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Impact of maternal depression on infant nutritional status and illness: a cohort study

Atif Rahman¹, Zafar Iqbal, James Bunn

¹School of Psychiatry and Behavioural Sciences, University of Manchester, Manchester, England. atif.rahman@ntlworld.com

Archives of General Psychiatry

|September 8, 2004

Insights

Maternal depression during pregnancy and after birth significantly increases infant malnutrition and diarrhea risk. Early intervention for maternal depression can improve infant physical health and development.

Area of Science:

Global Health
Maternal and Child Health
Psychiatry

Background:

Maternal depression is linked to child behavioral issues, but its impact on infant physical health is less understood.
Prenatal and postnatal depression may affect infant physical well-being.

Purpose of the Study:

To investigate maternal depression as a risk factor for infant malnutrition and illness in a low-income setting.
To assess the association between maternal depression and infant growth and morbidity.

Main Methods:

Prospective cohort study in rural Pakistan involving 632 pregnant women.
Infant growth and illness (diarrhea, respiratory infections) were monitored from birth to 12 months.
Maternal mental state was reassessed throughout the study period.

Main Results:

Infants of mothers with prenatal depression exhibited significant growth retardation (underweight and stunting) at 6 and 12 months.
Maternal depression increased the risk of recurrent diarrheal episodes (relative risk 2.4).
Chronic depression posed a greater risk than episodic depression, even after adjusting for confounders.

Conclusions:

Maternal depression during pregnancy and postpartum is a predictor of poor infant growth and increased diarrhea risk.
Identifying maternal depression can help identify high-risk infants for targeted interventions.
Treating maternal depression can positively impact both maternal mental health and infant physical development.

Read full analysis

Abstract

Background:

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.

Objective:

To determine whether maternal depression is a risk factor for malnutrition and illness in infants living in a low-income country.

Design:

Prospective cohort study.

Setting:

Rural community in Rawalpindi, Pakistan.

Participants:

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.

Main Outcome Measures:

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 socioeconomic status.

Results:

Infants of prenatally depressed mothers showed significantly more growth retardation than controls at all time points. The relative risks for being underweight (weight-for-age z score of less than -2) were 4.0 (95% confidence interval [CI], 2.1 to 7.7) at 6 months of age and 2.6 (95% CI, 1.7 to 4.1) at 12 months of age, and the relative risks for stunting (length-for-age z score of less than -2) were 4.4 (95% CI, 1.7 to 11.4) at 6 months of age and 2.5 (95% CI, 1.6 to 4.0) at 12 months of age. The relative risk for 5 or more diarrheal episodes per year was 2.4 (95% CI, 1.7 to 3.3). Chronic depression carried a greater risk for poor outcome than episodic depression. The associations remained significant after adjustment for confounders by multivariate analyses.

Conclusions:

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.

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