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Cited by 14Maternal Mental Health During Pregnancy and PostpartumLGBTQ Health, Identity, and PolicyMaternal and Neonatal Healthcare

Perinatal Depression Screening Among Sexual Minority Women

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Lapping-Carr, Leiszle, Dennard, Ashley, Wisner, Katherine L., Tandon, S. Darius·2023·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2023.2619PMC PMC10398540
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Abstract

Importance: A substantial number of births in the US are to sexual minority women (17% based on a nationally representative survey), yet there is little research on perinatal depression screening rates or symptom endorsement among sexual minority women (including women who identify as lesbian, bisexual, queer, pansexual, asexual, demisexual, and kinky as well as other-identified women who have sex with women). High rates of risk factors for perinatal depression (eg, intimate partner violence and history of mental illness) among sexual minority individuals magnify this gap in the literature. Objective: To describe the prevalence of female-identified sexual minority people giving birth in an academic medical center and compare perinatal depression screening rates and scores among sexual minority women and heterosexual cisgender women. Design, Setting, and Participants: This retrospective cohort study used deidentified medical record review of 18 243 female-identified individuals who gave birth at an academic medical center in Chicago, Illinois, between January 1 and December 31, 2019. Data were analyzed from April 5, 2021, to August 1, 2022. Main Outcomes and Measures: Proportion of women identified as having sexual minority status in the medical record, rates of standard care administration of the 9-item Patient Health Questionnaire between sexual minority women and heterosexual women, and depression screening scores and rates of positive depression screening results for sexual minority and heterosexual women. Results: Among 18 243 women (mean [SD] age, 33.8 [5.1] years; 10 453 [57.3%] of non-Hispanic White race and ethnicity), only 280 (1.5%; 95% CI, 1.3%-1.7%) were identified as having sexual minority status in the medical record. Significantly more sexual minority women vs heterosexual women attended at least 1 prenatal care visit (56 [20.0%] vs 2459 [13.7%]; P = .002) and at least 1 postpartum care visit (52 [18.6%] vs 2304 [12.8%]; P = .004). Sexual minority women were more likely to be screened for depression during postpartum care (odds ratio, 1.77; 95% CI, 1.22-2.52; P = .002) and more likely to screen positive for depression during the postpartum period (odds ratio, 2.38; 95% CI, 0.99-5.02; P = .03) than heterosexual women. Conclusions and Relevance: In this cohort study, sexual minority women identified in the medical record were highly engaged in obstetric care yet at high risk of postpartum depression. In addition, their sexual orientation was largely undocumented in medical records. These results highlight the need for investigations that include strategies for measuring sexual orientation because medical record review is unlikely to reliably capture these sexual identities during the perinatal period.

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Authors
Lapping-Carr, L., Dennard, A., Wisner, K. L., & Tandon, S. D.
Affiliations
Northwestern University (US)
Corresponding author
Lapping-Carr, Leiszle
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2023-11-01
Volume
80
Issue
11
Pages
1142
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2023.2619
PMC
PMC10398540
OpenAlex
W4385476017
Cited by
14
References
46
Citations by year
2026: 2 · 2025: 4 · 2024: 8
FWCI
3.57
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
perinatal depression, sexual minority women, depression screening, Patient Health Questionnaire, postpartum depression, prenatal care, postpartum care, intimate partner violence, maternal mental health, LGBTQ health disparities, lesbians, bisexual women, queer women
MeSH terms
Sexual and Gender Minorities, Adult, Depression, Female, Humans, Male, Pregnancy, Retrospective Studies, Sexual Behavior, Cohort Studies, Homosexuality, Female

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