Correlates of Poor Antepartum Mental Health among Women in the US: A Nationally Representative Population-Based Study

Serious mental health problems disproportionately affect women, and are particularly prevalent during childbearing years. However there is a paucity of research on the prevalence and determinants of antepartum mental health problems in representative US populations.

We examined data on 1,107 pregnant women from five panels of the 1996-2000 Medical Expenditure Panel Survey (MEPS). Poor antepartum mental health was defined as a report of depression or anxiety, or a subjective global mental health rating of “fair” or “poor” on a 5-point scale. Multivariate regression analyses were used to model the odds of poor mental health during pregnancy, controlling for confounders.

Approximately 8% of women in the US reported experiencing poor mental health during pregnancy. Multivariate analyses revealed that a history of mental health problems before pregnancy was the strongest correlate of antepartum mental health problems. Women caring for small children, who are unmarried, living in poverty, or living with chronic medical conditions were all more likely to report antepartum mental health problems.

This study identifies key risk factors associated with antepartum mental health problems in a nationally representative population-based sample of pregnant women. Women living in poverty, with low social support, in poor health, caring for small children, or with a history of poor mental health are at an increased risk of having antepartum mental health problems. Understanding these risk factors is critical to designing effective interventions, reducing inequities, and ultimately improving the long-term health of women and their children.