Postpartum Depression Risk Factors Among Recent Refugee, Asylum-seeking, Non-refugee Immigrant, and Canadian-born Women: Results from a Prospective Cohort Study

Overview

Journal Soc Psychiatry Psychiatr Epidemiol

Specialties Psychiatry
Public Health
Social Sciences

Date 2017 Feb 22

PMID 28220215

Citations 24

Authors

Cindy-Lee Dennis

Lisa Merry

Anita J Gagnon

Affiliations

Soon will be listed here.

Abstract

Purpose: The objective was to examine and compare risk factors for postpartum depression among: (1) recent (≤5 years) migrant and Canadian-born women, and (2) refugee, asylum-seeking, and non-refugee immigrant women.

Methods: A sample of 1536 women (1024 migrant and 512 Canadian-born) were recruited from 12 hospitals. Women completed questionnaires at 1-2 and 16 weeks postpartum including questions on socio-demographics, biomedical history, health services, and migration and resettlement factors. Bivariate analyses and multivariate logistic regression were performed to examine and compare risk factors for postpartum depressive symptoms at 16 weeks postpartum.

Results: Recent migrant women had significantly higher rates (6%) of depressive symptoms at 16 weeks postpartum than Canadian-born women (2.9%). Asylum-seekers had the highest rate (14.3%), followed by refugee (11.5%) and non-refugee immigrant women (5.1%). Migrant women at greatest risk to develop depressive symptoms were those who experienced abuse, had pain post-birth, worried about family members left behind, had food insecurity, and had reduced access to healthcare (limited insurance and/or no regular care-provider). Conversely, those with higher levels of social support and who felt they belonged to a community had a lower risk of developing depressive symptoms.

Conclusion: All childbearing recent migrant women should be considered at risk for postpartum depression. To prevent and support migrant women suffering postpartum depressive symptoms, barriers to healthcare need to be addressed and interventions should include assessments and support/programmes for abuse/violence, lack of social support, food insecurity, and stress/poor mental health. Treatment of pain during the postpartum period is also critical.

Citing Articles

Prevalence, Risk Factors, and Interventions of Postpartum Depression in Refugees and Asylum-Seeking Women: A Systematic Review and Meta-Analysis.

Heer K, Mahmoud L, Abdelmeguid H, Selvan K, Malvankar-Mehta M Gynecol Obstet Invest. 2024; 89(1):11-21.

PMID: 38219724 PMC: 10871679. DOI: 10.1159/000535719.

Postpartum depression and life experiences of mothers with an immigrant background living in the south of Sweden.

Johansson M, Ledung Higgins K, Dapi Nzefa L, Benderix Y Int J Qual Stud Health Well-being. 2023; 18(1):2187333.

PMID: 36880807 PMC: 10013500. DOI: 10.1080/17482631.2023.2187333.

Psychosocial and behavioral health indicators among immigrant and non-immigrant recent mothers.

Ewesesan R, Chartier M, Nickel N, Wall-Wieler E, Urquia M BMC Pregnancy Childbirth. 2022; 22(1):612.

PMID: 36008777 PMC: 9413808. DOI: 10.1186/s12884-022-04937-z.

Community-based doulas for migrant and refugee women: a mixed-method systematic review and narrative synthesis.

Khaw S, Zahroh R, ORourke K, Dearnley R, Homer C, Bohren M BMJ Glob Health. 2022; 7(7).

PMID: 35902203 PMC: 9341177. DOI: 10.1136/bmjgh-2022-009098.

Determinants of food security among people from refugee backgrounds resettled in high-income countries: A systematic review and thematic synthesis.

Gingell T, Murray K, Correa-Velez I, Gallegos D PLoS One. 2022; 17(6):e0268830.

PMID: 35653308 PMC: 9162305. DOI: 10.1371/journal.pone.0268830.

