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Prevalence and Correlates of Depressive Symptoms in Pregnancy African American Women

Prevalence and Correlates of Depressive Symptoms in Pregnancy African American Women. Nancy Jallo, PhD, FNP-BC, WHNP-BC Virginia Commonwealth University R. Jeanne Ruiz, PhD, WHNP-BC, Ohio State College of Nursing. Acknowledgements.

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Prevalence and Correlates of Depressive Symptoms in Pregnancy African American Women

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  1. Prevalence and Correlates of Depressive Symptoms in Pregnancy African American Women Nancy Jallo, PhD, FNP-BC, WHNP-BC Virginia Commonwealth University R. Jeanne Ruiz, PhD, WHNP-BC, Ohio State College of Nursing

  2. Acknowledgements Research supported by grant number 5-F31-NR008977 and 5-K30-AT000060 from the NINR and NCCAM at the NIH. Podium presentation supported by NIH/NINR-P30-NR011403. Its contents are solely the responsibility of the author and do not necessarily represent the official views of NINR or NCCAM.

  3. Overview of the Problem • Prenatal depression is associated with adverse obstetrical, fetal and neonatal outcomes • Disruption of the hypothalamic-pituitary-adrenal axis (HPA) is a proposed pathway linking depression to negative outcomes • Pregnant African American women maybe at increase risk for depressive symptoms • Limited evidence on the prevalence and correlates of depressive symptoms early in pregnancy in African American women

  4. Biological and Behavioral Factors: Demographics Health Behaviors Relationships Medical Conditions Individual Characteristics Stress Perceptions Coping Threats to Maternal Wellbeing: Depressive Symptoms Stress, Anxiety, PNI Framework Birth Outcomes Maternal-Infant Relationship Child Well-being Biologic Pathways: Neuroendocrine (CRH)

  5. Purpose • The purpose of this study was to examine the prevalence and correlates of depressive symptoms in African American women at 14-17 weeks gestation

  6. Methods • Design • Secondary analysis • Baseline measure of cohort participating in 12 week intervention study • Setting • Academic obstetrical service • Community obstetrical practice

  7. Methods (cont’d) • Participants • Inclusion • AA pregnant women between 18-40 yo • 14-17 weeks gestation • Ability to read, write and understand English • Verbalize a source of social support • Exclusion • History of thyroid, adrenal, cardiac, or chronic renal disease • Dissociative disorders, borderline personalities or psychotic psychology • Current use of corticosteroids • Multiple pregnancy • Cervical cerclage • Uterine or cervical abnormality • Current use of guided imagery

  8. Methods (cont’d)Self Report Measures • Demographic Questionnaire • Health History Questionnaire • Center for Epidemiologic Studies – Depression (CES-D) • Perceived Stress Scale (PSS) • Numeric Rating Scale of Stress (NRSS) • State Anxiety Scale (STAI)

  9. Methods (cont’d)Biological Measures • CRH • Venipuncture, blood centrifuged and plasma separated • Kept in -80 degree freezer until ready for assay • CRH was extracted using methanol technique to separate the binding protein from the peptide, then run with a Radioimmunoassay • Interassay coefficient of variation was <15%

  10. Procedure • Office staff invited potential participants to discuss study with researcher • 14-17 weeks • Informed Consent • Demographic and Health History • PSS, STAI, CES-D, NRSS • Blood drawn for plasma CRH

  11. Data analysis • Statistical Package for the Social Sciences (SPSS) 14 • Level of significance 0.05 • Assumptions tested • Descriptive – Demographics, Self Report Mean Scores • One sample t-test • Pearson correlations • Multiple Regression

  12. ResultsSample Characteristics(n=59)

  13. Results

  14. ResultsPredictors of Depressive Symptoms • A significant regression equation was found (F(2,56) = 42.644, p <.001) with an R2 of .604 Both PSS (stress) and STAI (anxiety) scores were predictors of depressive symptoms

  15. Depressive Scores Related to Stress and Anxiety 60 50 40 CES-D Scores 30 20 10 0 -3 -2 -1 0 1 2 3 4 Standardized Predicted Values from Regression of Stress and Anxiety Results

  16. Conclusions • In pregnant African American women at 14-17 weeks gestation: • High prevalence of depressive symptoms • PSS and NRRS (stress) and STAI (anxiety) scores were correlated with CES-D (depressive symptoms) • PSS and STAI scores predicted CES-D scores (depressive symptoms)

  17. Discussion/Implications • Limitations • High prevalence of depressive symptoms and strong correlations with psychosocial distress (stress and anxiety) in pregnant African American women early in the second trimester • Concept of maternal wellness/distress • Importance of early screening • Selection of screening tool • Future Research • Interventions for modifiable variables • Psychological and Physiologic pathways

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