Impact of maternal depression on physical health and nutrition of children in rural Rawalpindi, Pakistan
2000 to 2004
Liverpool School of Tropical Medicine, UK; University of Manchester, UK
Depression around childbirth is common, affecting approximately 10% to 15% of all mothers in Western societies. Recent epidemiological findings suggest that prevalence rates may be almost twice as high in South Asian mothers. Depression ranks among the top 5 disabling disorders worldwide. There is compelling evidence that maternal depression adversely affects the psychological and intellectual development of children. The risk for emotional and behavioral problems is known to be high among children of depressed mothers, but little is known about the impact of prenatal and postnatal depression on the physical health of infants.
The aim of this study was to systematically investigate the association between prenatal and postnatal maternal depression and infant physical outcomes in a representative rural community–based sample using a longitudinal, prospective cohort design. Six hundred thirty-two physically healthy women were assessed in their third trimester of pregnancy to obtain at birth a cohort of 160 infants of depressed mothers and 160 infants of psychologically well mothers. All infants were weighed and measured at birth and at 2, 6, and 12 months of age, and they were monitored for episodes of diarrhea and acute respiratory infections. The mothers’ mental states were reassessed at 2, 6, and 12 months. Data were collected on potential confounders of infant outcomes, such as birth weight and socio-economic status.
Infants of prenatally depressed mothers showed significantly more growth retardation than controls at all time points. Chronic depression carried a greater risk for poor outcome than episodic depression.
Maternal depression in the prenatal and postnatal periods predicts poorer growth and higher risk of diarrhea in a community sample of infants. As depression can be identified relatively easily, it could be an important marker for a high-risk infant group. Early treatment of prenatal and postnatal depression could benefit not only the mother’s mental health but also the infant’s physical health and development.
The study showed that the association between maternal mental health and infant physical health could help promote women’s mental health in the health care agenda. It could also provide a window of opportunity to elevate the social status of women in developing countries and in the process improve their own and their children’s physical and mental well-being.