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Prenatal Psychological Distress and Access to Mental Health Care in the ELFE Cohort

Published online by Cambridge University Press:  15 April 2020

M. Bales ,
E. Pambrun ,
M. Melchior ,
N.M.-C. Glangeaud-Freudenthal ,
M.-A. Charles ,
H. Verdoux  and
A.-L. Sutter-Dallay
M. Bales
Affiliation:
Bordeaux University, U657, 33000Bordeaux, France INSERM, U657, 33000Bordeaux, France
E. Pambrun
Affiliation:
Bordeaux University, U657, 33000Bordeaux, France INSERM, U657, 33000Bordeaux, France
M. Melchior
Affiliation:
INSERM, UMRS 1136 Pierre-Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, Paris, France Sorbonne University, UPMC Paris University, Paris, France
N.M.-C. Glangeaud-Freudenthal
Affiliation:
INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris Descartes University, Paris, France
M.-A. Charles
Affiliation:
Ined Inserm joint unit Elfe, Paris, France
H. Verdoux
Affiliation:
Bordeaux University, U657, 33000Bordeaux, France INSERM, U657, 33000Bordeaux, France University Department of Adult Psychiatry, Charles-Perrens Hospital, Bordeaux, France
A.-L. Sutter-Dallay*
Affiliation:
Bordeaux University, U657, 33000Bordeaux, France INSERM, U657, 33000Bordeaux, France University Department of Adult Psychiatry, Charles-Perrens Hospital, Bordeaux, France
*
*Corresponding author at: Pôle Universitaire Psychiatrie Adulte, Centre Hospitalier Charles-Perrens, 121, rue de la Bé chade, 33076 Bordeaux Cedex, France. Tel.: +33 5 56 56 17 82; fax: +33 5 56 56 35 15. E-mail address:alsutter@ch-perrens.fr (A.-L. Sutter-Dallay).
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Abstract

Background:

Pregnant women are vulnerable to the deleterious impact of environmental stressors. The aims were to identify the environmental and pregnancy characteristics independently associated with prenatal psychological distress and access to mental health care.

Methods:

We used data from the French cohort Étude Longitudinale Française depuis l’Enfance (ELFE), a nationally representative cohort of children followed-up from birth to adulthood. Information about prenatal psychological status and access to mental health care was collected during the maternity stay. Maternal/pregnancy characteristics independently associated with psychological distress and access to mental health care were explored using multivariate analyses.

Results:

Of the 15,143 mothers included, 12.6% reported prenatal psychological distress. Prenatal distress was more frequent in women with very low economical status, alcohol/tobacco use, unplanned/unwanted pregnancy, late pregnancy declaration, multiparity and complicated pregnancy (high number of prenatal visits, prenatal diagnosis examination, obstetrical complications). Of the women reporting prenatal distress, 25% had a prenatal consultation with a mental health specialist and 11% used psychotropic drugs during pregnancy. Decreased likelihood to consult a mental health specialist was found in young women, with intermediate educational level and born abroad.

Limitations:

Causal inferences should be made cautiously as the questionnaire did not collect information on the temporal sequence between psychological distress and associated characteristics.

Conclusions:

Women with social and obstetrical vulnerabilities are at increased risk of poor mental health during pregnancy. Improving mental health care access during pregnancy is a public health priority.

Keywords

PregnancyPerinatal psychological distressMental healthEnvironmental factorsAccess to mental health care
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 2 , February 2015 , pp. 322 - 328
Copyright
Copyright © Elsevier Masson SAS 2014

