Abstract
Objective: To test the hypothesis that maternal common mental disorders (CMD) are associated with poorer child nutritional status in four developing countries (Ethiopia, India, Vietnam, and Peru).
Design: Community based cross sectional survey in 20 sites in each of the four countries. Maternal CMD measured by the self reporting questionnaire 20 items (SRQ20). Potential confounding factors include: household poverty, household composition, maternal characteristics such as age and education, child characteristics such as birth weight, age, and sex. Possible mediating factors included the child's physical health and breast feeding status.
Setting: Urban and rural, poor and middle income areas in each country.
Participants: 2000 mothers and their children aged 6–18 months in each country.
Main outcome measures: Child stunting and underweight measured using standard anthropometric techniques.
Results: Levels of maternal CMD and child malnutrition are high in each study setting. After adjusting for confounding factors, the odds ratios (OR) for the association of maternal CMD with child stunting are: India 1.4 (95%CI 1.2 to 1.6), Peru 1.1 (0.9 to 1.4), Vietnam 1.3 (0.9 to 1.7), and Ethiopia 0.9 (0.7 to 1.2). For child underweight, the confounder adjusted ORs are: India 1.1 (0.9 to 1.4), Peru 0.9 (0.6 to 1.2), Vietnam 1.4 (1.1 to 1.8), and Ethiopia 1.1 (0.9 to 1.4). No clear evidence for effect modification by the child's age or sex was found. Possible mediating factors for the effect of maternal CMD on child malnutrition did not provide strong suggestions for potential mechanisms.
Conclusions: There was a relation between high maternal CMD and poor child nutritional status in India and Vietnam. However, the findings from Peru and Ethiopia do not provide clear evidence for a similar association being present in non-Asian countries. Regardless of the direction of the relation, child nutrition programmes in Asia should consider incorporating promotion of maternal mental health.
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Selected References
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- Anoop S., Saravanan B., Joseph A., Cherian A., Jacob K. S. Maternal depression and low maternal intelligence as risk factors for malnutrition in children: a community based case-control study from South India. Arch Dis Child. 2004 Apr;89(4):325–329. doi: 10.1136/adc.2002.009738. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Black Robert E., Morris Saul S., Bryce Jennifer. Where and why are 10 million children dying every year? Lancet. 2003 Jun 28;361(9376):2226–2234. doi: 10.1016/S0140-6736(03)13779-8. [DOI] [PubMed] [Google Scholar]
- Chandran Mani, Tharyan Prathap, Muliyil Jayaprakash, Abraham Sulochana. Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors. Br J Psychiatry. 2002 Dec;181:499–504. doi: 10.1192/bjp.181.6.499. [DOI] [PubMed] [Google Scholar]
- Davis Leigh, Edwards Helen, Mohay Heather, Wollin Judy. The impact of very premature birth on the psychological health of mothers. Early Hum Dev. 2003 Aug;73(1-2):61–70. doi: 10.1016/s0378-3782(03)00073-2. [DOI] [PubMed] [Google Scholar]
- Harpham Trudy, Reichenheim Michael, Oser Rebecca, Thomas Elizabeth, Hamid Narmeen, Jaswal Surinder, Ludermir Ana, Aidoo Magna. Measuring mental health in a cost-effective manner. Health Policy Plan. 2003 Sep;18(3):344–349. doi: 10.1093/heapol/czg041. [DOI] [PubMed] [Google Scholar]
- Inandi Tacettin, Elci Omur Cinar, Ozturk Ahmet, Egri Mucahit, Polat Aytac, Sahin Tahir K. Risk factors for depression in postnatal first year, in eastern Turkey. Int J Epidemiol. 2002 Dec;31(6):1201–1207. doi: 10.1093/ije/31.6.1201. [DOI] [PubMed] [Google Scholar]
- Patel V., DeSouza N., Rodrigues M. Postnatal depression and infant growth and development in low income countries: a cohort study from Goa, India. Arch Dis Child. 2003 Jan;88(1):34–37. doi: 10.1136/adc.88.1.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Patel Vikram, Rahman Atif, Jacob K. S., Hughes Marcus. Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia. BMJ. 2004 Apr 3;328(7443):820–823. doi: 10.1136/bmj.328.7443.820. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Patel Vikram, Rodrigues Merlyn, DeSouza Nandita. Gender, poverty, and postnatal depression: a study of mothers in Goa, India. Am J Psychiatry. 2002 Jan;159(1):43–47. doi: 10.1176/appi.ajp.159.1.43. [DOI] [PubMed] [Google Scholar]
- Rahman A., Iqbal Z., Harrington R. Life events, social support and depression in childbirth: perspectives from a rural community in the developing world. Psychol Med. 2003 Oct;33(7):1161–1167. doi: 10.1017/s0033291703008286. [DOI] [PubMed] [Google Scholar]
- Rahman A., Lovel H., Bunn J., Iqbal Z., Harrington R. Mothers' mental health and infant growth: a case-control study from Rawalpindi, Pakistan. Child Care Health Dev. 2004 Jan;30(1):21–27. doi: 10.1111/j.1365-2214.2004.00382.x. [DOI] [PubMed] [Google Scholar]
- Rahman Atif, Iqbal Zafar, Bunn James, Lovel Hermione, Harrington Richard. Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry. 2004 Sep;61(9):946–952. doi: 10.1001/archpsyc.61.9.946. [DOI] [PubMed] [Google Scholar]
- Waterlow J. C., Buzina R., Keller W., Lane J. M., Nichaman M. Z., Tanner J. M. The presentation and use of height and weight data for comparing the nutritional status of groups of children under the age of 10 years. Bull World Health Organ. 1977;55(4):489–498. [PMC free article] [PubMed] [Google Scholar]
- de Onis Mercedes, Blössner Monika, Borghi Elaine, Morris Richard, Frongillo Edward A. Methodology for estimating regional and global trends of child malnutrition. Int J Epidemiol. 2004 Nov 12;33(6):1260–1270. doi: 10.1093/ije/dyh202. [DOI] [PubMed] [Google Scholar]