Father’s Education: An Independent Marker of Risk for Preterm Birth

To explore the association between paternal education and preterm birth, taking into account maternal social and economic factors. We analyzed data from a population-based cross-sectional postpartum survey, linked with birth certificates, of women who gave birth in California from 1999 through 2005 (n = 21,712). Women whose infants’ fathers had not completed college had significantly higher odds of preterm birth than women whose infants’ fathers were college graduates, even after adjusting for maternal education and family income [OR (95% CI) = 1.26 (1.01–1.58)]. The effect of paternal education was greater among unmarried women than among married women. Paternal education may represent an important indicator of risk for preterm birth, reflecting social and/or economic factors not measured by maternal education or family income. Researchers and policy makers committed to understanding and reducing socioeconomic disparities in birth outcomes should consider paternal as well as maternal socioeconomic factors in their analyses and policy decisions.     

Abuse from In-Laws during Pregnancy and Post-Partum: Qualitative and Quantitative Findings from Low-income Mothers of Infants in Mumbai,India

To examine experiences of perinatal (in pregnancy or post-partum) abuse from in-laws and to assess associations between such experiences and perinatal intimate partner violence (IPV) from husbands, as reported by Indian women residing in low-income communities in Mumbai. The present study includes both qualitative and quantitative research conducted across two phases of study. The qualitative phase involved face-to-face, semi-structured in-depth interviews (n = 32) with women seeking health care for their infants (6 months or younger) and self-reporting emotional or physical abuse from their husband. The quantitative arm involved survey data collection (n = 1,038) from mothers seeking immunization for their infants 6 months or younger at three large Urban Health Centers in Mumbai. Results of the qualitative study documented the occurrence of both non-physical and physical abuse from in-laws during pregnancy and post-partum. Non-physical forms of abuse included forced heavy domestic labor, food denial and efforts toward prevention of medical care acquisition. Quantitative results demonstrated that 26.3% of the sample reported perinatal abuse (non-physical and physical) from in-laws and that women experiencing perinatal sexual or physical IPV from husbands were significantly more likely to report perinatal abuse from in-laws (AOR = 5.33, 95% CI = 3.93–7.23). Perinatal abuse from in-laws is not uncommon among women in India and may be compromising maternal and child health in this context; such abuse is also linked to perinatal violence from husbands. Programs and interventions that screen and address IPV in pregnant and post-partum populations in India should be developed to include consideration of in-laws.     

‘I need help’: Reasons new and re‐engaging callers contact the PANDA—Perinatal Anxiety and Depression Australia National Helpline

In Australia, the PANDA—Perinatal Anxiety & Depression Australia National Helpline (the Helpline) offers support to callers impacted by emotional health challenges in the perinatal period. Callers receive counselling from professional staff and peer support from volunteers. An understanding of factors that contribute to callers’ experiences of emotional distress, as well as potential barriers and facilitators to help‐seeking, can be used to inform future service design and delivery. A caller intake form is completed by Helpline staff when an individual contacts the service for the first time, or re‐engages after a period of non‐contact. We analysed all intake forms of individuals calling about their own emotional wellbeing from the middle month of each season in 2014: January, April, July, and October. Content analysis was undertaken, focusing on caller profile, patterns of help‐seeking, and reasons for caller engagement. Of the 365 calls, the majority were from women (n = 358, 98%) who were pregnant (n = 59, 16%) or had a child ≤12 months of age (n = 241, 75%). Many were seeking support regarding depression (n = 186, 51%) or anxiety (n = 162, 44%), with a number seeking help for both (n = 71, 20%). Almost a third were identified as being ‘at risk’, including a number who were experiencing thoughts of suicide or self‐harm. Complex interrelating factors contributed to callers’ emotional distress, including: stressful life events; pregnancy, birthing and parenting experiences; social isolation; and histories of mental health difficulties. Significant numbers of parents experience emotional health challenges in the perinatal period, but many do not receive adequate treatment. Complex factors contribute to callers’ distress, highlighting the need for health professionals to undertake thorough psychosocial assessments during the perinatal period so those that need additional support are identified, and appropriate care provided. Telephone Helplines like PANDAs assist overcoming barriers to care and provide specialised perinatal mental health support to families.     