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References

Alder, J., Fink, N., Bitzer, J., Hosli, I., Holzgreve, W.. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med 2007;20 (3):189–209.CrossRefGoogle ScholarPubMed
Alvidrez, J., Azocar, F.. Distressed women's clinic patients: preferences for mental health treatments and perceived obstacles. Gen Hosp Psychiatry 1999;21 (5):340–347.CrossRefGoogle ScholarPubMed
Andrade, L.H., Alonso, J., Mneimneh, Z., Wells, J.E., Al-Hamzawi, A., Borges, G., et al.Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychol Med 2013;9 :1–15.Google Scholar
Arroll, B., Khin, N., Kerse, N.. Screening for depression in primary care with two verbally asked questions: cross sectional study. BMJ 2003;327 (7424):1144–1146.CrossRefGoogle ScholarPubMed
Austin, M.P.. Marce International Society position statement on psychosocial assessment and depression screening in perinatal women. Best Pract Res Clin Obstet Gynaecol 2014;28 (1):179–187.CrossRefGoogle ScholarPubMed
Benett, H.. Prevalence of depression during pregnancy. Obstet Gynecol 2004;103 (4):698–709.CrossRefGoogle Scholar
Bennett, I.M., Coco, A., Coyne, J.C., Mitchell, A.J., Nicholson, J., Johnson, E., et al.Efficiency of a two-item pre-screen to reduce the burden of depression screening in pregnancy and postpartum: an IMPLICIT network study. J Am Board Fam Med 2008;21 (4):317–325.CrossRefGoogle ScholarPubMed
Bunevicius, R., Kusminskas, L., Bunevicius, A., Nadisauskiene, R.J., Jureniene, K., Pop, V.J.. Psychosocial risk factors for depression during pregnancy. Acta Obstet Gynecol Scand 2009;88 (5):599–605.CrossRefGoogle ScholarPubMed
Commander, M.J., Dharan, S.P., Odell, S.M., Surtees, P.G.. Access to mental health care in an inner-city health district. Association with demographic factors. Br J Psychiatry 1997;170 :317–320.CrossRefGoogle Scholar
Cooklin, A.R.R.H.J., Fisher, J.R.. Employee entitlements during pregnancy and maternal psychological well-being. Aust N Z J Obstet Gyneacol 2007;47 (6):483–490.CrossRefGoogle ScholarPubMed
Danel, T., Plancke, L., Amariei, A., Benoit, E., Gautier, S., Capele, C., et al.Prescription of psychotropic medicines to pregnant women in Nord-Pas-de-Calais, France. Therapie 2013;68 (1):31–36.CrossRefGoogle ScholarPubMed
Dayan, J., Creveuil, C., Dreyfus, M., Herlicoviez, M., Baleyte, J.M., O’Keane, V.. Developmental model of depression applied to prenatal depression: role of present and past life events, past emotional disorders and pregnancy stress. PLoS One 2010;5 (9):e12942.CrossRefGoogle ScholarPubMed
Dennis, C.L., Chung-Lee, L.. Postpartum depression help-seeking barriers and maternal treatment preferences: a qualitative systematic review. Birth 2006;33 (4):323–331.CrossRefGoogle ScholarPubMed
El-Hage, W., Leger, J., Delcuze, A., Giraudeau, B., Perrotin, F.. Amniocentesis, maternal psychopathology and prenatal representations of attachment: a prospective comparative study. PLoS One 2012;7 (7):e41777.CrossRefGoogle ScholarPubMed
Flynn, H.A., Marcus, S.M., Barry, K.L., Blow, F.C.. Rates and correlates of alcohol use among pregnant women in obstetrics clinics. Alcohol Clin Exp Res 2003;27 (1):81–87.CrossRefGoogle ScholarPubMed
Gater, R., Goldberg, D.. Pathways to psychiatric care in South Manchester. Br J Psychiatry 1991;159 :90–96.CrossRefGoogle ScholarPubMed
Gaynes, B.N., Gavin, N., Meltzer-Brody, S., Lohr, K.N., Swinson, T., Gartlehner, G., et al.Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (Summ) 2005;(119):1–8.Google ScholarPubMed
