Maternal Common Mental Disorders Research Articles

The Impact of Maternal Common Mental Disorders on Exclusive Breastfeeding in Eastern Ethiopia: A Prospective Cohort Study

The Impact of Maternal Common Mental Disorders on Exclusive Breastfeeding in Eastern Ethiopia: A Prospective Cohort Study

Common mental disorders and perinatal outcomes in Victoria, Australia: A population-based retrospective cohort study

PurposeCommon mental disorders (non-psychotic mental health conditions which impact on day-to-day functioning) are increasingly common in childbearing women and may impact significantly on both maternal and neonatal outcomes. Our study examines the associations between common mental disorders and perinatal outcomes. MethodsWe used routinely collected perinatal data (2009–2016) for this population-based retrospective cohort study (n = 597,522 singleton births). We undertook multiple logistic regression adjusting for key maternal medical conditions and sociodemographic factors to determine associations between maternal common mental disorders and adverse perinatal outcomes with confidence intervals set at 95%. ResultsWomen with common mental disorders were more likely to have an induction of labour and caesarean birth, have a postpartum haemorrhage (PPH), and be admitted to the Intensive Care Unit (ICU) than women without common mental disorders. Neonates of women with common mental disorders were more likely to have an Apgar score at five minutes of less than seven (a measure of neonatal wellbeing at birth), be born preterm and low birthweight, be admitted to the Special Care Nursery or Neonatal Intensive Care Unit (SCN/NICU) and have a congenital anomaly than neonates of women without common mental disorders. ConclusionCommon mental disorders during the perinatal period were associated with poorer perinatal outcomes for mothers and their neonates. Strategies that enable early recognition and response to maternal common mental disorders should be developed to mitigate the consequential impact on maternal and infant wellbeing.

Domestic violence patterns in postpartum women who delivered during the COVID-19 pandemic.

To longitudinally assess domestic violence (DV) during the postpartum period, identifying types, patterns and determinants of DV, according to mothers' reports in Fortaleza, Brazil. Data from the Iracema-COVID cohort study interviewed at home mothers who gave birth in the first wave of COVID-19, at 18 and 24 months after birth. Patterns of reported DV were classified as follows: no DV, interrupted DV, started DV and persistent DV. Adjusted multinomial logistic regressions were used to assess factors associated with persistent DV. DV was reported by 19 and 24% of the mothers at 18 and 24 months postpartum, respectively, a 5 percentage points increase. Persistent DV was present in 11% of the households in the period. The most frequent forms of DV were verbal aggression, reported by 17-20% of the mothers at 18 and 24 months, respectively; drunkenness or use of drugs at home, present in 3-5% of the households; physical aggression, reported by 1.2-1.6% of the mothers. Households with two or more forms of DV increased from 2 to 12% in the period. Adjusted factors associated with persistent DV were maternal common mental disorder, family headed by the mother and head of family's poor schooling. Food insecurity was associated with starting DV. Prevalence of DV was considerably high in the postpartum period. DV prevention policies should rely on improving care to women's mental health; preventing food insecurity; and fostering the educational level of young people of both sexes.

Adverse childhood experiences (ACEs) and suicidal behaviors in emerging adulthood: The 1993 Pelotas birth cohort

BackgroundSuicide is the second most common cause of death among young individuals (10–25 years). The risk of first occurrence of suicidal behavior increases significantly at the start of adolescence, highlighting the importance of research regarding the association between early life factors, such as adverse childhood experiences (ACEs), and suicidal behaviors. ObjectiveTo assess if ACEs are prospectively associated with lifetime suicide attempt and suicidal thoughts at young adulthood.Participants and Setting: Data from 3050 young adults from the 1993 Pelotas Birth Cohort. MethodsDiscrimination (of any type), financial hardship, maternal common mental disorders (CMD – SRQ-20), parental death, parental divorce and physical abuse were assessed at the 11-year follow-up. Data regarding suicidal thoughts and suicide attempt was assessed at 22 years with Mini International Neuropsychiatric Interview (MINI), version 5.0. Crude and adjusted logistic regression models were estimated. ResultsIn the adjusted model, those who suffered financial hardship (OR 2.51; 95 % CI 1.66–3.79), parental divorce (OR 1.44; 95 % CI 1.02–2.04) and maternal CMD (OR 1.72; 95 % CI 1.21–2.46) at 11 years were more likely to report suicidal thoughts at 22 years. Also, those who experienced financial hardship (OR 1.71; 95 % CI 1.13–2.58), physical abuse (OR 1.48; 95 % CI 1.08–2.04), discrimination (OR 1.74; 95 % CI 1.20–2.51), maternal CMD (OR 1.67; 95 % CI 1.20–2.32), or parental divorce (OR 1.41; 95 % CI 1.02–1.94) were more likely to report a lifetime suicide attempt. ConclusionThere was a strong association between financial hardship, maternal CMD and divorce during childhood, and suicidal thoughts, such as suicidal ideation or planning, at the beginning of adulthood. Financial hardship, discrimination, divorce, maternal CMD and physical abuse were associated with suicide attempt. These findings demonstrate that mental health support must be available following certain ACEs during childhood, alongside with ACEs prevention. More research is needed on the association between discrimination and suicide attempts, differentiating the nature and impact of each type of discrimination.

