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S Prady, L Fairley, K Bloor, S Gilbody, K Kiernan, K Pickett, P Raynor, J Wright
Born in Bradford is a large multi-ethnic birth cohort drawn from the North of England. We describe the risk factors associated with poor mental health in pregnancy for White and Pakistani-origin women.
We examined data from White (N=1901) and Pakistani (N=1360) women who completed the GHQ-28 in English. We used univariate and multivariate logistic regression to examine socio-demographic risk factors associated with scoring above the conventional threshold for poor mental health. We conducted a sensitivity analysis on the threshold method by comparing the highest and lowest scoring quintile within each ethnic group.
43% of White and 47% of Pakistani women scored above the threshold. For White women univariate risk factors were not living with a partner, self-reported financial worries and less education. For Pakistani women not being in a relationship and having financial worries were associated with poor mental health. Significant variables remaining in the multivariate models for both groups were financial worries (White OR 2.4, 95% CI 2.0 to 3.0; Pakistani 2.7, 2.1 to 3.5) and not being in a relationship (White 1.4, 1.0 to 2.1; Pakistani 2.6, 1.0 to 6.5). Sensitivity analyses indicated the same significant risk factors with the addition of cohabitation and younger age in the univariate analyses for White women. Pakistani women had worse within-quintile scores than White women (highest quintile difference 5.6 points, t=8.8, p<0.0001).
Prevalence and severity of poor mental health varies by ethnicity but consistency in the associated risk factors underline patterns of social disadvantage in both groups.