Poverty,Near-Poverty,and Hardship Around the Time of Pregnancy

To describe income levels and the prevalence of major hardships among women during or just before pregnancy. We separately analyzed 2002–2006 population-based postpartum survey data from California’s Maternal and Infant Health Assessment (n = 18,332) and 19 states participating in CDC’s Pregnancy Risk Assessment Monitoring System (n = 143,452) to examine income and several hardships (divorce/separation, domestic violence, homelessness, financial difficulties, spouse/partner’s or respondent’s involuntary job loss or incarceration, and, in California only, food insecurity and no social support) during/just before pregnancy. In both samples, over 30% of women were poor (income ≤100% of federal poverty level [FPL]) and 20% near-poor (101–200% FPL); and around 60% of low-income (poor or near-poor) women experienced at least one hardship. While hardship prevalence decreased significantly as income increased, many non-low-income women also experienced hardships; e.g., in California, 43% of all women and 13% with incomes >400% FPL experienced one or more hardships. These findings paint a disturbing picture of experiences around the time of pregnancy in the United States for many women giving birth and their children, particularly because 60% had previous births. The high prevalence of low income and of serious hardships during pregnancy is of concern, given previous research documenting the adverse health consequences of these experiences and recognition of pregnancy as a critical period for health throughout the life course. Low income and major hardships around the time of pregnancy should be addressed as mainstream U.S. maternal-infant health and social policy issues.     

Male Perpetration of Teen Dating Violence: Associations with Neighborhood Violence Involvement,Gender Attitudes,and Perceived Peer and Neighborhood Norms

This study aims to examine the link between male perpetration of teen dating violence (TDV) and neighborhood violence, as well as associations with gender attitudes and perceived peer and neighborhood norms related to violence among a sample of urban adolescent boys. Participants of this cross-sectional study (N = 275) were between the ages of 14 and 20 years and recruited from urban community health centers. Crude and adjusted logistic and linear regression models were used to examine TDV perpetration in relation to (a) neighborhood violence involvement, (b) perceptions of peer violence, (c) perceptions of neighborhood violence, and (d) gender attitudes. Slightly more than one in four (28%) boys reported at least one form of TDV perpetration; among boys who have ever had sex, almost half (45%) reported at least one form of TDV perpetration. In logistic and linear regression models adjusted for demographics, boys who reported TDV perpetration were more likely to report involvement in neighborhood violence (odds ratio (OR) = 3.1; 95% confidence interval (CI) = 1.7–5.5), beliefs that their friends have perpetrated TDV (OR = 2.7; 95%CI = 1.4–5.1), perceptions of violent activity within their neighborhood (OR = 3.0; 95%CI = 1.4–6.3), and greater support of traditional gender norms (β = 3.2, p = 0.002). The findings suggest that efforts are needed to address boys’ behaviors related to the perpetration of multiple forms of violence and require explicit efforts to reduce perceived norms of violence perpetration as well as problematic gender attitudes (e.g., increasing support for gender equity) across boys’ life contexts.     

Prevalence and Correlates of Depression in Pregnancy Among Turkish Women

The aim of this study was to evaluate prevalence and correlates of depression in pregnancy among Turkish women in Sivas, a semi-urban region consisting partly of people with low or middle socioeconomic status. This cross-sectional population-based study was conducted in 19 primary health care centers from urban areas of Sivas in Turkey. Two hundred fifty-eight eligible pregnant women were interviewed at their home to gather the study data. A questionnaire was used to determine the socio-demographics and obstetric characteristics of the study sample. The Turkish version of the Edinburg Postnatal Depression Scale (EPDS) was used to estimate the prevalence of depression. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to determine the social support of pregnant women. We found that with the cutoff of 13, of 258 pregnant women, 71 (27.5%) had prenatal depression. Mean EPDS score of the study population was 9.5 ± 5.2. We found a significant positive mild-moderate correlation between the EPDS score and maternal age (r = 0.30; P = 0.000). Significant positive mild correlations were found between the EPDS score and gravidity (r = 0.26; P = 0.000) and number of living children (r = 0.15; P = 0.042). There was a significant negative moderate correlation between the EPDS score and perceived social support score (r = −0.43; P = 0.000). The EPDS score of multiparas was significantly higher than that of primiparas (P = 0.000). EPDS scores of women with unplanned pregnancy were higher than those of women with planned pregnancies (P = 0.006). EPDS scores of women with a history of stillbirth were higher than those of women with no history of stillbirth (P = 0.044). Depression is a major public concern that needs to be at the forefront of antenatal assessments in Turkey as in other countries. Health professionals, especially nurses in prenatal settings, are in a unique position to detect antenatal depression. Nurses need to monitor pregnant women for depressive symptoms, especially those who are at increased risk of developing depression.     