Child educational progress in Born in Bradford pregnancies affected by gestational diabetes and also exposed to maternal common mental disorders

Gestational diabetes and the maternal mental disorders of anxiety and depression have been implicated in adverse offspring neuro-behavioural outcomes but these exposures have only been studied in isolation. 1051 children whose mothers were diagnosed with gestational diabetes in UK’s Born in Bradford cohort had linkage to maternal primary care records, providing diagnostic and treatment codes for depression and anxiety. Education record linkage provided results of the Early Years Foundation Stage Profile from the first year of school, aged five. Risk of not attaining a ‘Good level of development’ was analysed using multivariable Poisson regression within a generalised estimating equation framework. Multiple imputation was implemented for missing data. There was limited evidence of increased risk of failure to attain a ‘good level of development’ in those additionally exposed to maternal mental disorders (adjusted RR 1.21; 95% CI 0.94, 1.55). However, there was more evidence in children of Pakistani maternal ethnicity (adjusted RR 1.36; 95% CI 1.04, 1.77) than White British; this may have been driven by English not being the primary language spoken in the home. Therefore there may be groups with GDM in whom it is particularly important to optimise both maternal physical and mental health to improve child outcomes.

Household food insecurity, low maternal social support and maternal common mental disorders in East Mamprusi Municipality, Ghana

IntroductionBoth household food insecurity and maternal common mental disorders are public health concerns in Ghana but studies on them, and their interrelatedness are scarce. Social support is an independent determinant of mental health but can also moderate the link between risk factors and mental illness. Identifying the risk factors of mental illness may provide opportunities for intervention and help reduce disease burden and impact. This study examined the association between household food insecurity or low maternal social support and maternal common mental disorders in East Mamprusi Municipality, Ghana.MethodsThis was a community-based, cross-sectional study involving 400 mothers with children 6–23 months selected using multi-stage sampling. Summary scores for household food insecurity, maternal social support, and maternal common mental disorders were measured using Food Insecurity Experience Scale (FIES), Medical Outcome Study Social Support Scale (SSS), and WHO Self-Reporting Questionnaire 20 items (SRQ-20) respectively in personal interviews. Poisson regression models were fitted to determine the association of household food insecurity or low maternal social support with maternal common mental disorders, controlling for selected socio-demographic variables.ResultsThe mean age of the participants was 26.7 (± 6.68) years, and the mean FIES, SSS, and SRQ-20 scores were 5.62 [95% Confidence Interval (CI): 5.29–5.96] out of 8, 43.12 (95% CI: 41.34–44.90) out of 100, and 7.91 (95% CI: 7.38–8.45) out of 19 respectively. About two-thirds of the households (71.9%), and 72.7% and 49.5% of the women had food insecurity, low social support and probable common mental disorder respectively. In the adjusted analyses, a unit increase in FIES score was associated to a 4% increment in the predicted SRQ-20 score [Incident Risk Ratio (IRR) 1.04; 95% Confidence Interval (CI): 1.02, 1.06; p = 0.001], and the predicted SRQ-20 score of the women belonging to low social support category was 38% higher compared to that of women of high social support category (IRR 1.38; 95% CI: 1.14, 1.66; p = 0.001).ConclusionThe prevalence of household food insecurity and common mental disorders among mothers are high, and both household food insecurity and low social support are significantly related to common mental disorders in women. Interventions to reduce both household food insecurity, and common mental disorders in women are warranted, and should include social support for women.

Food insecurity among families with infants born during the COVID-19 pandemic in Fortaleza, Northeast Brazil

PurposeTo assess the prevalence of food insecurity (FI) among families with infants born during the COVID-19 pandemic and its associated factors in Fortaleza, the fifth largest city in Brazil.MethodsData from two survey rounds of the Iracema-COVID cohort study collected at 12 (n = 325) and 18 months (n = 331) after birth. FI was measured using the Brazilian Household Food Insecurity Scale. FI levels were described according to potential predictors. Crude and adjusted logistic regressions with robust variance were used to assess factors associated with FI. ResultsIn the 12- and 18-month follow-ups interviews, there was a 66.5% and 57.1% prevalence of FI, respectively. Over the study period, 3.5% of the families persisted in severe FI and 27.4% in mild/moderate FI. Households headed by mothers, with more children, low education and income, sustained maternal common mental disorders, and that were beneficiaries of cash transfer programs were the most affected by persistent FI.ConclusionsAlthough the prevalence of FI decreased in our sample, almost 60% of families in Fortaleza still have no regular access to enough and/or nutritionally appropriate food. We have identified the groups at higher FI risk, which can guide governmental policies.

