Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 10/2012

01-10-2012 | Original Paper

Antenatal depressive symptoms among Canadian-born and immigrant women in Quebec: differential exposure and vulnerability to contextual risk factors

Authors: Malgorzata Miszkurka, Lise Goulet, Maria Victoria Zunzunegui

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 10/2012

Login to get access

Abstract

Purpose

To examine the distribution of contextual risk factors for antenatal depression according to immigrant status and the length of stay in Canada, to assess the association between these risk factors and antenatal depression (AD) for Canadian-born and immigrant women, and to compare the vulnerability of Canadian-born and immigrant women to risk factors in relation to antenatal depression.

Methods

Women were recruited at routine ultrasound examinations (16–20 weeks), at antenatal blood sampling (8–12 weeks), or in antenatal care clinics. Cross-sectional analysis was performed on the baseline sample consisting of 5,162 pregnant women. CES-D scale was used to investigate depression. Levels of exposure to the selected risk factors according to immigrant status and length of stay were assessed using Chi-square-test or the t test. All measures of association were assessed using logistic regression. Multiplicative interaction terms were constructed between each of the risk factors and immigrant status to reveal differential vulnerability between Canadian-born and immigrant women.

Results

Prevalence of AD (CES-D ≥16 points) was higher in immigrants (32% [29.6–34.4]) than in Canadian-born women (22.8% IC 95% [21.4–24.1]). Immigrant women were significantly more exposed than Canadian-born women to adverse contextual risk factors such as high marital strain, lack of social support, poverty, and crowding. At the same level of exposure to risk factors, Canadian-born women presented higher vulnerability to AD when lacking social support (OR = 4.14 IC 95% [2.69; 6.37]) while immigrant women presented higher vulnerability to AD when lacking money for basic needs (OR = 2.98 IC 95% [2.06; 4.32]).

