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- Title
Perinatal Depression Screening Among Sexual Minority Women.
- Authors
Lapping-Carr, Leiszle; Dennard, Ashley; Wisner, Katherine L.; Tandon, S. Darius
- Abstract
Key Points: Question: Do sexual minority women giving birth at an academic medical center differ from heterosexual women in perinatal depression screening rates and scores? Findings: In this cohort study of 18 234 women giving birth within 1 year, only 1.5% identified as having sexual minority status according to their medical records. After birth, sexual minority women were screened for depression at higher rates and had greater odds of screening positive for depression compared with heterosexual women. Meaning: These findings suggest that, although sexual minority women are at high risk of postpartum depression, their sexual identities are largely undocumented in medical records, highlighting the need for strategies to measure sexual orientation that can reliably capture this information. 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. This cohort study assesses the prevalence of sexual minority women giving birth in an academic medical center within 1 year and compares perinatal depression screening rates and scores among sexual minority vs heterosexual women.
- Subjects
CHICAGO (Ill.); SEXUAL minority women; MINORITY stress; MEDICAL screening; POSTPARTUM depression; INTIMATE partner violence; ACADEMIC medical centers
- Publication
JAMA Psychiatry, 2023, Vol 80, Issue 11, p1142
- ISSN
2168-622X
- Publication type
Article
- DOI
10.1001/jamapsychiatry.2023.2619