Abstract
ObjectivesMaternal depression occurs in 13–20% of women from low-income countries, which is associated with negative child health outcomes, including diarrheal disease. However, few studies have investigated its impact on child risk of infectious disease. We studied the impacts of maternal depressive symptoms and parent–child interactions, independently, on the risk of Plasmodium falciparum malaria and soil-transmitted helminth infection in Beninese children.MethodsOur population included mothers and children enrolled in a clinical trial during pregnancy (MiPPAD) in Benin. The Edinburgh Postnatal Depression Scale (EPDS) assessed maternal depressive symptoms and the home observation measurement of the environment (HOME) assessed parent–child interactions. Blood and stool sample analyses diagnosed child malaria and helminth infection at 12, 18, and 24 months. Negative binomial and Poisson regression models with robust variance tested associations.ResultsOf the 302 mother–child pairs, 39 (12.9%) mothers had depressive symptoms. Median number of malaria episodes per child was 3 (0–14) and 29.1% children had at least one helminth infection. Higher EPDS scores were associated with lower HOME scores; relative risk (RR) 0.97 (95% confidence interval (CI) 0.95, 0.99), particularly with lower acceptance, involvement, and variety subscales; RR 0.92 (95% CI 0.85, 0.99), RR 0.82 (95% CI 0.77, 0.88), RR 0.93 (95% CI 0.88, 0.99), respectively. However, neither exposure was associated with risk of parasitic infection in children.Conclusions for PracticeMaternal depressive symptoms are associated with poor parent–child interactions, particularly acceptance of behavior, involvement with children, and variety of interactions, but these exposures do not independently impact risk of parasitic infection in children.
Highlights
ObjectivesMaternal depression occurs in 13–20% of women from low-income countries, which is associated with negative child health outcomes, including diarrheal disease
Our study included a sub-population of these children, 302 of whom were recruited for the TOLIMMUNPAL study to assess parasitic infection from 12 to 24 months of age and included in our analyses
Socio-demographic characteristics of our population are displayed in Table 1, along with characteristics of mother–child pairs not included in the 12-month prospective follow-up for parasitic infection
Summary
Maternal depression occurs in 13–20% of women from low-income countries, which is associated with negative child health outcomes, including diarrheal disease. We studied the impacts of maternal depressive symptoms and parent–child interactions, independently, on the risk of Plasmodium falciparum malaria and soil-transmitted helminth infection in Beninese children. Conclusions for Practice Maternal depressive symptoms are associated with poor parent–child interactions, acceptance of behavior, involvement with children, and variety of interactions, but these exposures do not independently impact risk of parasitic infection in children. Few studies have investigated how maternal depression and parent–child interactions independently impact child morbidity from infectious disease. One study found that post-natal depression increases risk of diarrheal illness in one-year-old children in a low-income setting (Rahman et al, 2007). Another linked post-natal depression to increased risk of febrile illness in Ghanaian and Ivorian infants one year after birth (Guo et al, 2013)
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