Conclusions

Important risk factor exposure inequalities exist between Canadian-born and immigrant pregnant women. Interventions should target poverty and social isolation. The observed high frequency of AD highlights the need to evaluate the effectiveness of preventive interventions of antenatal depression.
Literature
1.
Kaaya S, Mbwambo J, Kilonzo G, Van Den Borne H, Leshabari M, Fawzi M, Schaalma H (2010) Socio-economic and partner relationship factors associated with antenatal depressive morbidity among pregnant women in Dar es Salaam, Tanzania. Tanzan J Health Res 12(1):23–35PubMed
2.
Melville J, Gavin A, Guo Y, Fan M, Katon W (2010) Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstet Gynecol 116(5):1064–1070CrossRefPubMed
3.
Edwards B, Galletly C, Semmler-Booth T, Dekker G (2008) Antenatal psychosocial risk factors and depression among women living in socioeconomically disadvantaged suburbs in Adelaide, South Australia. Aust N Z J Psychiatry 42(1):45–50. doi:10.​1080/​0004867070173267​3 CrossRefPubMed
4.
Bowen A, Muhajarine N (2006) Antenatal depression. Can Nurse 102(9):26–30PubMed
5.
Koleva H, Stuart S, O’Hara M, Bowman-Reif J (2010) Risk factors for depressive symptoms during pregnancy. Arch Womens Ment Health 14(2):99–105CrossRefPubMed
6.
Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM (2010) Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 202(1):5–14
7.
Chui T, Tran K, Maheux H (2007) Immigration in Canada: a portrait of the foreign-born population, 2006 Census. Ottawa: Statistics Canada
8.
Miszkurka M, Goulet L, Zunzunegui MV (2010) Contributions of immigration to depressive symptoms among pregnant women in Canada. Can J Public Health 101(5):358–364PubMed
9.
Denton M, Prus S, Walters V (2004) Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health. Soc Sci Med 58(12):2585–2600CrossRefPubMed
10.
Rogler Lloyd H (1994) International migrations. A framework for directing research. Am Psychol 49(8):701–708CrossRef
11.
Kramer MS, Goulet L, Lydon J, Séguin L, McNamara H, Dassa C, Platt RW, Chen MF, Gauthier H, Genest J, Kahn S, Libman M, Rozen R, Masse A, Miner L, Asselin G, Benjamin A, Klein J, Koren G (2001) Socio-economic disparities in preterm birth: causal pathways and mechanisms. Pediatr Perinat Epidemiol, suppl(2):104–123
12.
Kramer MS, Wilkins R, Goulet L, Séguin L, Lydon J, Kahn SR, McNamara H, Dassa C, Dahhou M, Masse A, Miner L, Asselin G, Gauthier H, Ghanem A, Benjamin A, Platt RW (2009) Investigating socio-economic disparities in preterm birth: evidence for selective study participation and selection bias. Paediatr Perinat Epidemiol 23(4):301–309
13.
14.
Roberts RE (1980) Reliability of the CES-D scale in different ethnic contexts. Psychiatry Res 2(2):125–134CrossRefPubMed
15.
Giovanni AF (1983) Assessing depressive symptoms across cultures: Italian validation of the CES-D self-rating scale. J Clin Psychol 39(2):249–251CrossRef
16.
Stahl D, Sum CF, Lum SS, Liow PH, Chan YH, Verma S, Chua HC, Chong SA (2008) Screening for depressive symptoms: validation of the Center for Epidemiologic Studies Depression Scale (CES-D) in a multiethnic group of patients with diabetes in Singapore. Diabetes Care 31(6):1118–1119. doi:10.​2337/​dc07-2019 CrossRefPubMed
17.
Morton DJ, Schoenrock SA, Stanford EP, Peddecord KM, Molgaard CA (1989) Use of the CES-D among a community sample of older Mexican–Americans. J Cr Cultural Gerontol 4(4):289–306CrossRef
18.
Nguyen HT, Kitner-Triolo M, Evans MK, Zonderman AB (2004) Factorial invariance of the CES-D in low socioeconomic status African Americans compared with a nationally representative sample. Psychiatry Res 126(2):177–187CrossRefPubMed
19.
Vissandjee B, Carignan P, Bourdeau-Marchand M (1999) Les nouvelles immigrantes et la sante. L’infirmiere canadienne 95(4):35–41
20.
Vissandjee B, Desmeules M, Cao Z, Abdool S, Kazanjian A (2004) Integrating ethnicity and migration as determinants of Canadian women’s health. BMC Women’s Health 4(Suppl 1):S32CrossRefPubMed
21.
22.
Vega WA, Kolody B, Ramon V (1988) Marital strain, coping, and depression among Mexican–American women. J Marriage Fam 50(2):391–403CrossRef
23.
Osborne LN, Rhodes JE (2001) The role of life stress and social support in the adjustment of sexually victimized pregnant and parenting minority adolescents. Am J Community Psychol 29(6):833–849CrossRefPubMed
24.
Barrera M (1981) Social support in the adjustment of pregnant adolescents: assessment issues. In: Gottieb B (ed) Social network and social support. Sage, Beverly Hills, pp 69–96
25.
26.
Ehounoux NZ, Zunzunegui M-V, Seguin L, Nikiema B, Gauvin L (2009) Duration of lack of money for basic needs and growth delay in the Quebec longitudinal study of child development birth cohort. J Epidemiol Community Health 63(1):45–49. doi:10.​1136/​jech.​2007.​072157 CrossRefPubMed
27.
Lobel M (1997) The prenatal life event scale (PLES). State University of New York at Stony Brook, Stony Brook
28.
Lobel M, Dunkel-Schetter C, Scrimshaw SCM (1992) Prenatal maternal stress and prematurity: a prospective study of socioeconomically disadvantaged women. Health Psychol 11(1):32–40CrossRefPubMed
29.
30.
31.
Wu Z, Noh S, Kaspar V, Schimmele CM (2003) Race, ethnicity, and depression in Canadian society. J Health Soc Behav 44(3):426–441CrossRefPubMed
