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Impact of Insecure Immigration Status and Ethnicity on Antenatal Mental Health Among Migrant Women.

OBJECTIVE
There is limited evidence on the prevalence and odds of antenatal common mental disorders (CMDs) among migrant women and the effect on risk of intersecting variables such as immigration status and ethnicity. This study aimed to estimate the prevalence and odds of antenatal CMDs among migrant women compared to UK-born women in an inner-London maternity service.


METHODS
A cross-sectional survey stratified by response to depression screening questions was administered at first antenatal appointment. CMDs were assessed using the Structured Clinical Interview for DSM-IV. Recruitment took place between November 2014 and June 2016.


RESULTS
Prevalence of antenatal CMDs was 21% (95% CI, 16-28) among migrant women (n = 283) and 24% (95% CI, 18-31) among UK-born women (n = 262). There was no significant difference in the odds of CMDs among migrant women compared to UK-born women (OR = 0.86; P = .57; 95% CI, 0.51-1.44). Migrant women, particularly those with insecure immigration status, had increased odds of posttraumatic stress disorder (OR = 29.08; P < .01; 95% CI, 4-188). When analyses were stratified by ethnicity, there was no effect of migrant status for white women, but for ethnic minority (nonwhite) women, migrant status decreased odds of having a CMD (OR = 0.31; P = .02; 95% CI, 0.12-0.82).


CONCLUSIONS
Antenatal common mental disorders are prevalent among migrant women, but migrant status is unlikely to increase risk on its own. Immigration status, ethnicity, and other intersecting variables of social disadvantage must be investigated simultaneously to examine the perinatal mental health of heterogeneous migrant populations.