Golberg, G.D., Huxley, P.Mental illness in the Community: pathways to psychiatric care. London: Tavistok; 1980.Google Scholar
Goodwin, R.D., Keyes, K., Simuro, N.. Mental disorders and nicotine dependence among pregnant women in the United States. Obstet Gynecol 2007;109 (4):875–883.CrossRefGoogle ScholarPubMed
Grigoriadis, S., VonderPorten, E.H., Mamisashvili, L., Tomlinson, G., Dennis, C.L., Koren, G., et al.The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 2013;74 (4):e321–e341.CrossRefGoogle ScholarPubMed
Grote, N.K., Bridge, J.A., Gavin, A.R., Melville, J.L., Iyengar, S., Katon, W.J.. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 2010;67 (10):1012–1024.CrossRefGoogle ScholarPubMed
Holzman, C., Eyster, J., Tiedje, L.B., Roman, L.A., Seagull, E., Rahbar, M.H.. A life course perspective on depressive symptoms in mid-pregnancy. Matern Child Health J 2006;10 (2):127–138.CrossRefGoogle ScholarPubMed
Inserm, Médicaments psychotropes : consommation et pharmacodépendances. Une expertise collective de l’Inserm. France: INSERM; 2012.Google Scholar
Jeong, H.G.L.J.S., Lee, M.S., Kim, S.H., Jung, I.K., Joe, S.H.. The association of psychosocial factors and obstetric history with depression in pregnant women: focus on the role of emotional support. Gen Hosp Psychiatry 2013;35 (4):354–358.CrossRefGoogle ScholarPubMed
Kallen, B., Borg, N., Reis, M.. The use of central nervous system active drugs during pregnancy. Pharmaceuticals 2013;6 (10):1221–1286.CrossRefGoogle ScholarPubMed
Kelly, R.H., Danielsen, B.H., Golding, J.M., Anders, T.F., Gilbert, W.M., Zatzick, D.F.. Adequacy of prenatal care among women with psychiatric diagnoses giving birth in California in 1994 and 1995. Psychiatr Serv 1999;50 (12):1584–1590.CrossRefGoogle ScholarPubMed
Koleva, H., Stuart, S., O’Hara, M.W., Bowman-Reif, J.. Risk factors for depressive symptoms during pregnancy. Arch Womens Ment Health 2011;14 (2):99–105.CrossRefGoogle ScholarPubMed
Kopelman, R.C., Moel, J., Mertens, C., Stuart, S., Arndt, S., O’Hara, M.W.. Barriers to care for antenatal depression. Psychiatr Serv 2008;59 (4):429–432.CrossRefGoogle ScholarPubMed
Kowalcek, I., Huber, G., Muhlhof, A., Gembruch, U.. Prenatal medicine related to stress and depressive reactions of pregnant women and their partners. J Perinat Med 2005;31 (3):216–224.Google Scholar
Lancaster, C.A., Gold, K.J., Flynn, H.A., Yoo, H., Marcus, S.M., Davis, M.M.. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 2010;202 (1):5–14.CrossRefGoogle ScholarPubMed
Larsson, C., Sydsjo, G., Josefsson, A.. Health, sociodemographic data, and pregnancy outcome in women with antepartum depressive symptoms. Obstet Gynecol 2004;104 (3):459–466.CrossRefGoogle ScholarPubMed
Le Strat, Y., Dubertret, C., Le Foll, B.. Prevalence and correlates of major depressive episode in pregnant and postpartum women in the United States. J Affect Disord 2011;135 (1–3):128–138.CrossRefGoogle ScholarPubMed
Leaf, P.J., Livingston, M.M., Tischler, G.L., Weissman, M.M., Holzer, C.E., Myers, J.K.. Contact with health professionals for the treatment of psychiatric and emotional problems. Med Care 1985;23 (12):1322–1337.CrossRefGoogle ScholarPubMed
Lewis, S.J., Araya, R., Smith, G.D., Freathy, R., Gunnell, D., Palmer, T., et al.Smoking is associated with, but does not cause, depressed mood in pregnancy – a mendelian randomization study. PLoS One 2011;6 (7):e21689.CrossRefGoogle Scholar