Adjustment among Mothers Reporting Same-Gender Sexual Partners: A Study of a Representative Population Sample from Quebec Province (Canada)

We examined the well-being of mothers and non-mothers reporting exclusive opposite-gender sexual partners (OG), same-gender sexual partners (SG), or both (BI) in a representative sample of 20,773 participants (11,034 women) 15-years-old or older from the population of Quebec province in Canada. Participants completed a self-administered questionnaire and SG and BI women (n = 179) were matched to a sample of OG women (n = 179) based on age, income, geographical area, and children (having at least one 18-year-old or younger biological or adopted child at home). We assessed social milieu variables, risk factors for health disorders, mental health, and quality of mothers’ relationship with children. The findings indicated a sexual orientation main effect: Mothers and non-mothers in the SG and BI group, as compared to their OG controls, were significantly less likely to live in a couple relationship, had significantly lower levels of social support, higher prevalence of early negative life events, substance abuse, suicide ideation, and higher levels of psychological distress. There were no Sexual Orientation X Parenthood status effects. The results further indicated that sexual orientation did not account for unique variance in women’s psychological distress beyond that afforded by their social milieu, health risk factors, and parenthood status. No significant differences were found for the quality of mothers’ relationship with children. SG-BI and OG mothers with low levels of social integration were significantly more likely to report problems with children than parents with high levels of social integration. We need to understand how marginal sexualities and their associated social stigma, as risk indicators for mothers, interact with other factors to impact family life, parenting skills, and children’s adjustment.     

Influence of Maternal Education on Child Immunization and Stunting in Kenya

In 2003, the child mortality rate in Kenya was 115/1000 children compared to 88/1000 average for Sub-Saharan African countries. This study sought to determine the effect of maternal education on immunization (n = 2,169) and nutritional status (n = 5,949) on child’s health. Cross-sectional data, Kenya Demographic Health Survey (KDHS)-2003 were used for data analyses. 80% of children were stunted and 49% were immunized. After controlling for confounding, overall, children born to mothers with only a primary education were 2.17 times more likely to be fully immunized compared to those whose mothers lacked any formal education, P < 0.001. For nutrition, unadjusted results, children born to mothers with primary education were at 94% lower odds of having stunted growth compared to mothers with no primary education, P < 0.01. Policy implications for child health in Kenya should focus on increasing health knowledge among women for better child health outcomes.     

Impact of a Health Promotion Intervention on Maternal Depressive Symptoms at 15?months Postpartum

Given that diet, physical activity, and social support are associated with depression, we examined whether a health promotion intervention designed to modify these factors in low-income, postpartum women would reduce depressive symptoms. This study used a randomized, controlled design to examine the effect of the Just for You (JFY) Program, an educational intervention promoting healthy lifestyles through home visits by nutrition paraprofessionals and motivational telephone counseling, on postpartum depressive symptoms. A total of 679 women income-eligible for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were recruited at 6-20 weeks post delivery and randomized to Usual WIC Care or JFY. Using an intention-to-treat analysis, the authors modeled depressive symptoms on the Center for Epidemiologic Studies Depression Scale (CES-D) among 403 women (59%) completing follow-up at a mean of 15 months infant age, adjusting for baseline CES-D, age, household income and randomization strata (body mass index (BMI), race/region). As a secondary analysis, the authors evaluated potential mediators related to social support and self-efficacy to change one or more health behaviors targeted by the intervention. Women randomized to JFY reported 2.5 units lower CES-D score (P = 0.046) compared with those receiving Usual WIC Care alone. This relationship was attenuated by change in self-efficacy (β = −2.3; P = 0.065), suggesting this construct may partially have mediated the effect of JFY on maternal depressive symptoms. A health promotion intervention delivered through home visits and telephone calls can reduce depressive symptoms at 15 months postpartum among low-income, ethnically diverse women.     

