Supplemental Nutrition Programs During Pregnancy and the Early Postnatal Period

Abstract

Depression is among the most prevalent and high-risk perinatal health problems. From studies using objective measures of depression, it is estimated that in the United States, the period prevalence of major depression during pregnancy ranges from 9.4 to 12.7%, and that 21.9% of women have a major depressive episode during the first year postpartum (Gaynes et al., 2005). Peripartum depression may differentially affect women in various cultural, ethnic, and/or socioeconomic groups. A review of 143 studies of postpartum depression in 40 counties (Halbreich & Karkun, 2006) showed a wide range of prevalence rates in different countries, from nearly 0 to nearly 60%. Within the United States, most studies directly comparing rates of perinatal depression in different racial/ethnic groups have found increased prevalence in African-American and Hispanic women as compared to white women (Howell, Mora, Horowitz, & Leventhal, 2005; Orr, Blazer, & James, 2006). Factors posited to account for these differences include variations in the types and severity of risk factors (e.g., poverty, stress), protective factors (e.g., social support, enriched nutrition), ways of communicating symptoms or distress, conceptualizations of mental illness, levels of stigma, and biological vulnerabilities. When only studies employing structured clinical interviews (as opposed to self-report) are analyzed, the prevalence of major depression is comparable among difference socioeconomic groups, but the prevalence of minor (subsyndromal) depression is more prevalent among women with lower socioeconomic status (Gavin et al., 2005).