Racial/Ethnic Disparities in Antenatal Depression in the United States: A Systematic Review

Background: More than 10% of pregnant women in the United States (U.S.) suffer from depression, which has far-reaching consequences on maternal and fetal well-being. There is conflicting evidence regarding the prevalence of antenatal depression among different race and ethnic groups. This systematic review aimed to summarize the existing literature concerning racial/ethnic disparities in the prevalence of antenatal depression in the U.S.

Methods: Databases PubMed, CINAHL and PsycINFO were searched online for research studies published in English in peer-reviewed journals until January 2014, using a pre-designed search strategy. Following an initial screening of titles and abstracts, full-texts were retrieved and examined to ascertain eligibility based on pre-specified criteria. Relevant data were summarized in a data extraction form independently by two reviewers.

Results: After initial screening, 58 articles were identified, from which 23 met the eligibility criteria. All the eligible studies were observational epidemiological and the prevalence of antenatal depression varied from 5% to 35%.  The majority of the studies (12 out of 23 studies) suggested a higher prevalence among African-Americans compared with non-Hispanic whites. In addition, some studies reported that Asians, Hispanics and other minorities had a higher odds of depression compared to non-Hispanic whites. However, one study found a lower risk among Latinas, and a few studies reported no statistically significant difference between the racial/ethnic groups.

Conclusion: Non-Hispanic Black women, followed by Hispanics, appear to have a higher risk of suffering from depression during their pregnancy. Further research is needed to determine factors that may be leading to these differences.