A
study of 439 U.S. and Mexican-born Latinas seeking pregnancy and postpartum
services at public health clinics in San Antonio uncovered elevated levels of
depression among the more "Americanized" women, report researchers from The
University of Texas School of Public Health and The University of Texas Health
Science Center at San Antonio in the most recent online issue of the Maternal
and Child Health Journal.
"Americanization" or acculturation is the process by which immigrants adopt the
lifestyle and customs of their host nation, and key indicators include preferred
language and place of birth, lead author Marivel Davila said. Davila is a
graduate student at the UT School of Public Health and a quantitative research
analyst at the UT Health Science Center at San Antonio.
Elevated levels of depression were reported by the women born in the United
States, as well as those who asked to conduct their interviews in English. Two
non-acculturation variables were associated with elevated depression - being
single and being pregnant.
"Screening for depression during pregnancy is important for this population
group, given Latinas' high rates of fertility and births to single women,
particularly among more acculturated U.S.- born Latinas," Davila and her
colleagues wrote in the article.
According to the National Center for Health Statistics, single motherhood among
Latinas in Texas exceeds the national average. In Texas in 2005, 43 percent of
all Latina births were to single women. Nationally, the overall average was 37
percent.
"The sample for this study was a low-income population," Davila said. "Our
conclusions may or may not be different for women in other socioeconomic status
(SES) groups. Hence, more research needs to be conducted among Latinas from
differing SES groups, including research focusing on the role of social support
and cultural values/beliefs related to childbirth and pregnancy among Latinas."
The women were interviewed in eight family planning clinics and six prenatal
clinics of the San Antonio Metropolitan Health District (SAMHD) between May and
August of 2003. Of the participants, 318 were born in Mexico and 121 in the
United States. They were given the choice of conducting the interview in English
or Spanish.
"The higher prevalence rate of depression in Americanized Latina women is of
concern in our community as the population demographics clearly indicate a
significant rate of growth of this group in their childbearing years," said
Fernando A. Guerra, M.D., director of health for the San Antonio Metropolitan
Health District. "Thus, it is important to more clearly understand the
circumstances that affect their physical and emotional well-being during
pregnancy so that preventive measures can be initiated. This is critical for the
overall health of both the mother and child."
Women in the study were part of the Perinatal Depression Project for Healthy
Start, an initiative to provide mental health services to pregnant and
postpartum women by SAMHD. They were screened for depressive symptoms using the
Center for Epidemiologic Studies - Depression (CES-D) Scale, a 20-item,
questionnaire designed to gauge the level of depressive symptoms over the
previous week. Women with a score of 21 or greater were classified as having
elevated depressive symptoms.
"Women who were US-born were significantly more likely than Mexican-born women
to meet the cutoff score (21 on the CES-D scale)," the authors wrote. "Women who
conducted their interview in English were significantly more likely to express
depressive symptoms compared to women who conducted their interview in Spanish."
Davila said symptoms of depression may include: emotional stress, helplessness,
irritability and anger. Symptoms specific to the pregnancy and postpartum period
can include overly intense worries about the baby, and a lack of interest or
fear of harming the baby.