Racial Differences in Perinatal Depression among HIV-infected Women

BackgroundPerinatal depression may further complicate the health of women with human immunodeficiency virus (HIV) infection. Diagnosis and subsequent treatment of depressive symptoms may significantly improve the health of mother and newborn.ObjectiveWe sought to examine the association between race and perinatal depression among a sample of low-income women with HIV infection.MethodsThis retrospective cohort study used data from a multi-state Medicaid administrative claims database to study HIV-infected perinatal women between 2003 and 2007. Multivariate regression analysis was used to study the objective.ResultsThe overall prevalence of perinatal depression in the sample (n = 650) was 27.8%. Black women had significantly lower odds of experiencing perinatal depression (odds ratio 0.328; 95% confidence interval 0.225-0.479) compared with non-black women. Non-black women showed significantly higher comorbidity severity scores than black women (0.356 vs. 0.220, P = .035).ConclusionsThis study found that non-black women may be more vulnerable to perinatal depression. Improved health care provider vigilance for depressive symptoms among low-income, HIV-infected women of all races during the perinatal period is warranted.     

Risk Factors for Sub-Clinical and Major Postpartum Depression Among a Community Cohort of Canadian Women

Objectives To identify prenatal and perinatal factors that predict women at risk of sub-clinical and major postpartum depression among a cohort of low medical risk pregnant women in Canada. Methods Data from 1,403 women who completed a randomized controlled trial of supplementary support during pregnancy was analyzed to identify risk factors for sub-clinical and major postpartum depression. The Edinburgh Postnatal Depression Scale (EPDS), completed at eight weeks postpartum, was used to classify each woman’s depression symptom severity. Demographic, obstetric, behavioral risk, mental health and psychosocial factors were considered. Multiple logistic regression analyses were used to identify risk factors most predictive of sub-clinical and major postpartum depression. Results After adjustment for other covariates, variables that increased the risk of sub-clinical postpartum depression included a history of depression (OR = 2.27, CI = 1.42–3.63), anxiety symptoms during pregnancy (OR = 2.12, CI = 1.09–4.11), being born outside Canada (OR = 1.87, CI = 1.17–3.00), and low parenting self-efficacy (OR = 1.65, CI = 1.06–2.55). Variables that increased the risk of major postpartum depression included a history of depression (OR = 2.78, CI = 1.56–4.97), being born outside Canada (OR = 2.97, CI = 1.70–5.17), depressive symptoms during pregnancy (OR = 2.83, CI = 1.29–6.19) and not breastfeeding at eight weeks postpartum (OR = 2.12, CI = 1.21–3.70). Conclusions A history of depression and being born outside Canada predicted women who were at an increased risk of sub-clinical and major postpartum depression. The remaining risk factors specific to sub-clinical and major postpartum depression suggest some differences between women vulnerable to sub-clinical compared to major depressive symptoms in the postpartum period, which may have implications for targeted screening and intervention strategies.     

Women at risk: Gender inequality and maternal health

Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15–49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52, p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03, p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women’s exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women’s active participation in decisions about their own health during pregnancy and delivery.     

A Western Australian Survey of Breastfeeding Initiation,Prevalence and Early Cessation Patterns

This paper reports on current initiation and prevalence rates, in Western Australia, differentiating ‘any’ breastfeeding with ‘exclusive’ breastfeeding whilst exploring patterns and reasons for stopping breastfeeding. The results presented are part of a larger study examining women’s perceptions of care and wellbeing in the early postnatal period. A cross sectional survey was used to examine infant feeding practices during the hospital stay and at 9 weeks post birth from Western Australian women with a registered live birth between February and June 2006. Data obtained from 2,669 women revealed a 93% (n = 2,472) initiation rate of any breastfeeding. More multiparous women (73.5%) were exclusively breastfeeding in hospital compared to primiparous women (65.2%), which decreased to 57.1 and 49.2%, respectively at 9 weeks. Of those who had ceased by 9 weeks, more multiparous women (71.1%) ceased before 3 weeks. Reasons cited for ceasing in order of frequency were insufficient milk supply, infant related reasons, pain and discomfort and emotional reasons. Younger maternal age, primiparous women, lower maternal education levels, offering a combination of breast milk and formula in hospital and caesarean birth were significant independent predictors of early cessation. Although initiation rates including “any” breast milk are meeting NHMRC dietary guidelines of 90%, the 60% target of exclusive breastfeeding is not being achieved for 3 months or in fact at 9 weeks. Targeted support for at risk groups such as younger, less well-educated, primiparous women must continue. Evidence based policies to protect breastfeeding must address the practice of offering formula to breastfed infants in hospital and the impact of increasing interventions such as caesarean births.     

