Long-Lasting Maternal Depression and Child Growth at 4 Years of Age: A Cohort Study

Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
The Journal of pediatrics (Impact Factor: 3.79). 09/2010; 157(3):401-6. DOI: 10.1016/j.jpeds.2010.03.008
Source: PubMed


To investigate the association between sustained maternal depression at 12, 24, and 48 months post-partum and child anthropometry at age of 4 years.
A total of 99.2% of the 4287 children born in 2004 in Pelotas, Brazil, were enrolled in a cohort study. At 3, 12, 24, and 48 months, mothers were interviewed and provided information on several characteristics. Maternal depression was investigated through the Edinburgh Postnatal Depression Scale (EPDS). Weight-for-age, height-for-age, and weight-for-height z-scores at 48 months, according to World Health Organization growth curves, were the outcomes. Multivariate analyses were conducted through logistic regression.
At the 48-month follow-up, of the 3792 children, prevalence of underweight was 1.7%; stunting, 3.6%; wasting, 0.6%; and overweight, 12.2%. Depression (EPDS>or=13) was observed in 17.9% of the 3748 mothers. Of the mothers, 4.7% were persistently depressed at the 12-, 24-, and 48-month visits. In crude analyses, maternal depression was positively associated with underweight and stunting. After adjustment, maternal depression was not associated with any of the anthropometric indices.
Long-lasting maternal depression at 12, 24, and 48 months post-partum is not a risk factor for impaired child growth or overweight at age of 4 years.

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Available from: Marlos RODRIGUES Domingues
    • "Some national organizations recommend screening and initial management of postpartum depression in primary care settings (Earls & The Committee on Psychosocial Aspects of Child and Family Health, 2010; National Institute for Health Care Management, 2010), whereas others have suggested that there is not yet enough evidence to recommend universal screening but suggest that it should be considered (American College of Obstetricians and Gynecologists, 2010). Because of the detrimental effects that parental depression has on childhood development and other health-related outcomes (Kurstjens & Wolke, 2001; Maughan, Cicchetti, Toth, & Rogosch, 2007; Ramchandani et al., 2005; Santos, Matijasevich, Domingues, Barros, & Barros, 2010), pediatricians and pediatric nurse practitioners (PNPs) are often assuming a primary role in identifying and referring caregivers for suspected depression. However, few interventions aimed specifically at depressed mothers exist for delivery within pediatric primary care settings (Bauer, Stanton, Carroll, & Downs, 2013; Berkule et al., 2014). "
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    ABSTRACT: Parental depression has been associated with adverse child outcomes. However, the specific parenting behaviors that may result in such child outcomes and the effect of family-centered care (FCC) on positive parenting behavior of depressed parents has not previously been examined. Data from the National Survey of Early Childhood Health was used (n = 2,068). Groups were stratified by the presence of parental depression and compared with regard to demographics and the mean number of specific positive parenting behaviors. Generalized linear models were developed based on testing whether individuals performed more or less than the median number of positive behaviors. Lastly, we tested whether depression independently predicted each outcome after adjustment for FCC, coping, social support, and ethnicity to evaluate if depression independently predicted each outcome after adjustment. No difference was found in demographic variables between parents who were depressed and not depressed. Parents who were not depressed performed significantly more routines (p = .036); reported coping better with parenting (p < .001); performed significantly less punitive behaviors (p = .022); and needed/had less social support (p = .002) compared with parents who were depressed. Individual items and scale scores were associated in the expected directions. FCC was independently associated with study variables but did not moderate the effect of depression. These data identify specific parenting behaviors that differ between parents who report depressive symptoms compared with parents who do not have depressive symptoms. More targeted interventions coordinated through a medical home are needed for parents with depressive symptoms to reduce the child health disparities often associated with parental depression. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
    No preview · Article · Jul 2015 · Journal of Pediatric Health Care
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    • "Maternal depressive symptoms are known risk factors for poor child development outcomes (e.g., Beck, 1998; Cooper and Murray, 1998). Various studies have documented impairments in children of depressed parents on an array of factors such as growth (Duarte et al., 2012; Santos et al., 2010), mental health (Muzik and Borovska, 2010), illness (Casey et al., 2004; Turney, 2011), feeding (Casey et al., 2004; Ndokera and MacArthur, 2011; Rahman et al., 2004) and cognitive development (Azak, 2012). Because there is an emerging literature documenting links between postpartum depression and differences in child development (Conroy et al., 2012; Foss et al., 2004; Korja et al., 2008; Paulson et al., 2006, 2009; Podestá et al., 2013; Quevedo et al., 2012; Walker et al., 2007), international research in this area is timely and important. "
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    ABSTRACT: Background The Self-Reporting Questionnaire (SRQ) is a screening instrument that has been shown to be an effective measure of depression in postpartum women and is widely used in developing nations. Methods The SRQ was administered to 2028 mothers from eight nations at two time points: one and six months postpartum. All data were obtained from the Interactions of Malnutrition and Enteric Infections: Consequences for Child Health and Development (MAL-ED) study. The sample included women from MAL-ED sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania. This study examined three aspects of validity of SRQ scores including (a) structural validity, (b) cross-cultural invariance, and (c) invariance over time. Results A 16-item, one-factor structure with items reflecting somatic symptoms removed was deemed to be superior to the original structure in this postpartum population. Although differential item functioning (DIF) across sites was evident the one-factor model was a good fit to the data from seven sites, and the structure was invariant across the one- and six-month time points. Limitations Findings are based on data from self-report scales. No information about the clinical status of the participants was available. Conclusions Overall, findings support the validity of a modified model of the SRQ among postpartum women. Somatic symptoms (e.g., headaches, not sleeping well) may not reflect internalizing problems in a postpartum population. Implications for researchers and practitioners are discussed.
    Full-text · Article · Oct 2014 · Journal of Affective Disorders
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    • "We found an association between mild maternal depressive symptoms and child BMI over time, but no relation between moderate to severe depressive symptoms and child BMI. This finding adds to mixed results of studies in both developed and developing countries, showing positive, negative, and null associations between maternal depressive symptoms and child BMI [4,7,8,30]. One study showed an association between maternal postpartum depressive symptoms and child overall adiposity using data from birth to age three, but no relation was observed with BMI z-score, weight-for-height z-score or the ratio of subscapular to tricep skinfold (a measure of central adiposity) [30]. "
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    ABSTRACT: Background Maternal depressive symptoms are negatively associated with early child growth in developing countries; however, few studies have examined this relation in developed countries or used a longitudinal design with data past the second year of the child’s life. We investigated if and when early maternal depressive symptoms affect average growth in young children up to age 6 in a nationally representative sample of US children. Methods Using data from 6,550 singleton births from the Early Childhood Longitudinal Study -- Birth Cohort (ECLS-B), we fit growth trajectory models with random effects to examine the relation between maternal depressive symptoms at 9 months based on the twelve-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) and child height and body mass index (BMI) to age 6 years. Results Mothers with moderate/severe depressive symptoms at 9 months postpartum had children with shorter stature at this same point in time [average 0.26 cm shorter; 95% CI: 5 cm, 48 cm] than mothers without depressive symptoms; children whose mothers reported postpartum depressive symptoms remained significantly shorter throughout the child’s first 6 years. Conclusions Results suggest that the first year postpartum is a critical window for addressing maternal depressive symptoms in order to optimize child growth. Future studies should investigate the role of caregiving and feeding practices as potential mechanisms linking maternal depressive symptoms and child growth trajectories.
    Full-text · Article · Jul 2014 · BMC Pediatrics
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