Makregiorgos, H., Joubert, L., Epstein, I.. Maternal mental health: pathways of care for women experiencing mental health issues during pregnancy. Soc Work Health Care 2013;52 (2–3):258–279.CrossRefGoogle ScholarPubMed
Marcus, S.M., Flynn, H.A., Blow, F.C., Barry, K.L.. Depressive symptoms among pregnant women screened in obstetrics settings. J Womens Health 2003;12 (4):373–380.CrossRefGoogle ScholarPubMed
McNeil, T., Sjöström, K.Mcneil-Sjöström scale for obstetric complications. Malmö: Lund University Department of Psychiatry, Malmö University Hospital; 1995.Google Scholar
Melville, J.L., Gavin, A., Guo, Y., Fan, M.Y., Katon, W.J.. Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstet Gynecol 2010;116 (5):1064–1070.CrossRefGoogle Scholar
Najman, J.M., Morrison, J., Williams, G., Andersen, M., Keeping, J.D.. The mental health of women 6 months after they give birth to an unwanted baby: a longitudinal study. Soc Sci Med 1991;32 (3):241–247.CrossRefGoogle Scholar
Pajulo, M., Savonlahti, E., Sourander, A., Helenius, H., Piha, J.. Antenatal depression, substance dependency and social support. J Affect Disord 2001;65 (1):9–17.Google ScholarPubMed
Pilling, S., Whittington, C., Taylor, C., Kendrick, T., Guideline Development, G.. Identification and care pathways for common mental health disorders: summary of NICE guidance. BMJ 2011;342 :d2868.CrossRefGoogle ScholarPubMed
Pirus, C., Bois, C., Dufourg, M.-N., Lanoë, J.-L., Vandentorren, S., Leridon, H., et al. La construction d’une cohorte : l’expérience du projet français Elfe population. 2010;65 :637–670.Google Scholar
Redshaw, M., Henderson, J.. From antenatal to postnatal depression: associated factors and mitigating influences. J Womens Health 2013;22 (6):518–525.CrossRefGoogle ScholarPubMed
Rubertsson, C., Wickberg, B., Gustavsson, P., Radestad, I.. Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample. Arch Womens Ment Health 2005;8 (2):97–104.CrossRefGoogle Scholar
Rubertsson, C., Hellstrom, J., Cross, M., Sydsjo, G.. Anxiety in early pregnancy: prevalence and contributing factors. Arch Womens Ment Health 2014;17 (3):221–228.CrossRefGoogle ScholarPubMed
Sas Insitute Inc. Base SAS 9. 3 Procedures Guide. Cary, NC, USA: SAS; 2011.Google Scholar
Scholle, S.H., Haskett, R.F., Hanusa, B.H., Pincus, H.A., Kupfer, D.J.Addressing depression in obstetrics/gynecology practice. Gen Hosp Psychiatry 2003;25 (2):83–90.CrossRefGoogle ScholarPubMed
Sherbourne, C.D., Dwight-Johnson, M., Klap, R.Psychological distress, unmet need, and barriers to mental health care for women. Womens Health Issues 2001;11 (3):231–243.Google ScholarPubMed
Sutter-Dallay, A.L., Murray, L., Dequae-Merchadou, L., Glatigny-Dallay, E., Bourgeois, M.L., Verdoux, H.A prospective longitudinal study of the impact of early postnatal vs. chronic maternal depressive symptoms on child development. Eur Psychiatry 2011;26 (8):484–489.CrossRefGoogle ScholarPubMed
Volpe, U., Fiorillo, A., Luciano, M., Del Vecchio, V., Palumbo, C., Calo, S., et al.Pathways to mental health care in Italy: results from a multicenter study. Int J Soc Psychiatry 2013;60 (5):508–513.CrossRefGoogle ScholarPubMed
Whooley, M.A., Avins, A.L., Miranda, J., Browner, W.S.Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997;12 (7):439–445.CrossRefGoogle ScholarPubMed
Woolhouse, H., Brown, S., Krastev, A., Perlen, S., Gunn, J.Seeking help for anxiety and depression after childbirth: results of the Maternal Health Study. Arch Womens Mental Health 2009;12 (2):75–83.CrossRefGoogle ScholarPubMed
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