Health Professional’s Perceptions and Practices in Relation to Functional Capacity Evaluations: Results of a Quantitative Survey

Introduction This study investigated the perceptions and practices of Australian health professionals in relation to the use of functional capacity evaluations (FCE’s). Methods A quantitative cross-sectional study design was used to survey health professionals who conduct FCE’s and who were working for one of 219 rehabilitation providers in NSW, Australia. Seventy seven returned surveys were eligible for inclusion. Results Eleven different FCE’s were being utilised with many health professionals using more than one FCE. The most commonly used FCE was non-standardised (56%, n = 43) followed by 52% (n = 40) using the Workhab, and 18% (n = 14) using Valpar. Both non-standardised and standardised assessments were being used by 90% (n = 69) of respondents. Health professionals reported using all or parts of the FCE, and indicated identical FCE’s are not always conducted, with adaptation of the FCE, due to client injury (82%, n = 62) and job (80%, n = 43) occurring. About 60% of respondents had no choice in the type of FCE they conducted, and of the 40% with a choice, this was not influenced by other stakeholders in the process. Accreditation and training, characteristics of assessment tasks, standardisation, reliability, cost, length and flexibility were all identified as factors affecting the selection of an FCE. Conclusions This study demonstrated that health professionals in NSW Australia, are not routinely using standardised tools for FCE’s. Health professional perceptions suggest accreditation, training and the characteristics of the FCE were important factors in FCE selection. In practice, participants tended to use parts of an FCE rather than the whole FCE. Adaptation of FCE’s was common, due to client injury and specific job requirements.     

Disgust and Contamination Sensitivity in Vaginismus and Dyspareunia

This study examined the potential role of disgust propensity and contamination sensitivity in vaginismus. Women suffering from vaginismus (n = 20) or dyspareunia (n = 22), and a group of women without sexual complaints (n = 30) completed self report measures indexing their (1) general dispositional disgust propensity, and (2) sensitivity for (ideational) contamination by sexual stimuli as a function of its source (self, partner, unknown). In support of the idea that disgust may be involved in vaginismus, women with vaginistic complaints displayed a generally enhanced dispositional disgust propensity. The sensitivity for contamination by sexual stimuli did not vary across groups. However, especially when the source was the participant’s partner, the willingness ratings might have been influenced by demand and may, therefore, not accurately reflect participant’s actual sensitivity for contamination by sexual stimuli. Future studies using more implicit or behavioral measures are necessary to more definitely test the role of disgust in vaginismus.     

Social Network Characteristics and HIV Sexual Risk Behavior among Urban African American Women

HIV/AIDS has emerged as a significant health threat for African American women with well-documented disparities. The purpose of this study was to assess the association between social network characteristics and high-risk sexual behaviors among a sample of urban African American women at risk of heterosexually acquired HIV/STIs. We performed a cross-sectional study of baseline data collected from the CHAT study, a randomized HIV-prevention trial targeting urban HIV-at-risk women in Baltimore, MD. Our primary outcomes were risky sexual behaviors defined as either (a) two or more sexual partners or (b) having a risky sex partner within the past 90 days. Bivariable and multivariable logistic regression examining the associations between individual and social network factors and our two outcomes of interest were conducted. The study population included 513 sexually active African American women with a mean age of 41.1 years. High levels of unemployment (89.5%), depressive symptoms (60.0%), and drug use (68.8%) were present among this high-risk urban cohort. Controlling for individual factors including participant drug use, age, and depression, having two or more sex partners within the past 90 days was associated with having a larger personal network (OR = 1.11; 95% CI, 1.06 and 1.17); more network members who pitched in to help (OR = 1.22; 95% CI, 1.04 and 1.44), provided financial support (OR = 1.33; 95% CI, 1.11 and 1.60), or used heroin or cocaine (OR = 1.26; 95% CI, 1.14 and 1.40). Having a risky sexual partner within the past 90 days was associated with having a larger social network (OR = 1.06; 95% CI, 1.00 and 1.12) and having more social networks who used heroin or cocaine (OR = 1.30; 95% CI, 1.14 and 1.49).In summary, social network characteristics are associated with HIV sexual risk behaviors among African American urban women. Social-network-based interventions that promote norms pertaining to HIV risk reduction and provide social support are needed for African American women at risk of heterosexually acquired HIV/STIs.     