References

Dennis C, Hodnett E, Kenton L, Weston J, Zupancic J, Stewart D . Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial. BMJ. 2009; 338:a3064. PMC: 2628301. DOI: 10.1136/bmj.a3064. View

Kalt A, Hossain M, Kiss L, Zimmerman C . Asylum seekers, violence and health: a systematic review of research in high-income host countries. Am J Public Health. 2013; 103(3):e30-42. PMC: 3673512. DOI: 10.2105/AJPH.2012.301136. View

Miszkurka M, Zunzunegui M, Goulet L . Immigrant status, antenatal depressive symptoms, and frequency and source of violence: what's the relationship?. Arch Womens Ment Health. 2012; 15(5):387-96. DOI: 10.1007/s00737-012-0298-7. View

Kirmayer L . Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment. J Clin Psychiatry. 2001; 62 Suppl 13:22-8; discussion 29-30. View

Huddleston-Casas C, Charnigo R, Simmons L . Food insecurity and maternal depression in rural, low-income families: a longitudinal investigation. Public Health Nutr. 2008; 12(8):1133-40. DOI: 10.1017/S1368980008003650. View

Schweitzer R, Melville F, Steel Z, Lacherez P . Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Aust N Z J Psychiatry. 2006; 40(2):179-87. DOI: 10.1080/j.1440-1614.2006.01766.x. View

Merry L, Gagnon A, Hemlin I, Clarke H, Hickey J . Cross-border movement and women's health: how to capture the data. Int J Equity Health. 2011; 10:56. PMC: 3235058. DOI: 10.1186/1475-9276-10-56. View

Miranda J, Siddique J, Der-Martirosian C, Belin T . Depression among Latina immigrant mothers separated from their children. Psychiatr Serv. 2005; 56(6):717-20. DOI: 10.1176/appi.ps.56.6.717. View

Lent M, Petrovic L, Swanson J, Olson C . Maternal mental health and the persistence of food insecurity in poor rural families. J Health Care Poor Underserved. 2009; 20(3):645-61. DOI: 10.1353/hpu.0.0182. View

10.

Mahon A, Merry L, Lu O, Gagnon A . Postpartum Pain in the Community Among Migrant and Non-migrant Women in Canada. J Immigr Minor Health. 2016; 19(2):407-414. DOI: 10.1007/s10903-016-0364-8. View

11.

Carpiano R, Hystad P . "Sense of community belonging" in health surveys: what social capital is it measuring?. Health Place. 2011; 17(2):606-17. DOI: 10.1016/j.healthplace.2010.12.018. View

12.

Gagnon A, Dougherty G, Wahoush O, Saucier J, Dennis C, Stanger E . International migration to Canada: the post-birth health of mothers and infants by immigration class. Soc Sci Med. 2012; 76(1):197-207. DOI: 10.1016/j.socscimed.2012.11.001. View

13.

Fung K, Dennis C . Postpartum depression among immigrant women. Curr Opin Psychiatry. 2010; 23(4):342-8. DOI: 10.1097/YCO.0b013e32833ad721. View

14.

Howard L, Oram S, Galley H, Trevillion K, Feder G . Domestic violence and perinatal mental disorders: a systematic review and meta-analysis. PLoS Med. 2013; 10(5):e1001452. PMC: 3665851. DOI: 10.1371/journal.pmed.1001452. View

15.

Asanin J, Wilson K . "I spent nine years looking for a doctor": exploring access to health care among immigrants in Mississauga, Ontario, Canada. Soc Sci Med. 2008; 66(6):1271-83. DOI: 10.1016/j.socscimed.2007.11.043. View

16.

Gaynes B, Gavin N, Meltzer-Brody S, Lohr K, Swinson T, Gartlehner G . Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (Summ). 2005; (119):1-8. PMC: 4780910. DOI: 10.1037/e439372005-001. View

17.

Trivedi M . The link between depression and physical symptoms. Prim Care Companion J Clin Psychiatry. 2005; 6(Suppl 1):12-6. PMC: 486942. View

18.

Freedman J . Sexual and gender-based violence against refugee women: a hidden aspect of the refugee "crisis". Reprod Health Matters. 2016; 24(47):18-26. DOI: 10.1016/j.rhm.2016.05.003. View

19.

Sword W, Watt S, Krueger P . Postpartum health, service needs, and access to care experiences of immigrant and Canadian-born women. J Obstet Gynecol Neonatal Nurs. 2006; 35(6):717-27. DOI: 10.1111/j.1552-6909.2006.00092.x. View

20.

Kurth E, Jaeger F, Zemp E, Tschudin S, Bischoff A . Reproductive health care for asylum-seeking women - a challenge for health professionals. BMC Public Health. 2010; 10:659. PMC: 2988736. DOI: 10.1186/1471-2458-10-659. View