Adolescent mothers and their children affected by HIV-An exploration of maternal mental health, and child cognitive development.

Some children born to adolescent mothers may have developmental challenges, while others do not. Research focusing on which children of adolescent mothers are at the highest risk for cognitive delay is still required. Both maternal HIV status and maternal mental health may affect child development. An examination of maternal mental health, especially in the presence of maternal HIV infection may be timely. This study explores the relationship between the mental health of adolescent mothers (comparing those living with and not living with HIV) and the cognitive development performance scores of their children. Additional possible risk and protective factors for poor child development are explored to identify those children born to adolescent mothers who may be at the greatest risk of poor cognitive development. Cross-sectional data utilised within the analyses was drawn from a large cohort of adolescent mothers and their children residing in South Africa. Detailed study questionnaires were completed by adolescent mothers relating to their self and their child and, standardised cognitive assessments were completed by trained researchers for all children using in the Mullen Scales of Early Learning. Chi-square, t-tests (Kruskal Wallis tests, where appropriate), and ANOVA were used to explore sample characteristics and child cognitive development scores by maternal mental health status (operationalised as likely common mental disorder) and combined maternal mental health and HIV status. Multivariable linear regression models were used to explore the relationship between possible risk factors (including poor maternal mental health and HIV) and, child cognitive development scores. The study included 954 adolescent mothers; 24.1% (230/954) were living with HIV, 12.6% (120/954) were classified as experiencing likely common mental disorder. After adjusting for covariates, maternal HIV was found to be associated with reduced child gross motor scores (B = -2.90 [95%CI: -5.35, -0.44], p = 0.02), however, no other associations were identified between maternal likely common mental disorder, or maternal HIV status (including interaction terms), and child cognitive development scores. Sensitivity analyses exploring individual maternal mental health scales identified higher posttraumatic stress symptomology scores as being associated with lower child cognitive development scores. Sensitivity analyses exploring potential risk and protective factors for child cognitive development also identified increased maternal educational attainment as being protective of child development scores, and increased child age as a risk factor for lower development scores. This study addresses a critical evidence gap relating to the understanding of possible risk factors for the cognitive development of children born to adolescent mothers affected by HIV. This group of mothers experience a complex combination of risk factors, including HIV, likely common mental disorder, and structural challenges such as educational interruption. Targeting interventions to support the cognitive development of children of adolescent mothers most at risk may be of benefit. Clearly a basket of interventions needs to be considered, such as the integration of mental health provision within existing services, identifying multiple syndemics of risk, and addressing educational and structural challenges, all of which may boost positive outcomes for both the mother and the child.

Maternal mental health and child nutritional status in an urban slum in Bangladesh: A cross-sectional study.

Poor mental health may diminish a mother's capacity to adequately care for her child, resulting in a negative impact on the child's nutrition. This study aims to determine the association between maternal mental health and child nutritional status in a poor urban population in Bangladesh. We carried out a cross-sectional study among 264 mother-child pairs in an urban slum area of Bangladesh. The Self-Reporting Questionnaire-20 (SRQ-20) was used to assess maternal mental health. An SRQ-20 score ≥7 was considered a common mental disorder (CMD). Anthropometric measurements were performed to assess nutritional status of the children. The prevalence of maternal CMD was 46.2%. Maternal CMD was associated with poorer child feeding practice (p<0.001), poorer hygiene practice (p<0.001), poorer preventive care service use (p = 0.016), and suffering from diarrheal diseases (p = 0.049). The prevalence of stunting, wasting and underweight in children was 44.3%, 18.2% and 33.7%, respectively. A poorer child feeding practice was associated with wasting (p = 0.004) and underweight (p<0.001) but not with stunting. Poorer hygiene practices and suffering from diarrheal diseases were associated with stunting and underweight, but not with wasting. In multivariable analysis, maternal CMD was associated with child wasting (adjusted odds ratio, aOR = 2.25, 95% CI = 1.15-4.43). The association between maternal CMD and child underweight found in the bivariate analysis was attenuated and no longer statistically significant after multivariable analysis (aOR = 1.77, 95% CI = 0.94-3.33). No statistically significant association was observed between maternal CMD and stunting in this study (aOR = 1.46, 95% CI = 0.84-2.54). Maternal mental health affects nutritional status of the children where child feeding practice, hygiene practice and preventive care use might play a role. Interventions to address maternal mental health in child nutrition programs might improve child nutritional status.

