal of Affective Disorders, 175, 34–52. https://doi.org/10.1016/j.jad.2014.12.041.CrossRefPubMed

Räisänen, S., Lehto, S. M., Nielsen, H. S., Gissler, M., Kramer, M. R., & Heinonen, S. (2014). Risk factors for and perinatal outcomes of major depression during pregnancy: A population-based analysis during 2002–2010 in Finland. British Medical Journal Open, 4, 1–8. https://doi.org/10.1136/bmjopen-2014-004883.CrossRef

Rich-Edwards, J., Kleinman, K., Abrams, A., Harlow, B. L., McLaughlin, T. J., Joffe, H., & Gillman, M. W. (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology and Community Health, 60, 221–227. https://doi.org/10.1136/jech.2005.039370.CrossRefPubMedPubMedCentral

Save the Children. (2015). State of the world’s mothers: The urban disadvantage. Retrieved March 16, 2017, from http://www.savethechildren.org.

Sidebottom, A., Harrison, P. A., Godecker, A. L., & Kim, H. (2012). Validation of the patient health screening questionnaire (PHQ-9) for prenatal depression screening. Archives of Women’s Mental Health, 15, 367–374. https://doi.org/10.1007/s00737-012-0295-x.CrossRefPubMed

Spitzer, R. L., Kroenke, K., Williams, J. B., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166, 1092–1097. https://doi.org/10.1001/archinte.166.10.1092.CrossRefPubMed

Teufel, J., Heller, S. M., & Dausey, D. J. (2014). Medical-legal partnerships as a staregy to improve social causes of stress and disease. American Journal of Public Health, 104, e6–e7. https://doi.org/10.2105/AJPH.2014.302268.CrossRefPubMedPubMedCentral

World Health Organization and Calouste Gulbenkian Foundation. (2014). Social determinants of mental health. Geneva: World Health Organization. Retrieved January 30, 2018 from http://apps.who.int/iris/bitstream/10665/112828/1/9789241506809_eng.pdf.

Zhong, Q., Gelaye, B., Rondon, M. B., Sanchez, S. E., Barrios, Y. V., Simon, G. E., … Williams, M. A. (2014). Comparative performance of Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale for screening antepartum depression. Journal of Affective Disorders, 162, 1–7. https://doi.org/10.1016/j.jad.2014.03.028.CrossRefPubMedPubMedCentral

Zhong, Q.-Y., Gelaye, B., Zaslavsky, A. M., Fann, J. R., Rondon, M. B., Sanchez, S. E., & Williams, M. A. (2015). Diagnostic validity of the Generalized Anxiety Disorder-7 (GAD-7) among pregnant women. PLoS ONE, 10, e0125096. https://doi.org/10.1371/journal.pone.0125096.CrossRefPubMedPubMedCentral

Titel: Material Hardship and Mental Health Symptoms Among a Predominantly Low Income Sample of Pregnant Women Seeking Prenatal Care
verfasst von: Jennifer Katz
Hugh F. Crean
Catherine Cerulli
Ellen L. Poleshuck
Publikationsdatum: 14.03.2018
Verlag: Springer US
Erschienen in: Maternal and Child Health Journal / Ausgabe 9/2018
Print ISSN: 1092-7875
Elektronische ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-018-2518-x

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Material Hardship and Mental Health Symptoms Among a Predominantly Low Income Sample of Pregnant Women Seeking Prenatal Care

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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