Racial and Ethnic Differences in Prenatal Life Stress and Postpartum Depression Symptoms

Published:November 13, 2015DOI:


      This study determined the risk of core depression symptoms based on life stress domains during pregnancy and whether stressors varied by race/ethnicity. The sample consisted of 2,344 White, African American, Hispanic, and Asian/Pacific Islander (API) Massachusetts women who recently gave birth. African Americans and Hispanics who endorsed high relational and high financial stress were more likely to report high depressed mood and loss of interest; high physical stress was associated with high depressed mood among API. Screening based on life stress domains may be informative in determining risk for core depression symptoms during the postpartum period especially for minority groups.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Psychiatric Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Arroll B.
        • Goodyear-Smith F.
        • Crengle S.
        • Gunn J.
        • Kerse N.
        • Fishman T.
        • Hatcher S.
        Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population.
        Annals of Family Medicine. 2010; 8: 348-353
        • Bauer A.M.
        • Chen C.-N.
        • Alegría M.
        Associations of physical symptoms with perceived need for and use of mental health services among Latino and Asian Americans.
        Social Science & Medicine (1982). 2012; 75: 1128-1133
        • Beck C.T.
        Recognizing and screening for postpartum depression in mothers of NICU infants.
        Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses. 2003; 3 (Retrieved from 37-46
        • Beeghly M.
        • Olson K.L.
        • Weinberg M.K.
        • Pierre S.C.
        • Downey N.
        • Tronick E.Z.
        Prevalence, Stability, and Socio-Demographic Correlates of Depressive Symptoms in Black Mothers During the First 18 Months Postpartum.
        Maternal and Child Health Journal. 2003; 7: 157-168
        • Broman C.L.
        The health consequences of racial discrimination.
        Ethnicity and Disease. 1996; 6: 146-153
        • Burchinal M.R.
        • Roberts J.E.
        • Hooper S.
        • Zeisel S.A.
        Cumulative risk and early cognitive development: A comparison of statistical risk models.
        Developmental Psychology. 2000; 36: 793-807
        • Da Costa D.
        • Larouche J.
        • Dritsa M.
        • Brender W.
        Psychosocial correlates of prepartum and postpartum depressed mood.
        Journal of Affective Disorders. 2000; 59: 31-40
        • Eid M.
        • Diener E.
        Norms for experiencing emotions in different cultures: inter- and intranational differences.
        Journal of Personality and Social Psychology. 2001; 81: 869-885
        • Gavin N.I.
        • Gaynes B.N.
        • Lohr K.N.
        • Meltzer-Brody S.
        • Gartlehner G.
        • Swinson T.
        Perinatal depression: a systematic review of prevalence and incidence.
        Obstetrics and Gynecology. 2005; 106 (Retrieved from 1071-1083
        • Gavin A.R.
        • Melville J.L.
        • Rue T.
        • Guo Y.
        • Dina K.T.
        • Katon W.J.
        Racial differences in the prevalence of antenatal depression.
        General Hospital Psychiatry. 2011; 33: 87-93
        • Hatch S.L.
        • Dohrenwend B.P.
        Distribution of traumatic and other stressful life events by race/ethnicity, gender, SES and age: A review of the research.
        American Journal of Community Psychology. 2007; 40: 313-332
        • Hobfoll S.E.
        Stress, Culture, and Community: The Psychology and Philosophy of Stress.
        Plenum Press, New York City1998
        • Hobfoll S.E.
        • Ritter C.
        • Lavin J.
        • Hulsizer M.R.
        • Cameron R.P.
        Depression prevalence and incidence among inner-city pregnant and postpartum women.
        Journal of Consulting and Clinical Psychology. 1995; 63 (Retrieved from 445-453
        • Howell E.A.
        • Mora P.A.
        • Horowitz C.R.
        • Leventhal H.
        Racial and Ethnic Differences in Factors Associated With Early Postpartum Depressive Symptoms.
        Race. 2005; 105: 1442-1450
        • Johnstone S.J.
        • Boyce P.M.
        • Hickey A.R.
        • Morris-Yatees A.D.
        • Harris M.G.
        Obstetric risk factors for postnatal depression in urban and rural community samples.
        The Australian and New Zealand Journal of Psychiatry. 2001; 35 (Retrieved from 69-74
        • Kanazawa A.
        • White P.M.
        • Hampson S.E.
        Ethnic variation in depressive symptoms in a community sample in Hawaii.
        Cultural Diversity and Ethnic Minority Psychology. 2007; 13: 35-44
        • Kendler K.S.
        • Myers J.
        • Prescott C.A.
        Sex differences in the relationship between social support and risk for major depression: A longitudinal study of opposite-sex twin pairs.
        The American Journal of Psychiatry. 2005; 162: 250-256
        • Kiernan K.E.
        • Huerta M.C.
        Economic deprivation, maternal depression, parenting and children’s cognitive and emotional development in early childhood.
        The British Journal of Sociology. 2008; 59: 783-806
        • Kroenke K.
        • Spitzer R.L.
        • Williams J.B.W.
        The Patient Health Questionnaire-2: validity of a two-item depression screener.
