Impact of maternal depression on the physical health of infants
Başlık:
Impact of maternal depression on the physical health of infants
Yazar:
Rahman, Atif S., author.
ISBN:
9780438043657
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (309 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 76-08C.
Özet:
Background: Very high rates of child malnutrition have been reported in the developing world, especially South Asia. In Pakistan, up to 30 percent children are underweight and 50 percent are short for their age. The determinants of malnutrition in this largely food- sufficient region are not fully understood. This study examines the possibility of maternal depression as a risk factor for infant malnutrition and poor health. The continuous care and attention of children is a demanding task and poor mental health in mothers might be expected to have adverse consequences on their children's health and nutrition. Maternal competence in child care is likely to play a greater role in the child's physical well being and survival chances in developing countries, as the environment is frequently more hostile than in the developed world. There is likely to be a particularly high risk during the first year of life, not only because this is a time of increased susceptibility of mothers to a depressive episode (a state which often becomes chronic) but also because it is during this period that the infant requires most care. The aim of this study is to systematically investigate this association in a representative rural community-based sample in Rawalpindi, Pakistan, using a longitudinal prospective cohort design. Method: 160 infants of mothers diagnosed to have depressive disorder in the third trimester, and 160 infants of mothers psychologically well in the third trimester, were followed up for one year. Weight and height measurements on infants were carried out at birth, 2, 6 and 12 months and episodes of infections (diarrhoea and acute respiratory infection) were assessed through fortnightly visits. Mothers' mental state was reassessed at 2, 6 and 12 months. All psychiatric assessments were carried out using the WHO Schedule for Clinical Assessment in Neuropsychiatry (SCAN). Disability was assessed using the Brief Disability Questionnaire (BDQ). Information was also collected on demographic, socio-economic, and socio-cultural variables. Results: The response rate was 92%. The one-year rate on onset of depression in the mothers was 20 percent. 56 percent of mothers depressed antenatally were depressed on follow-up at 2,6 and 12 months. There was a strong association between maternal depression and infant growth and other infant health outcomes. At six months and one year of age, infants of depressed mothers were, on average, 600 to 700 grams (about three-quarter of one SD weight-for-age) lighter, and 1.3 to 1.7 centimetres (over half an SD height-for-age) shorter, compared to infants of non-depressed mothers. The relative risk for being moderately-severely underweight is 4.0 at 6 months and 2.6 at 12 months, while the risk for being moderately-severely stunted is 4.4 at 6 months and 2.5 at one year. Infants of depressed mothers also had a higher risk (RR 2.1) of having low birth weight (less than 2500gm). Multiple logistic regression analyses showed that socio-economic and socio-cultural factors did not confound the association between maternal depression and infant growth. There was evidence of a dose-response relationship between maternal depression and infant grow outcomes. Relative risk for being underweight and stunted was almost doubled when infants of chronically depressed mothers (depressed all year) were compared with infants of supernormal mothers (well all year). Maternal depression was associated with other health outcomes. Infants of depressed mothers have more episodes of diarrhoea, and are less likely to be immunized. Conclusions: Maternal depression is a strong and independent predictor of poorer growth and higher rates of common infections in infants in the first year of life. It may also be a strong marker for other infant risk factors such as poor social support and economic adversity. The findings have implications for both infant and maternal health policy and practice.
Notlar:
School code: 1543
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(684302.1) | 684302-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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