Disputation

Nilam Shakeel, MD, Institute of Health and Society, defended her thesis “Depressive symptoms in pregnant and postpartum women. The role of ethnicity, level of integration, and physical activity—the STORK–Groruddalen population-based cohort study” for the degree of PhD (Philosophiae Doctor) on June 3rd. Principal supervisor was Professor Anne Karen Jenum.

Summary of the research

There is strong evidence that depression during pregnancy and postpartum may have adverse health effects on mother and infant. The aims of this thesis were to assess the prevalence of depressive symptoms in the perinatal period in a multiethnic population, and explore the association with ethnicity, the level of integration, and physical activity.

We used data from the Stork Groruddalen study, a prospective cohort, with data from early pregnancy to 3 months postpartum from 823 healthy pregnant women, attending the Child Health Clinics in Groruddalen in Oslo in 2008-2010. The included women were representative for the pregnant population in the city districts. Physical activity was recorded objectively, all information material was translated into eight different languages and the study included those who did not speak Norwegian. Hence, 59% of the participants were of ethnic minority background.

We found that ethnic minorities have more than doubled risk for developing depressive symptoms measured by the Edinburgh Postnatal Depression Scale, EPDS, compared to Western European women both in pregnancy and postpartum. Ethnic minority background, negative life-events, poor self-reported health and depression earlier in life are associated with depressive symptoms in late pregnancy. Ethnic minority background, negative life-events, depression earlier in life or pregnancy and lack of social support are associated with postpartum depressive symptoms. When replacing ethnicity with the level of integration in the models, a low level of integration was associated with perinatal depressive symptoms. Further, physical activity during pregnancy in line with recommendations was associated with lower level of depressive symptoms postpartum.