Objective: This study assessed the prevalence of antenatal psychiatric illness in low-income, ethnically diverse patients in an urban
obstetric clinic and examined associations between positive psychiatric screens and inadequate utilization of prenatal care.
Methods: Bilingual research assistants administered the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire
and the Mood Disorder Questionnaire to 154 English- and Spanish-speaking pregnant patients attending routine prenatal visits.
We assessed associations between patient characteristics, current and past psychiatric diagnoses, and utilization of prenatal
care.
Results: Forty-five (29%) women screened positive for criteria for current psychiatric disorders with the highest rates for major
or minor depression (26%) and anxiety disorders (10%). Inadequate prenatal care utilization was significantly associated with
past psychiatric history and domestic abuse in the last year, but not with current psychiatric diagnosis, alcohol abuse, age,
primiparity, marital status, receipt of government assistance, or unplanned pregnancy. Even after adjustment for possible
confounding risk factors (e.g. past substance abuse, single marital status, unstable housing, education less than high school,
and having other children), past psychiatric history was still significantly associated with inadequate prenatal care utilization
and delayed initiation of care.
Conclusions: A high percentage of disadvantaged pregnant women meet screening criteria for psychiatric disorders when screened during
routine prenatal visits. Screening for past psychiatric history in routine prenatal visits could identify patients at risk
for inadequate utilization of prenatal care.
Keywords: Antenatal psychiatric illness; prenatal screening; prenatal care; underserved pregnant women.