Identifying the protective and risk factors of perinatal depression and anxiety: A cross-sectional study of Black women in the Greater Toronto Area

Black women and birthing parents in high-income countries, including Canada, are at a heightened risk of perinatal mood disorders including depression and anxiety. Understanding the risk and protective factors of Black maternal mental health is imperative for advancing mental health equity. The study aimed to estimate the proportions of participants reporting Perinatal Mood and Anxiety Disorders (PMADs) symptoms and to identify the protective and risk factors associated with symptoms of PMADs. We surveyed 329 eligible Black women and birthing persons from the Greater Toronto Area using validated scales. Descriptive and inferential analyses, including a two-step hierarchical multiple regression were used to analyze the data. An estimated proportion of sample self-reporting moderate and the possibility of major symptoms of perinatal depression was 17.3% and 55.6% respectively. Social support (β = -0.26, p < .001) and net income of more than $50,000 per annum (β = -0.19, p < .001) were protective factors whereas parental stress (β = 0.35, p < .001), everyday discrimination (β = 0.29, p < .001), and endorsement of Strong Black Woman Archetype (β = 0.26, p < .001) were risk factors of perinatal depression. Having two children (β = -0.11, p < .03) and social support (β = -0.10, p < .01) emerged as protective factors against perinatal anxiety whereas parental stress (β = 0.41, p < .001), everyday discrimination (β = 0.29, p < .001), and endorsement of the strong Black woman archetype (β = 0.26, p < .001) were risk factors of perinatal anxiety. The findings underscore the need for targeted equity-based interventions and policies to address the risk factors and strengthen protective factors.