MHLU - Health Status Resource

Maternal Health

Maternal Health

Key Findings: 

Maternal mental health

A significantly higher percent of women in Middlesex-London reported having a mental health concern during pregnancy compared to women in Ontario from 2013 to 2017. Nearly 30% of women who gave birth in Middlesex-London in 2017 reported a mental health concern during pregnancy, compared to 18.1% in Ontario (Fig. 11.2.1).

The percent of women in Middlesex-London who reported having a mental health concern during pregnancy increased over time from 2013 to 2017 (Fig. 11.2.1).

Women less than 20 years of age reported the highest percentage of mental health concern during pregnancy from 2013 to 2017 in Middlesex-London. In 2017, 61.1% of women in this age group reported a mental health concern during pregnancy, compared to 25.3% among women aged 30 to 34 (Fig. 11.2.2).

Having a mental health concern during pregnancy was significantly higher among the urban population of Middlesex-London compared to the rural population from 2013 to 2017. Among both populations, the percent of women reporting a mental health concern during pregnancy increased over time during this period (Fig. 11.2.3).

The percent of women in Middlesex-London who reported having anxiety during pregnancy was 16.6% in 2017, compared to 11.6% in Ontario. The percent of women reporting anxiety during their pregnancy increased over time for Middlesex-London and Ontario from 2013 to 2017 (Fig. 11.2.4).

The percent of women in Middlesex-London who reported depression during pregnancy was 18.3% in 2017, compared to 8.8% in Ontario. The percent of women reporting anxiety during pregnancy increased significantly over time for Middlesex-London from 2013 to 2017, whereas only modest increases were observed in Ontario and the Peer Group (Fig. 11.2.5).

The percent of women who gave birth in Middlesex-London that reported having a history of postpartum depression was 8.2% in 2016, compared to 3.9% in Ontario and 4.9% in the Peer Group. The percent in Middlesex-London increased each year from 2015 to 2017 (Fig. 11.2.6).

Interpretive notes:

According to the World Health Organization, mental health is “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.”1

Pregnancy is a time of change and transition in a woman’s body and life, and can lead to an increased risk of poor mental health.2 Mental health issues such as depression and anxiety are common during pregnancy.3 Symptoms of anxiety and depression during pregnancy have been associated with a higher odds of low birth weight and preterm births.4, 5 These symptoms can result in poorer nutrition and lower physical activity levels in pregnant women.6 Also, depressive symptoms during pregnancy have been strongly associated with depressive symptoms postpartum.5


Maternal weight gain

The percentage of women in Middlesex-London who gained the recommended amount of weight during pregnancy was 29.9% in 2016, compared to 32.0% in Ontario and 30.0% in the Peer Group. The percent in Middlesex-London was not significantly different from Ontario in 2015 and 2016 (Fig. 11.2.7).

There was no significant difference between the percentages in the urban and rural populations of Middlesex-London from 2015 to 2017 (not shown).

Women aged 40 and older had the highest percent who gained the recommended amount of weight during pregnancy of all age groups in Middlesex-London from 2014 to 2017. Women less than 20 years generally had the lowest percent who gained the recommended amount of weight (Fig 11.2.8).

The percent of women in Middlesex-London who gained more than the recommended amount of weight during pregnancy was significantly higher than Ontario from 2014 to 2016 (Fig. 11.2.9).

The percent of women in Middlesex-London who gained less than the recommended amount of weight during pregnancy was significantly lower than Ontario from 2014 to 2016 (Fig. 11.2.10).

Interpretive notes:

Gestational weight gain (GWG) is the amount of weight gained by a woman during pregnancy. The recommended weight gain7 for a woman during pregnancy depends on her pre-pregnancy body mass index (BMI). Data show that women who gain the recommended amount of weight during pregnancy have better outcomes than those who do not.7 Women who gain more weight than recommended have a higher risk for a caesarean delivery (C-section) and large for gestational age babies.8 Women who gain less weight than recommended have a higher risk for preterm births and small for gestational age babies.8


How this Indicator was Calculated: 
Ontario Public Health Standard: 

Healthy Growth and Development Guideline, 2018

Ontario Public Health Standards: Requirements for Programs, Services, and Accountability


References:

1.      World Health Organization. Mental Health: Strengthening Our Response [Internet]. 2018 [cited 2018 Nov 14]. Available from: http://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response

2.      Public Health Agency of Canada. Pregnancy and Women's Mental Health in Canada: Results from the Canadian Maternity Experiences Survey [Internet]. 2014 [cited 2018 Nov 13]. Report No.: 140282. Available from: https://www.canada.ca/content/dam/canada/health-canada/migration/healthy-canadians/publications/healthy-living-vie-saine/pregnancy-mental-health-grossesse-sante-mentale/alt/pregnancy-mental-health-grossesse-sante-mentale-eng.pdf

3.      World Health Organization. Improving Maternal Mental Health [Internet]. 2008 [cited 2018 Nov 14]. Available from: http://www.who.int/mental_health/prevention/suicide...

4.      Dunkel Schetter C, Tanner L. Anxiety, Depression and Stress in Pregnancy: Implications for Mothers, Children, Research, and Practice. Curr Opin Psychiatry [Internet]. 2012 [cited 2018 Nov 13];25(2):141-48. Available from: https://www.ncbi.nlm.nih.gov/pmc/PMC4447112/ DOI: 10.1097/YCO.0b013e3283503680

5.      Eastwood J, Ogbo FA, Hendry A, Noble J, Page A, for the Early Years Research Group. The Impact of Antenatal Depression on Perinatal Outcomes in Australian Women. PLoS One [Internet]. 2017 [cited 2018 Nov 14];12(1):e0169907. Available from: https://doi.org/10.1371/journal.pone.0169907 DOI: 10.1371/journal.pone.0169907

6.      Omidvar S, Faramarzi M, Hajian-Tilak K, Nasiri Amiri F. Associations of Psychosocial Factors with Pregnancy Healthy Life Styles. PLoS ONE [Internet]. 2018 [cited 2018 Dec 2];13(1):e0191723. Available from: https://doi.org/10.1371/journal.pone.0191723 DOI: 10.1371/journal.pone.0191723

7.      Institute of Medicine National Research Council Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight Gain During Pregnancy: Reexamining the Guidelines [Internet]. Washington (DC): National Academies Press (US); 2009. Available from: https://www.ncbi.nlm.nih.gov/books/NBK32813/.

8.      Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of Gestational Weight Gain with Maternal and Infant Outcomes: A Systematic Review and Meta-Analysis. JAMA [Internet]. 2017 [cited 2018 Nov 14];317(21):2207-25. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815056/ DOI: 10.1001/jama.2017.3635

Last modified on: January 24, 2019

Jargon Explained

Any mental health concern during pregnancy
The percentage of women who gave birth (live or still) who experienced any mental health concern during pregnancy (includes anxiety, depression, history of postpartum depression, addiction, bipolar disorder, schizophrenia, or other).

Depression during pregnancy
The percentage of women who gave birth (live or still) who experienced depression during pregnancy.

Anxiety during pregnancy
The percentage of women who gave birth (live or still) who experienced anxiety during pregnancy.

History of postpartum depression
The percentage of women who gave birth (live or still) who previously had a history of postpartum depression.