Improved perinatal health through qualified antenatal care in urban Phnom Penh,Cambodia

Objectives  The aim of this study is to examine the utilities of antenatal care with comprehensive health education qualified in Phnom Penh for the health of mothers and infants during perinatal and postpartum periods. Attention was given to the existing socioeconomic disparties among women in this urban area, and the utilities were discussed irrespective of socioeconomic status. Methods  A total of 436 pregnant women in an urban area in Phnom Penh were selected using a complete survey in randomly sampled villages and were followed up. Participating in antenatal care with comprehensive health education at least three time was regarded as the use of “qualified antenatal care” during pregnancy. In this study, we investigated the independent associations of the use of qualified antenatal care with the following outcome variables after the adjustment for the influence of socieconomic variables: postpartum maternal health knowledge, postpartum maternal anemia, low birth weight, and infant immunization. Results  Of the 314 subjects who completed the follow-up examination, 66.8% used qualified antenatal care during pregnancy. The use of qualified antenatal care was positively associated with postpartum maternal health knowledge (OR=2.38, 95% CI: 1.12–5.05). and reductions in the incidences of postpartum anemia (OR=0.22,95% CI: 0.05–0.95) and low birth weight (OR=0.05,95% CI: 0.01–0.39) after the adjustment of the influence of socioeconomic status. The infants born to mothers who used qualified antenatal care had significantly higher coverage of BCG, DPT₁, and DTP₃ immunizations (P<0.001,P<0.001, andP<0.01, respectively), independent of their socioeconomic conditions. Conclusion  This study shows the solid utilities of qualified antenatal care in Phnom Penh for perinatal health.     

Preconception Health: Awareness, Planning, and Communication Among a Sample of US Men and Women

It is important to educate both men and women about preconception health (PCH), but limited research exists in this area. This paper examines men’s and women’s awareness of exposure to PCH information and of specific PCH behaviors, PCH planning, and PCH discussions with their partners. Data from Porter Novelli’s 2007 Healthstyles survey were used. Women and men of reproductive age were included in the analysis (n = 2,736) to understand their awareness, planning, and conversations around PCH. Only 27.9% of women and men reported consistently using an effective birth control method. The majority of men (52%) and women (43%) were unaware of any exposure to PCH messages; few received information from their health care provider. Women were more aware than men of specific pre-pregnancy health behaviors. Women in the sample reported having more PCH conversations with their partners than did men. PCH education should focus on both women and men. Communication about PCH is lacking, both between couples and among men and women and their health care providers. PCH education might benefit from brand development so that consumers know what to ask for and providers know what to deliver.     

Mother-Infant Interaction, Life Events and Prenatal and Postpartum Depressive Symptoms Among Urban Minority Women in Primary Care

Objectives: Prenatal and postpartum depression are significant mental health problems that can have negative effects on mother-infant interactions. We examined the relationships among mother-infant interactions, depressive symptoms, life events, and breastfeeding of low-income urban African American and Hispanic women in primary care settings. Methods: Participants were 89 African American and Hispanic women who were part of a larger mental health intervention study conducted in community health centers. Questionnaire data on depression, as well as negative and positive life events, were collected during pregnancy and at three-months postpartum, while mother-infant interaction observations and breastfeeding practice were only collected at three-months postpartum. Results: The ratings of maternal behavior for ‘depressed’ mothers did not differ from ‘nondepressed’ mothers. Except for gaze aversion behavior, infants' behavior while interacting with their mothers did not differ by maternal depression level. Hierarchical regression analyses revealed that maternal positive life events positively predicted infant interactional summary ratings, while maternal negative life events were inversely associated with maternal interactional summary ratings. Conclusions: To improve services in primary care, perinatal screenings for depression can help identify those women most at risk. When follow-up use of structured diagnostic instruments is not possible or cost-effective, clinician assessment of severity of depression will determine women with clinical levels of depression. Reducing negative life events is beyond the control of women or clinicians but cognitive interventions to help women focus on positive life events can reduce the deleterious effects of depression on mothers and their infants.