Depressive symptoms in the second trimester relate to low oxytocin levels in African-American women: a pilot study

Low-income African-American women report elevated prenatal depressive symptoms more often (42 %) than the national average (20 %). In the USA in 2012, 16.5 % of African-American women experienced a premature birth (less than 36 completed gestational weeks) compared to 10.3 % of white women. In addition, 13 % of African-American women had a low-birth weight infant (less than 2,500 g) compared to 7 % of white women. Variation in the neuropeptide, oxytocin has been implicated in perinatal depression, maternal behavior, regulation of stress responses, and may be associated with this health disparity. The purpose of this investigation was to examine factors associated with prenatal depressive symptoms, including plasma oxytocin levels and birth weight, in a sample of urban African-American women. Pregnant African-American women (N = 57) completed surveys and had blood drawn twice during pregnancy at 15-22 weeks and 25-37 weeks. In addition, birth data were collected from medical records. A large number of participants reported elevated prenatal depressive symptoms at the first (n = 20, 35 %) and the second (n = 19, 33 %) data points. Depressive symptoms were higher in multigravidas (t(51) = -2.374, p = 0.02), women with higher anxiety (r(47) = 0.71, p = 0.001), women who delivered their infants at an earlier gestational age (r(51) = -0.285, p = 0.04), and those without the support of the infant's father (F(4, 48) = 2.676, p = 0.04). Depressive symptoms were also higher in women with low oxytocin levels than in women with high oxytocin levels (F(2, 47) = 3.3, p = 0.05). In addition, women who had low oxytocin tended to have infants with lower birth weights (F(2, 47) = 2.9, p = 0.06). Neither prenatal depressive symptoms nor prenatal oxytocin levels were associated with premature birth. Pregnant multigravida African-American women with increased levels of anxiety and lacking the baby's father's support during the pregnancy are at higher risk for prenatal depressive symptoms. Prenatal depressive symptoms are associated with low oxytocin levels and lower infant birth weights. Further research is needed to understand the mechanisms between prenatal depressive symptoms, oxytocin, and birth weight in order to better understand this health disparity

Risk Factors for Postpartum Depressive Symptoms in Low-Income Women With Very Low-Birth-Weight Infants

PURPOSE: This study examined factors associated with postpartum depressive symptoms in mothers with premature infants in the neonatal intensive care unit (NICU). SUBJECTS: A total of 113 new mothers with very low-birth-weight infants in their initial NICU admission were recruited from 2 urban hospitals servicing low-income minority communities. DESIGN: This study employed a cross-sectional design. METHODS: Data were collected during the infants' postpartum NICU admission and included maternal demographic information (eg, age, education, race, living with the baby's father), infant illness severity (Neurobiologic Risk Score from infant's medical record), and maternal psychological measures (the Center for Epidemiologic Studies Depression Scale, the Perinatal Posttraumatic Stress Questionnaire, and the State-Trait Anxiety Inventory). RESULTS: The findings indicated that 47 (42%) women had elevated postpartum depressive symptoms and 33 (30%) women had elevated postpartum posttraumatic stress symptoms (PTSs). Factors associated with postpartum depressive symptoms included PTS, anxiety, maternal age, and whether the mother lived with the baby's father (F₄, ₁₀₄ = 52.27, P < .001). The severity of the infants' illness, parental stress, and maternal education were not associated with depressive symptoms among low-income mothers of NICU infants. CONCLUSIONS: On the basis of our findings, we recommend that low-income women should be screened for symptoms of anxiety, posttraumatic stress, and postpartum depression on their infants' admission to the NICU. When this is not feasible, we advise NICU healthcare providers to assess women for familial support, maternal age, posttraumatic stress related to their infants birth, and anxiety to determine which mothers are at the greatest risk for postpartum depressive symptoms. Screening for postpartum depression in the NICU can aid in early identification and treatment, thereby decreasing negative consequences for mothers and their infants