Abstract
Over 50% of mothers in rural Mexico have high depressive symptoms, and their children’s health and development are likely to be negatively affected. A critical question is whether children vary in their vulnerability to the effects of high maternal depressive symptoms according to their indigenous ethnicity, maternal education, or household wealth. Our sample included 4442 mothers and 5503 children from an evaluation of Mexico’s social welfare program. Maternal depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) Scale, and child behavior was measured using an adapted version of the Behavior Problems Index (BPI). Multiple linear regression models were used to explore the associations between maternal depressive symptoms and child behavior problems, and the heterogeneity of associations by indigenous ethnicity, maternal education, and household assets. We found that having greater maternal depressive symptoms was significantly associated with having a child with more behavior problems (β = 0.114, p < 0.0001, [95% CI 0.101, 0.127]), in adjusted models. In tests of heterogeneity, the association between maternal depressive symptoms and child behavior problems was strongest in households with indigenous ethnicity, low maternal education, or in households with fewer assets. These results strengthen the case for effective mental health interventions in low- and middle-income countries, particularly among the most vulnerable families where mothers and children appear to be at the greatest risk.
Highlights
Depression is common among mothers, and is a major source of disability [1,2], among the poor [3]
We explored the possible heterogeneity of associations of maternal depression and child outcomes by indigenous status, maternal education and household assets
The mean maternal Center for Epidemiologic Studies Depression (CES-D) score was 16.17 (0–60 point scale; SD 9.44), and 44.12% were over the US-based cutoff score of 16
Summary
Depression is common among mothers, and is a major source of disability [1,2], among the poor [3]. Maternal depression has been identified as a key risk factor for poor child development [6]. Given that children who grow up in poverty are already at greater risk of poor developmental outcomes, the potential effects of maternal depression on child health and development are of particular concern in low-and middle-income countries [7]. Previous research has documented the detrimental effects of maternal depression on children’s cognitive skills, motor skills, and academic achievement [8,9,10]. Maternal depression has shown negative effects on children’s linear growth [11,12] and indicators of illness, such as diarrhea [13,14,15]
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