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Published on: June 13, 2021
Postnatal depression and faltering growth: a community study
Louise Margaret O'Brien1, Elizabeth Gardner Heycock, Mariam Hanna
1Academic Department of Paediatrics, North Staffordshire Hospital, Stoke on Trent, United Kingdom. lmobri02@gwise.louisville.edu
Insights
Maternal depression is significantly more common in children experiencing faltering growth. Early identification and integrated care for both mother and child are crucial for better health outcomes.
Area of Science:
- Child Health
- Maternal Mental Health
- Developmental Pediatrics
Background:
- Faltering growth in children under two years is a significant concern.
- Maternal mental health, particularly postnatal depression, can impact child development.
- Understanding the link between child growth and maternal well-being is vital for early intervention.
Purpose of the Study:
- To investigate the association between faltering growth in young children and maternal postnatal depression.
- To determine if maternal mental health issues are more prevalent in families with children experiencing growth faltering.
Main Methods:
- Studied children under two years with faltering growth identified via community health records.
- Mothers completed the Edinburgh Postnatal Depression Scale and Hospital Anxiety and Depression Scale.
- Matched control groups and clinical interviews were used for comparison and diagnosis.
Main Results:
- Mothers of children with faltering growth showed significantly higher rates of depression and anxiety.
- 33% of mothers in the index group scored above the depression threshold vs. 22% in controls (OR: 1.71).
- 21% of mothers in the index group met criteria for a depressive episode vs. 11% in controls (OR: 1.88).
Conclusions:
- Maternal depression is significantly more prevalent in children with faltering growth.
- Clinical management should address both the child's growth and the mother's mental health.
- Integrated care for the mother-child dyad is recommended for primary and secondary healthcare professionals.
Objective:
To investigate the association between faltering growth in children and maternal postnatal depression.
Methods:
Children aged < or =2 years were identified from community child health surveillance records if their weights fell across 2 centile channels on standardized growth charts or fell below the second centile. Mothers of these index children were invited to complete the Edinburgh Postnatal Depression Scale and the anxiety subscale of the Hospital Anxiety and Depression Scale. Those who scored above threshold values on either scale were interviewed with the revised Clinical Interview Schedule. Matched control children were obtained from health visitor records, and records of their weights were obtained. Mothers of control children completed the same questionnaires.
Results:
A total of 196 index children and 567 control children were studied. Significantly more mothers in the index group scored above the threshold for both the Edinburgh Postnatal Depression Scale (33% vs 22%; odds ratio [OR]: 1.71; 95% confidence interval [CI]: 1.16-2.53) and the Hospital Anxiety and Depression Scale (24% vs 13%; OR: 2.08; 95% CI: 1.33-3.25) questionnaires. Furthermore, clinical interviews with these mothers demonstrated that 21% of the index group and 11% of the control group fulfilled criteria for depressive episode (OR: 1.88; 95% CI: 1.21-2.94).
Conclusions:
Depression in mothers of children with faltering growth during the first 2 years of life is significantly greater than in mothers of children who are gaining weight appropriately. In view of the high rates of maternal depression in children with poor weight gain, clinical management at presentation of either problem should focus on both members of the mother-child dyad and on the interaction between mother and child. These findings have implications for all professionals who work in primary and secondary health care.
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