{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T14:11:52Z","timestamp":1763388712149,"version":"3.45.0"},"reference-count":50,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:00:00Z","timestamp":1763164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Illinois Chicago Center for Clinical and Translational Science","award":["UL1 TR002003"],"award-info":[{"award-number":["UL1 TR002003"]}]},{"name":"the National Institute of Child Health and Human Development of the National Institutes of Health","award":["R01HD114624"],"award-info":[{"award-number":["R01HD114624"]}]},{"name":"National Institute of Diabetes and Digestive and Kidney Disease of the National Institutes of Health","award":["R01DK136085"],"award-info":[{"award-number":["R01DK136085"]}]},{"name":"National Heart, Lung, and Blood Institute of the National Institutes of Health","award":["R34HL155481"],"award-info":[{"award-number":["R34HL155481"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Chronic exposure to structural violence and environmental hazards may disrupt stress regulation, trigger inflammation, and impair iron metabolism in women. Iron deficiency has been associated with depression, but the combined impact of environmental stressors and anemia on maternal mental health remains understudied. We analyzed associations between 28 neighborhood-level environmental stressors, hemoglobin levels, and depressive symptoms (measured by the Patient Health Questionnaire-9) during early pregnancy, using retrospective data from 1964 pregnant patients (2015\u20132019) at an urban health center in Chicago. Demographic and residential data were linked to environmental indicators from the Chicago Health Atlas. Factor analysis reduced the environmental variables, and multivariable regression models examined associations with PHQ-9 scores at first pregnancy encounter. Participants were predominantly non-Hispanic Black (56%) and Hispanic (27%), with 13% anemic and 16% screening positive for depressive symptoms. Poverty, non-Hispanic Black race, single status, public or no insurance, and unemployment were associated with higher depressive symptoms. Among anemic individuals, neighborhood crime was significantly associated with depressive symptoms, while hemoglobin levels and gestational age were not. These findings highlight how environmental and social inequities contribute to maternal mental health disparities and support the need for integrated, equity-focused prenatal care interventions.<\/jats:p>","DOI":"10.3390\/ijerph22111727","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T14:04:07Z","timestamp":1763388247000},"page":"1727","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Environmental Stressors, Anemia, and Depressive Symptoms in Pregnancy: Unpacking the Combined Risks"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7004-5843","authenticated-orcid":false,"given":"Ruth A.","family":"Pobee","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, University of Illinois Chicago, 808 S Wood St., Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6466-1516","authenticated-orcid":false,"given":"Rebecca K.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, University of Illinois Chicago, 1603 W Taylor St., Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3885-6950","authenticated-orcid":false,"given":"Prathiba","family":"Balakumar","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, University of Illinois Chicago, 1603 W Taylor St., Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4951-4726","authenticated-orcid":false,"given":"Yongchao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Colleges of Engineering and Medicine; University of Illinois Chicago, 851 S Morgan St., Chicago, IL 60607, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz Pe\u00f1alver","family":"Bernab\u00e9","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Colleges of Engineering and Medicine; University of Illinois Chicago, 851 S Morgan St., Chicago, IL 60607, USA"},{"name":"Center for Bioinformatics and Quantitative Biology, University of Illinois Chicago, 820 S Wolcott St., Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2217-1105","authenticated-orcid":false,"given":"Mary Dawn","family":"Koenig","sequence":"additional","affiliation":[{"name":"Department Human Development Nursing Science, College of Nursing, University of Illinois Chicago, 845 South Damen Avenue, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102322","DOI":"10.1016\/j.pmedr.2023.102322","article-title":"Assessment of prenatal depression among U.S. pregnant women without access to paid sick leave and regular place of care: National Health Interview Survey of U.S.-born and non-U.S.-born","volume":"35","author":"Sulley","year":"2023","journal-title":"Prev. 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