Maternal mental health and its association with infant growth at 6 months in ethnic groups: results from the Born-in-Bradford birth cohort study
TL;DR: Maternal mental health in pregnancy is an independent influence on infant growth up to 6 months and is associated with ethnicity which was itself associated with deprivation in the authors' sample.
Abstract: Objective
To identify factors associated with infant growth up to 6 months, with a particular focus on maternal distress, and to explore the effect of ethnicity on any relation between maternal distress and infant growth.
Methods
Cohort study recruiting White and Pakistani women in the United Kingdom (UK). Infant growth was measured at birth and 6 months. Standard assessment of mental health (GHQ-28) was undertaken in pregnancy (26–28 weeks gestation) and 6 months postpartum. Modelling included social deprivation, ethnicity, and other known influences on infant growth such as maternal smoking and alcohol consumption.
Results
Maternal distress improved markedly from pregnancy to 6 months postpartum. At both times Pakistani women had more somatic and depression symptoms than White women. Depression in pregnancy (GHQ subscale D) was associated with lower infant growth at 6 months. Self-reported social dysfunction in pregnancy (GHQ subscale C) was associated with lower gestational age.. Pakistani women reported higher GHQ scores during pregnancy associated with smaller infants at birth. They lived in areas of higher social deprivation, reported less alcohol consumption and smoking postnatally, all independent influences on growth at 6 months.
Conclusions
Maternal mental health in pregnancy is an independent influence on infant growth up to 6 months and is associated with ethnicity which was itself associated with deprivation in our sample. There is a complex relationship between symptoms of maternal distress, ethnicity, deprivation, health behaviours, and early infant growth. Measures should include both emotional and somatic symptoms and interventions to reduce risks of poor early growth need to include psychological and social components.
Citations
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TL;DR: Findings confirm the high prevalence of MDE among pregnant women in LMIC settings and suggest rates of depression may be increased in settings where women are exposed to multiple risks.
89 citations
Cites background from "Maternal mental health and its asso..."
...…disabling effect on maternal functioning (Manikkam and Burns, 2012), and the negative consequences for the health and development of infants and children (Grote et al., 2010; Nasreen et al., 2010; Patel and Prince, 2006; Rahman et al., 2003a, 2003b; Tomlinson et al., 2004; Traviss et al., 2012)....
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...Depression during the perinatal period is of particular concern because of the disabling effect on maternal functioning (Manikkam and Burns, 2012), and the negative consequences for the health and development of infants and children (Grote et al., 2010; Nasreen et al., 2010; Patel and Prince, 2006; Rahman et al., 2003a, 2003b; Tomlinson et al., 2004; Traviss et al., 2012)....
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TL;DR: Although about half of White British women are at risk of primary CMV infection in pregnancy and the associated increased risk of congenital infection, most congenital CMV infections are likely to be in children born to South Asian women with non-primary infection during pregnancy.
Abstract: Objective: To estimate the seroprevalence of cytomegalovirus (CMV), Epstein Barr virus (EBV) and varicella zoster virus (VZV) among pregnant women in Bradford by ethnic group and country of birth. Methods: A stratified random sample of 949 pregnant women enrolled in the Born in Bradford birth cohort was selected to ensure sufficient numbers of White UK born women, Asian UK born women and Asian women born in Asia. Serum samples taken at 24-28 weeks’ gestation were tested for CMV IgG, EBV IgG and VZV IgG. Each woman completed a questionnaire which included socio-demographic information. Results: CMV seroprevalence was 49% among the White British women, 89% among South Asian UK born women and 98% among South Asian women born in South Asia. These differences remained after adjusting for sociodemographic factors. In contrast, VZV seroprevalence was 95% among women born in the UK but significantly lower at 90% among South Asian women born in Asia. EBV seroprevalence was 94% overall and did not vary by ethnic group/country of birth. Conclusions: Although about half of White British women are at risk of primary CMV infection in pregnancy and the associated increased risk of congenital infection, most congenital CMV infections are likely to be in children born to South Asian women with non-primary infection during pregnancy. South Asian women born in South Asia are at risk of VZV infection during pregnancy which could produce congenital varicella syndrome or perinatal chickenpox. Differences in CMV and VZV seroprevalence by ethnic group and country of birth must be taken into account when universal immunisation against these viruses is contemplated.
