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      The association between maternal and partner experienced racial discrimination and prenatal perceived stress, prenatal and postnatal depression: findings from the growing up in New Zealand cohort study

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          Abstract

          Background

          A growing number of studies document the association between maternal experiences of racial discrimination and adverse children’s outcomes, but our understanding of how experiences of racial discrimination are associated with pre- and post-natal maternal mental health, is limited. In addition, existent literature rarely takes into consideration racial discrimination experienced by the partner.

          Methods

          We analysed data from the Growing Up in New Zealand study to examine the burden of lifetime and past year experiences of racial discrimination on prenatal and postnatal mental health among Māori, Pacific, and Asian women in New Zealand (NZ), and to study the individual and joint contribution of mother’s and partner’s experiences of lifetime and past year racial discrimination to women’s prenatal and postnatal mental health.

          Results

          Our findings show strong associations between lifetime and past year experiences of ethnically-motivated interpersonal attacks and unfair treatment on mother’s mental health. Māori, Pacific, and Asian women who had experienced unfair treatment by a health professional in their lifetime were 66 % more likely to suffer from postnatal depression, compared to women who did not report these experiences. We found a cumulative effect of lifetime experiences of ethnically-motivated personal attacks on poor maternal mental health if both the mother and the partner had experienced a racist attack.

          Conclusions

          Experiences of racial discrimination have severe direct consequences for the mother’s mental health. Given the importance of mother’s mental health for the basic human needs of a healthy child, racism and racial discrimination should be addressed.

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          Most cited references61

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          Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

          The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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            Screening for depression during pregnancy with the edinburgh depression scale (EDDS)

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              Maternal stress and preterm birth.

              This study examined a comprehensive array of psychosocial factors, including life events, social support, depression, pregnancy-related anxiety, perceived discrimination, and neighborhood safety in relation to preterm birth (<37 weeks) in a prospective cohort study of 1,962 pregnant women in central North Carolina between 1996 and 2000, in which 12% delivered preterm. There was an increased risk of preterm birth among women with high counts of pregnancy-related anxiety (risk ratio (RR) = 2.1, 95% confidence interval (CI): 1.5, 3.0), with life events to which the respondent assigned a negative impact weight (RR = 1.8, 95% CI: 1.2, 2.7), and with a perception of racial discrimination (RR = 1.4, 95% CI: 1.0, 2.0). Different levels of social support or depression were not associated with preterm birth. Preterm birth initiated by labor or ruptured membranes was associated with pregnancy-related anxiety among women assigning a high level of negative impact weights (RR = 3.0, 95% CI: 1.7, 5.3). The association between high levels of pregnancy-related anxiety and preterm birth was reduced when restricted to women without medical comorbidities, but the association was not eliminated. The prospective collection of multiple psychosocial measures on a large population of women indicates that a subset of these factors is associated with preterm birth.
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                Author and article information

                Contributors
                +44 (0)161-275-0277 , Laia.becares@manchester.ac.uk
                p.atatoacarr@auckland.ac.nz
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                22 September 2016
                22 September 2016
                2016
                : 15
                : 155
                Affiliations
                [1 ]University of Manchester, Humanities Bridgeford Street, G.14, Oxford Road, Manchester, M13 9PL UK
                [2 ]Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1142 New Zealand
                Article
                443
                10.1186/s12939-016-0443-4
                5034520
                27658457
                655f766e-78b3-49ca-a85b-d06d361f0ef9
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 3 May 2016
                : 12 September 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000269, Economic and Social Research Council;
                Award ID: ES/K001582/1
                Funded by: FundRef http://dx.doi.org/10.13039/501100000770, University of Manchester;
                Award ID: Hallsworth Fellowship
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Health & Social care
                racial discrimination,ethnicity,new zealand,prenatal,postnatal,depression,perceived stress

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