Racial and ethnic health disparities of self-reported postpartum depression among foreign born women in Oregon

Postpartum depression (PPD) may cause serious health consequences for both mother and child. Foreign born women may experience stress due to feelings of isolation and adversity during acculturation and be prone to PPD. However, immigrant women may be more resilient in coping with stress, i.e., “healthy immigrant effect”. Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) respondents from 2005-2007 were asked about postpartum depressive symptoms (PDS) at 3 months postpartum, on average. We defined PDS when mothers reported that she always or often: 1) felt down, depressed or hopeless and/or 2) had little interest or pleasure in doing things. We estimated unadjusted and adjusted odd ratios (OR and aOR, respectively) with weighted multivariate logistic regression models and tested for interaction by race/ethnicity. The prevalence of PDS among foreign born women was 13.3% compared to 11.3% among US-born women and 11.8% overall. Foreign born women were not more likely to report PDS (OR=1.2, 95%CI: 1.0-1.5). However, after controlling for confounders, foreign born Asian women were 1.9 (95%CI: 1.1-3.3) times more likely to report PDS than US-born Asians and 2.3 times more likely (95%CI: 1.1-5.0) than US-born non-Hispanic Whites. This relationship was not found among other race/ethnicity groups. Poverty (aOR=1.5, 95%CI: 1.1-2.2), partner-related (aOR=2.4, 95%CI: 1.8-3.2) and traumatic stress (aOR=1.5, 95%CI: 1.1-2.1) were also associated with PDS. Degree of acculturation and levels of support and access to healthcare may help to explain these differences among foreign born women. Clinicians and public health professionals should provide culturally appropriate screening and treatment for high-risk populations.