        Medical Care. 2003; 41: 1284-1292
        • Lancaster C.A.
        • Gold K.J.
        • Flynn H.A.
        • Yoo H.
        • Marcus S.M.
        • Davis M.M.
        Risk factors for depressive symptoms during pregnancy: A systematic review.
        American Journal of Obstetrics and Gynecology. 2010; 202: 5-14
        • Liu C.H.
        • Tronick E.
        Prevalence and predictors of maternal postpartum depressed mood and anhedonia by race and ethnicity.
        Epidemiology and Psychiatric Sciences. 2013; : 1-9
        • Liu C.H.
        • Tronick E.
        Rates and predictors of postpartum depression by race and ethnicity: Results from the 2004–2007 New York City PRAMS survey (Pregnancy Risk Assessment Monitoring System).
        Maternal and Child Health Journal. 2013; 17: 1599-1610
        • Liu C.H.
        • Tronick E.
        Re-conceptualising prenatal life stressors in predicting post-partum depression: cumulative-, specific-, and domain-specific approaches to calculating risk.
        Paediatric and Perinatal Epidemiology. 2013; 27: 481-490
        • Lu M.C.
        • Chen B.
        Racial and ethnic disparities in preterm birth: The role of stressful life events.
        American Journal of Obstetrics and Gynecology. 2004; 191: 691-699
        • Mesquita B.
        • Karasawa M.
        Different emotional lives.
        Cognition & Emotion. 2002; 16: 127-141
        • Myers H.F.
        Ethnicity- and socio-economic status-related stresses in context: an integrative review and conceptual model.
        Journal of Behavioral Medicine. 2009; 32: 9-19
        • Nilchaikovit T.
        • Hill J.M.
        • Holland J.C.
        The effects of culture on illness behavior and medical care: Asian and American differences.
        General Hospital Psychiatry. 1993; 15 (Retrieved from 41-50
        • O’Hara M.W.
        • Swain A.M.
        Rates and risk of postpartum depression—a meta-analysis.
        International Review of Psychiatry. 1996; 8: 37-54
        • Rich‐Edwards J.W.
        • Kleinman K.
        • Abrams A.
        • Harlow B.L.
        • McLaughlin T.J.
        • Joffe H.
        • Gillman M.W.
        Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice.
        Journal of Epidemiology & Community Health. 2006; 60: 221-227
        • Ritter C.
        • Hobfoll S.E.
        • Lavin J.
        • Cameron R.P.
        • Hulsizer M.R.
        Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women.
        Health Psychology. 2000; 19 (Retrieved from 576-585
        • Robertson E.
        • Grace S.
        • Wallington T.
        • Stewart D.E.
        Antenatal risk factors for postpartum depression: a synthesis of recent literature.
        General Hospital Psychiatry. 2004; 26: 289-295
        • Shonkoff J.P.
        Building a new biodevelopmental framework to guide the future of early childhood policy.
        Child Development. 2010; 81: 357-367
        • Sibitz I.
        • Berger P.
        • Freidl M.
        • Topitz A.
        • Krautgartner M.
        • Spiegel W.
        • Katschnig H.
        ICD-10 or DSM-IV? Anhedonia, fatigue and depressed mood as screening symptoms for diagnosing a current depressive episode in physically ill patients in general hospital.
        Journal of Affective Disorders. 2010; 126: 245-251
        • Sibitz I.
        • Berger P.
        • Freidl M.
        • Topitz A.
        • Krautgartner M.
        • Spiegel W.
        • Katschnig H.
        ICD-10 or DSM-IV? Anhedonia, fatigue and depressed mood as screening symptoms for diagnosing a current depressive episode in physically ill patients in general hospital.
        Journal of Affective Disorders. 2010; 126: 245-251
        • Thoits P.A.
        Stress and health: major findings and policy implications.
        Journal of Health and Social Behavior. 2010; : S41-S53
        • Vega W.A.
        • Kolody B.
        • Valle R.
        • Weir J.
        Social networks, social support, and their relationship to depression among immigrant Mexican women.
        Human Organization. 1991; 50: 154-162
        • Wei G.
        • Greaver L.B.
        • Marson S.M.
        • Herndon C.H.
        • Rogers J.
        Postpartum depression: racial differences and ethnic disparities in a tri-racial and bi-ethnic population.
        Maternal and Child Health Journal. 2008; 12 (Retrieved from 699-707
        • Williams D.R.
        • Yu Y.
        • Jackson J.S.
        • Anderson N.B.
        Racial differences in physical and mental health: Socio-economic status, stress, and discrimination.
        Journal of Health Psychology. 1997; 2: 335-351
        • Yonkers K.A.
        • Ramin S.M.
        • Rush A.J.
        • Navarrete C.A.
        • Carmody T.
        • March D.
        • Leveno K.J.
        Onset and persistence of postpartum depression in an inner-city maternal health clinic system.
        The American Journal of Psychiatry. 2001; 158 (Retrieved from 1856-1863
        • Zayas L.H.
        • Cunningham M.
        • McKee M.D.
        • Jankowski K.R.B.
        Depression and negative life events among pregnant African-American and Hispanic women.
        Women's Health Issues. 2002; 12 (Retrieved from 16-22