260285 Racial disparities in depression screening among prenatal and postpartum women

Wednesday, October 31, 2012 : 10:35 AM - 10:50 AM

Patricia M. McGovern, PhD, MPH , Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
One in 10 women is depressed during pregnancy or any month within the year after childbirth. Because screening is an important entrance to treatment, we investigated the question of potential racial/ethnic disparities in prenatal and postpartum depression screening. We analyzed data from 2210 women who had a live birth while continuously enrolled (one year before pregnancy and one year after delivery) in one health plan. Diagnoses were identified by ICD-9 codes and race/ethnicity and screening were measured from plan administrative and electronic medical records. We conducted logistic regression to estimate the association of any depression screening (using the Patient Health Questionnaire, PHQ-9) by race/ethnicity, adjusted for preconception depression and anxiety, age, chronic health problems, health insurance (public or private), provider specialty, and English proficiency Women's race/ethnicity was reported as 57% White, 19% Black, 12% Asian, 5% mixed race/ethnicity, 4% Hispanic, 3% unknown, and <1% American Indian. Only 14% of women had any depression screening. Differences in screening were associated with race. Compared with white women, the following groups had lower adjusted odds ratios (AOR) revealing subgroups with decreased risk of screening: Asian 0.25; 95% CI (0.12, 0.51); Black 0.48; 95%CI (0.31, 0.74), and mixed/Native American 0.42; 95% CI (0.21, 0.87). Our findings suggest racial disparities in depression screening and represent a conservative estimate relative to the general population based upon our analyses from an insured population. Given the serious outcomes of untreated depression for mothers and infants, investigation of barriers to women's prenatal and postpartum depression screening is needed.

Learning Areas:
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Discuss the significance of depression screening for women during the preconception, prenatal and postpartum period. Identify factors that may explain the low rates of prenatal and postpartum depression screening among women. Identify if racial disparities existed in depression screening for the women studied and the implications of any differences for maternal and child health research and practice.

Keywords: Depression, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-principal investigator of the grant that funded the research and have over 20 years of experience with federally funded research and publications on the topic of women's postpartum mental and physical health. Among my scientific interests is early identification of women's prenatal and postpartum depression and associated prevention and control policies and programs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.