Original article| Volume 21, ISSUE 4, P293-303, July 2011

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Understanding Depressive Symptoms among High-Risk, Pregnant, African-American Women

  • Kristine M. Molina
    Correspondence to: Kristine M. Molina, M.S., 530 Church Street, East Hall, Psychology Department, Ann Arbor, MI 48109; Phone: 413-218-0087.
    Psychology and Women’s Studies Departments, University of Michigan, Ann Arbor, MI, United States
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  • Michele Kiely
    Michele Kiely, Dr. P.H., DESPR/NICHD/NIH, 6100 Rockville, MD 20852; Phone: 301-594-1261.
    Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
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      Depression has been shown to be a risk factor of poor pregnancy outcomes among African-American women. The goal of this study was to examine both risk and protective factors of depressive symptoms among urban, high-risk African-American, pregnant women.


      Data were drawn from a larger randomized controlled trial, Health Outcomes of Pregnancy Education that was a part of the National Institutes of Health–DC Initiative to Reduce Infant Mortality in Minority Populations in the District of Columbia. For purposes of the present study, a sample of African-American pregnant women (n = 1,044) were recruited from six urban prenatal care clinics. Baseline depressive symptoms were assessed using the Hopkins Symptom Checklist-Depression Scale.


      Forty-four percent of women were confirmed as moderately to severely depressed at baseline. In multivariate linear regression analysis among the total sample, maternal age, intimate partner violence, illicit drug and alcohol use during pregnancy, and reproductive history (no live birth/only loss; no live birth/no loss) were associated with increased depressive symptoms. Being very happy about the pregnancy, having emotional support from others, and reporting more positive expectancies about the ability to regulate negative moods were associated with decreased depressive symptoms.


      Results highlight the importance of attending to the context of high-risk, African-American, pregnant women, paying attention to both risk and protective factors of poor psychological well-being. Implications for future research in this area are discussed.
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      Kristine M. Molina is a doctoral candidate in the joint PhD program in Personality & Social Contexts Psychology and Women's Studies at the University of Michigan.


      Michele Kiely's research focuses on health disparities, infant mortality and women's health, particularly as it pertains to pregnancy and pregnancy outcomes.