%0 Journal Article %J Women Health %D 2013 %T Views and experiences of suicidal ideation during pregnancy and the postpartum: findings from interviews with maternal care clinic patients. %A Tabb, Karen M %A Gavin, Amelia R %A Guo, Yuqing %A Huang, Hsiang %A Debiec, Kate %A Katon, Wayne %K Adult %K Depression %K Depression, Postpartum %K Female %K Follow-Up Studies %K Humans %K Interviews as Topic %K Maternal Health Services %K Mothers %K Postpartum Period %K Pregnancy %K Pregnancy Complications %K Risk Factors %K Stress, Psychological %K Suicidal Ideation %K Surveys and Questionnaires %K Young Adult %X

INTRODUCTION: Perinatal suicidality (i.e., thoughts of death, suicide attempts, or self-harm during the period immediately before and up to 12 months after the birth of a child) is a significant public health concern. Few investigations have examined the patients' own views and experiences of maternal suicidal ideation.

METHODS: Between April and October 2010, researchers identified 14 patient participants at a single university-based medical center for a follow-up, semi-structured interview if they screened positive for suicidal ideation on the Patient Health Questionnaire-9 (PHQ-9) short form. In-depth interviews followed a semi-structured interview guide. Researchers transcribed all interviews verbatim and analyzed transcripts using thematic network analysis.

RESULTS: Participants described the experience of suicidality during pregnancy as related to somatic symptoms, past diagnoses, infanticide, family psychiatric history (e.g., completed suicides and family member attempts), and pregnancy complications. The network of themes included the perinatal experience, patient descriptions of changes in mood symptoms, illustrations of situational coping, and reported mental health service use.

IMPLICATIONS: The interview themes suggested that in this small sample, pregnancy represented a critical time period to screen for suicide and to establish treatment for the mothers in the study. These findings may assist health care professionals in the development of interventions designed to identify, assess, and prevent suicidality among perinatal women.

%B Women Health %V 53 %P 519-35 %8 2013 %G eng %N 5 %R 10.1080/03630242.2013.804024 %0 Journal Article %J Prev Sci %D 2012 %T Maternal early life risk factors for offspring birth weight: findings from the add health study. %A Gavin, Amelia R %A Thompson, Elaine %A Rue, Tessa %A Guo, Yuqing %K Adolescent %K Child Abuse %K Depression %K Factor Analysis, Statistical %K Female %K Humans %K Infant, Low Birth Weight %K Infant, Newborn %K Longitudinal Studies %K Mothers %K Risk Factors %K Smoking %K Social Class %K Substance-Related Disorders %X

The aim of this study was to examine the pathways that link mothers' early life socio economic status (SES) and mothers' experience of childhood maltreatment with birth weight among their later born offspring. Data were drawn from a nationally representative longitudinal survey of school-aged respondents, initially enrolled during adolescence in Wave I (1994-1995) and Wave II (1996) of the National Longitudinal Study of Adolescent Health and followed-up in adulthood in Wave III (2001-2002). Data on offspring birth weight were obtained from nulliparous females (Nā€‰=ā€‰1,897) who had given birth between Waves II and III. Analyses used structural equation modeling to examine the extent to which early life maternal risk predicted offspring birth weight, and demonstrated that maternal childhood SES and maternal childhood maltreatment predicted offspring birth weight through several mediated pathways. First, maternal adolescent substance use and prenatal cigarette use partially mediated the association between maternal childhood SES and offspring birth weight. Second, maternal adolescent depressive symptoms and adult SES partially mediated the association between maternal childhood SES and offspring birth weight. Third, adult SES partially mediated the association between maternal childhood SES and offspring birth weight. Fourth, maternal adolescent substance use and prenatal cigarette use partially mediated the association between maternal childhood maltreatment and offspring birth weight. Finally, maternal adolescent depressive symptoms and adult SES partially mediated the association between maternal childhood maltreatment and offspring birth weight. To our knowledge, this is the first study to identify maternal childhood maltreatment as an early life risk factor for offspring birth weight among a nationally representative sample of young women, and to demonstrate the mechanisms that link childhood SES and maltreatment to offspring birth weight. These findings suggest the importance of designing and implementing prevention and intervention strategies to address early life maternal social conditions in an effort to improve inter generational child health at birth.

%B Prev Sci %V 13 %P 162-72 %8 2012 Apr %G eng %N 2 %R 10.1007/s11121-011-0253-2 %0 Journal Article %J Obstet Gynecol %D 2010 %T Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. %A Melville, Jennifer L %A Gavin, Amelia %A Guo, Yuqing %A Fan, Ming-Yu %A Katon, Wayne J %K Adolescent %K Adult %K Depressive Disorder %K Female %K Humans %K Middle Aged %K Panic Disorder %K Pregnancy %K Pregnancy Complications %K Prevalence %K Risk Factors %K Spouse Abuse %K Stress, Psychological %K Suicide %K Urban Population %K Young Adult %X

OBJECTIVE: To estimate the prevalence of major and minor depression, panic disorder, and suicidal ideation during pregnancy while also identifying factors independently associated with antenatal depressive disorders.

METHODS: In this prospective study, participants were 1,888 women receiving ongoing prenatal care at a university obstetric clinic from January 2004 through January 2009. Prevalence of psychiatric disorders was measured using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria based on the Patient Health Questionnaire. Multiple logistic regression identified factors associated with probable major depressive disorder and any depressive disorder.

RESULTS: Antenatal depressive disorders were present in 9.9% with 5.1% (97) meeting criteria for probable major depression and 4.8% (90) meeting criteria for probable minor depression. Panic disorder was present in 3.2% (61), and current suicidal ideation was reported by 2.6% (49). Among patients with probable major depression, 29.5% (28) reported current suicidal ideation. Psychosocial stress (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.21-1.36), domestic violence (OR 3.45; 95% CI 1.46-8.12), chronic medical conditions (OR 3.05; 95% CI 1.63-5.69), and race (Asian: OR 5.81; 95% CI 2.55-13.23; or African American: OR 2.98; 95% CI 1.24-7.18) each significantly increased the odds of probable antepartum major depressive disorder, whereas older age (OR 0.92; 95% CI 0.88-0.97) decreased the odds. Factors associated with odds of any depression were similar overall except that Hispanic ethnicity (OR 2.50; 95% CI 1.09-5.72) also independently increased the odds of any depression.

CONCLUSION: Antenatal major and minor depressive disorders are common and significantly associated with clinically relevant and identifiable risk factors. By understanding the high point prevalence and associated factors, clinicians can potentially improve the diagnosis and treatment rates of serious depressive disorders in pregnant women.

LEVEL OF EVIDENCE: II.

%B Obstet Gynecol %V 116 %P 1064-70 %8 2010 Nov %G eng %N 5 %R 10.1097/AOG.0b013e3181f60b0a