Association between maternal-child interaction, maternal depression and early child development: an observational...

Maternal responsiveness, defined as a mother's ability to perceive her infant's behaviour and respond appropriately, may be compromised with maternal depression and thereby impact early child development (ECD). These relationships have not been studied comprehensively in sub-Saharan Africa, where two-thirds of children are at risk of not reaching their developmental potential. This sub-study of the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe evaluated the relationship between maternal-child interaction, maternal depressive symptoms and ECD using validated tools.

The Edinburgh Postnatal Depression Scale (EPDS) and Observed Mother-Child Interaction (OMCI) tool were administered to mother-infant dyads in the cluster-randomised trial. ECD was assessed using the Malawi Developmental Assessment Tool (MDAT) and MacArthur-Bates Communicative Development Inventory (CDI). Generalised estimating equations were used to estimate effect sizes while accounting for within-cluster correlation and primary results were adjusted for confounding factors.

A total of 540 mother-infant dyads were included. 5.5% of mothers met the EPDS cut-off score for depressive symptoms. There was a positive association between OMCI score and MDAT motor, language and MacArthur-Bates CDI. For every 10 unit change in total OMCI score, there was a rise of 5.1 units (95% CI 3.6 to 6.6) in total MDAT score (out of 138 points), equivalent to a 0.54 SD increase. There was no statistically significant association between EPDS score and OMCI or ECD scores.

Within a sample of rural Zimbabwean mother-infant dyads undergoing directly observed assessment, quality of maternal-child interaction was associated with ECD scores at 24 months of age.