Perinatal & Pediatric
Trajectories of perinatal depressive symptoms in Black and Latina pregnant individuals Sara Aghaee* Sara Aghaee Lyndsay A. Avalos Elaine Kurtovich Ai Kubo
Over 10% of pregnant individuals experience perinatal depression, with disproportionately high rates among Black and Latina individuals. The literature suggests that perinatal depression is better characterized as trajectories, yet studies on these populations are scarce. This study examines trajectories of perinatal depressive symptoms among Black and Latina individuals in an integrated healthcare delivery system, and their associations with clinical outcomes.
We determined trajectory groups using the Patient Health Questionnaire-9 (PHQ-9), a 9-item depression screener. Total scores range 0-27. Depression severity is characterized as little (0-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe (20-27). Scores of 10+ are associated with clinical levels of depression. Outcomes included preterm delivery (<37 weeks), low birth weight (<2500 grams), low APGAR scores (0-3, 4-6) and having a c-section. Data were extracted from the electronic health records and research databases.
We examined data from 10,562 pregnancies resulting in singleton live births among Black (22%) and Latina (78%) individuals starting June 2022. We identified 5 trajectory groups using SAS procedure TRAJ: low-stable (23%), mild-stable (45.9%), mild-increasing (13.1%), moderate-stable (13.1%), and moderate-increasing (4.9%). Individuals in the mild-stable (OR: 1.25, 95%CI: 1.04-1.51), mild-increasing (1.35, 1.05-1.172), moderate-stable (1.29, 1.01-1.66) and moderate-increasing (1.45, 1.04-2.01) groups had increased odds of experiencing preterm births compared to those in the low-stable group. Similar associations were found for low birth weight and APGAR scores.
Our findings suggest that having even subclinical levels of depression may be associated with birth outcomes, and that effect estimates vary by severity and trend. Serial depression screenings may be a cost-effective tool for reducing health disparities associated with perinatal depression.