32.
Williams DR (2002) Racial/ethnic variations in women’s health: the social embeddedness of health. Am J Public Health 92(4):588–597CrossRefPubMed
33.
Fung K, Dennis C-L Postpartum depression among immigrant women. Curr Opin Psychiatry 23(4):342–348 310.1097/YCO.1090b1013e32833ad32721
34.
35.
Xie R-H, He G, Koszycki D, Walker M, Wen SW (2009) Prenatal social support, postnatal social support, and postpartum depression. Ann Epidemiol 19(9):637–643CrossRefPubMed
36.
Stewart DE, Gagnon A, Saucier JF, Wahoush O, Dougherty G (2008) Postpartum depression symptoms in newcomers. Can J Psych 53:121–124
37.
38.
39.
Rudnicki SR, Graham JL, Habboushe DF, Ross RD (2001) Social support and avoidant coping: correlates of depressed mood during pregnancy in minority women. Women Health 34(3):19–34CrossRefPubMed
40.
Antonucci TC (1994) A life-span view of women’s social relations. In: Turner BF, Troll LE (eds) Women Growing Older Sage Publications Thousand Oaks, CA, pp 239–269
41.
Fuhrer R, Stansfeld SA, Chemali J, Shipley MJ (1999) Gender, social relations and mental health: prospective findings from an occupational cohort (Whitehall II study). Soc Sci Med 48(1):77–87CrossRefPubMed
42.
Westdahl CMS, Magriples U, Kershaw TS, Rising SS, Ickovics JR (2007) Social support and social conflict as predictors of prenatal depression. Obstet Gynecol 110(1):134–140CrossRefPubMed
43.
House JS (2001) Social isolation kills, but how and why? Psychosom Med 63(2):273–274PubMed
44.
Mechakra-Tahiri S, Zunzunegui MV, Seguin L (2007) Self-rated health and postnatal depressive symptoms among immigrant mothers in Quebec. Women Health 45:1–17
45.
Van Hulst A, Séguin L, Zunzunegui MV, Vélez MP, Nikiéma B (2011) The influence of poverty and social support on the perceived health of children born to minority migrant mothers. Ethn Health 16(3):185–200
46.
Tang T, Oatley K, Toner B (2007) Impact of life events and difficulties on the mental health of chinese immigrant women. J Immigr Minority Health 9(4):281–290CrossRef
47.
Reitz J (2007) Immigrant employment success in Canada, Part I: individual and contextual causes. J Int Migr Integr 8(1):11–36CrossRef
48.
Lawrence E, Nylen K, Cobb RJ (2007) Prenatal expectations and marital satisfaction over the transition to parenthood. J Fam Psychol 21(2):155–164CrossRefPubMed
49.
Lawrence E, Rothman AD, Cobb RJ, Rothman MT (2008) Marital satisfaction across the transition to parenthhood. J Fam Psychol 22(1):41–50CrossRefPubMed
50.
Mchale SM, Huston T (1985) The effect of the transition to parenthood on the marriage relationship: a longitudinal study. J Fam Issues 6(4):409–433CrossRefPubMed
51.
Records K, Rice M (2007) Psychosocial correlates of depression symptoms during the third trimester of pregnancy. J Obstet Gynecol Neonatal Nurs 36(3):231–242CrossRefPubMed
52.
53.
Rubertsson C, Wickberg B, Gustavsson P, Rådestad I (2005) Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample. Arch Women’s Ment Health 8(2):97–104. doi:10.​1007/​s00737-005-0078-8 CrossRef
54.
Stewart M, Anderson J, Beiser M, Mwakarimba E, Neufeld A, Simich L, Spitzer D (2008) Multicultural meanings of social support among immigrants and refugees. Int Migr 46(3):123–159CrossRef
55.
56.
MacArthur C, Winter HR, Bick DE, Lilford RJ, Lancashire RJ, Knowles H, Braunholtz DA, Henderson C, Belfield C, Gee H (2003) Redesigning postnatal care: a randomised controlled trial of protocol-based midwifery-led care focused on individual women’s physical and psychological health needs. Health Technol Assess 7(37):1–98
57.
58.
59.
Harvey ST, Pun PKK (2007) Analysis of positive Edinburgh depression scale referrals to a consultation liaison psychiatry service in a two-year period. Int J Ment Health Nurs 16(3):161–167CrossRefPubMed
60.
Leigh B, Milgrom J (2008) Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry 8(1):24CrossRefPubMed
61.
Murray L, Cooper PJ (1997) Effects of postnatal depression on infant development. Arch Dis Child 77:99–101CrossRefPubMed
62.
Hollins K (2007) Consequences of antenatal mental health problems for child health and development. Curr Opin Obstet Gynecol 19(6):568–572CrossRefPubMed
Metadata
Title
Antenatal depressive symptoms among Canadian-born and immigrant women in Quebec: differential exposure and vulnerability to contextual risk factors
Authors
Malgorzata Miszkurka
Lise Goulet
Maria Victoria Zunzunegui
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 10/2012
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-011-0469-2

Other articles of this Issue 10/2012

Social Psychiatry and Psychiatric Epidemiology 10/2012 Go to the issue

Original Paper

Socioeconomic status and children’s mental health: results from the Bergen Child Study

Original Paper

Khat use among Somali mental health service users in South London

Original Paper

School performance and hospital admission due to unipolar depression: a three-generational study of social causation and social selection

Original Paper

Suicidal behaviours in adolescents in Nova Scotia, Canada: protective associations with measures of social capital

Original Paper

A UK population-based study of the relationship between mental disorder and victimisation

Original Paper

Common patterns of violence experiences and depression and anxiety among adolescents