85 citations
Cites background from "Maternal mental health and its asso..."
...The full BiB cohort recruited 12,453 women during 13,776 pregnancies between 2007 and 2010, 85% of those eligible [22], and the cohort is broadly characteristic of the city’s maternal population....
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TL;DR: The results showed that a high prevalence of depression in sub-Saharan Africa may pose a serious public health threat to women and their offspring.
Abstract: In low-income countries, perinatal depression is common, but longitudinal data on its influence on child health are rare. We examined the association between maternal depression and febrile illness in children. There were 654 mother/child dyads in Ghana and Cote d'Ivoire that were enrolled in a prospective birth cohort in 2010-2011 and underwent 2-years of follow up. Mothers were examined for depression using the Patient Health Questionnaire depression module antepartum and 3 and 12 months postpartum. The hazard of febrile illness in children of depressed and nondepressed mothers was estimated using a recurrent event Cox proportional hazards model. The prevalences of antepartum depression in mothers from Cote d'Ivoire and Ghana were 28.3% and 26.3%, respectively. The prevalences of depression at 3 and 12 months postpartum were 11.8% and 16.1% (Cote d'Ivoire) and 8.9% and 7.2% (Ghana). The crude and adjusted (for country and socioeconomic status) hazard ratios of febrile illness in children of depressed mothers compared with those in children of nondepressed mothers were 1.57 (95% confidence interval: 1.20, 2.07) and 1.32 (95% confidence interval: 1.01, 1.74) respectively. Perinatal depression was frequent and associated with febrile illness in the offspring. Our results showed that a high prevalence of depression in sub-Saharan Africa may pose a serious public health threat to women and their offspring.
55 citations
TL;DR: It is concluded that maternal depressive symptoms are important to consider when assessing risks for obesity in preschool-aged children; however, more research is needed examining the impact of other facets of maternal psychopathology on obesity risk in pre-schoolers.
50 citations
Cites background from "Maternal mental health and its asso..."
...Ramsay, Gisel, McCusker, Bellavance, and Platt (2002) found no relationship between child underweight and maternal depressive symptoms in a sample of Canadian women of average socioeconomic status, whilst (Traviss et al., 2012) found Pakistani women with depressive symptoms who were living in areas of high social deprivation within the United Kingdom were more likely to have underweight children than Caucasian women with depressive symptoms with less social deprivation....
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...…no relationship between child underweight and maternal depressive symptoms in a sample of Canadian women of average socioeconomic status, whilst (Traviss et al., 2012) found Pakistani women with depressive symptoms who were living in areas of high social deprivation within the United Kingdom…...
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TL;DR: Sexual functioning during the postpartum year is a biopsychosocial process which is challenging for most couples, although there are exceptions, and these challenges need to be pathologized.
Abstract: This paper is written to introduce postpartum sexual functioning through a biopsychosocial lens, including challenges and interventions for optimal sexual functioning during the postpartum period, both for women and their partners. While considered to be dysfunctional compared to sexual functioning outside of the perinatal period, changes to sexual functioning in the year following childbirth are common. Biological and physiological factors which affect postpartum sexual functioning include method of delivery, breastfeeding and hormonal changes, and sleep. Psychosocial factors impacting postpartum sexual functioning include mental health, identity transition with adjusting to parenting, body image, social support, cultural context, and romantic relationships. Basson’s model of female sexual response is also discussed. Sexual functioning during the postpartum year is a biopsychosocial process which is challenging for most couples, although there are exceptions. These challenges need to be pathologized. Healthcare providers need to better support new parents with their sexual health.
45 citations
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TL;DR: Copyright (©) 1999–2012 R Foundation for Statistical Computing; permission is granted to make and distribute verbatim copies of this manual provided the copyright notice and permission notice are preserved on all copies.
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TL;DR: The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community was found to have satisfactory sensitivity and specficity, and was also sensitive to change in the severity of depression over time.
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TL;DR: In this article, a shorter, 28-item General Health Questionnaire (GHQ) consisting of four subscales: somatic symptoms, anxiety and insomnia, social dysfunction and severe depression was proposed.
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