Pregnancy-Related Depression and Maternal-Child Health: A Comparison of Prenatal Care Formats.

摘要

Community-based prenatal care can provide an important context for promoting the health of low-income women and their infants. However, pregnancy-related mood disorders are associated with a variety of damaging negative physical, emotional, and social outcomes that disrupt what is generally a time of joy and increased attention to health. Low-income women who face multiple barriers to securing adequate health care may particularly benefit from an integrative model of prenatal care that can promote physical and psychological health during and after pregnancy. Centering Pregnancy (CP) is an alternative prenatal care format conducted in groups that addresses physical, social, and educational needs in one unified program. The purpose of this study is to examine perinatal depression and engagement in care for CP and traditional care formats. The participant set consisted of 222 African American and 269 Hispanic women seeking prenatal care at a primary care clinic in a medically underserved neighborhood of Chicago. Women in CP tended to be younger and have had fewer pregnancies. CP was associated with a greater number of medical visits attended and depression screenings administered during prenatal care, while there was no difference found during postpartum. There was no difference between prenatal care formats in history of depression prior to pregnancy or reported perinatal depression levels. Depression symptoms reported also did not differ between African American and Hispanic women, or between women who preferred care in English versus Spanish. However, depression rates declined over the course of pregnancy for both types of prenatal care. Further research on potential psychosocial impacts of CP is recommended.