Breastfeeding Practices Before and During the COVID-19 Pandemic in Fortaleza, Northeastern Brazil.

Physical distancing associated with the COVID-19 pandemic may lead to suboptimal maternal mental health, social support after birth, and infant feeding practices. To compare breastfeeding prevalence in participants who were pregnant at a time when strict physical distancing measures were imposed in Fortaleza, the capital of Ceará state, Brazil, with the pre-pandemic breastfeeding levels, and to assess the association of breastfeeding prevalence with maternal common mental disorders, and sociodemographic and health predictors. A cross-sectional prospective two-group comparison design using two population-based surveys was carried out in Fortaleza before and after the pandemic. Participants (n = 351) who had a live birth in Fortaleza in July or August 2020, and participants (n = 222) who had a child younger than 12 months in 2017 were surveyed. Crude and adjusted multinomial logistic regressions with robust variance were used to estimate risk ratios and 95% confidence intervals (CI). Similar prevalence of exclusive breastfeeding were observed in 2021 (8.1%) and 2017 (8.5%; p = .790). An increase in predominant (2.2% vs. 13.4%; p < .001) and a decrease in complementary breastfeeding (64.0% vs. 48.4%; p = .037) was observed in 2021, compared to 2017. The prevalence of maternal common mental disorders also increased in 2021 (17.6% vs. 32.5%, p < .001). No statistically significant associations were found between breastfeeding patterns, maternal common mental disorders, and other predictors in 2017 or 2021. Participants who delivered during the COVID-19 pandemic delayed solid foods introduction and breastfed predominantly longer than participants during the pre-pandemic period. While common mental disorders significantly increased, they were not associated with differences in breastfeeding.

Cohort profile: maternal and child health and parenting practices during the COVID-19 pandemic in Ceará, Brazil: birth cohort study (Iracema-COVID)

PurposeMaternal and child health and parenting practices during the COVID-19 pandemic in Ceará (Iracema-COVID) is a longitudinal, prospective population-based birth cohort designed to understand the effects of the pandemic and...

Development of type 2 diabetes in women with comorbid gestational diabetes and common mental disorders in the Born in Bradford cohort

ObjectivesTo compare, in a population of women with gestational diabetes mellitus (GDM), the time to diagnosis of Type 2 diabetes in those with and without common mental disorder (CMD) (depression...

Common perinatal mental disorders and post-infancy child development in rural Ethiopia: A population-based cohort study.

ObjectiveTo investigate whether maternal common mental disorders (CMD) in the postnatal period are prospectively associated with child development at 2.5 and 3.5 years in a rural low‐income African setting.MethodsThis study was nested within the C‐MaMiE (Child outcomes in relation to Maternal Mental health in Ethiopia) population‐based cohort in Butajira, Ethiopia, and conducted from 2005 to 2006. The sample comprised of 496 women who had recently given birth to living, singleton babies with recorded birth weight measurements, who were 15 to 44 years of age, and residing in six rural sub‐districts. Postnatal CMD measurements were ascertained 2 months after delivery. Language, cognitive, and motor development were obtained from the child 2.5 and 3.5 years after birth using a locally adapted version of the Bayley Scales of Infant Development (3rd Ed). Maternal CMD symptoms were measured using a locally validated WHO Self‐Reporting Questionnaire. A linear mixed‐effects regression model was used to analyze the relationship between postnatal CMD and child development.ResultsAfter adjusting for confounders, there was no evidence for an association between postnatal CMD and overall child development or the cognitive sub‐domain in the preschool period. There was no evidence of effect modification by levels of social support, socioeconomic status, stunting, or sex of the child.ConclusionsPrevious studies from predominantly urban and peri‐urban settings in middle‐income countries have established a relationship between maternal CMD and child development, which contrasts with the findings from this study. The risk and protective factors for child development may differ in areas characterized by high social adversity and food insecurity. More studies are needed to investigate maternal CMD’s impact on child development in low‐resource and rural areas.

Effects of Stress and Nativity on Maternal Antenatal Substance Use and Postnatal Mental Disorders.

Background: Maternal substance use and common mental disorders (CMDs) during or after pregnancy can lead to negative health outcomes among mothers and infants. We examined whether nativity (US-born versus foreign-born) and stress levels during pregnancy were associated with antenatal substance use and postnatal CMDs. Methods: We analyzed the Boston Birth Cohort, a racially diverse cohort recruited at birth with rolling enrollment since 1998. Information on antenatal substance use (tobacco and/or alcohol use) was obtained using an in-person postpartum questionnaire (n = 6,514). Information on postnatal CMDs (depression and/or anxiety) was obtained from medical records (n = 2,052). Nativity and stress during pregnancy were self-reported. We performed multivariate logistic regression to examine how nativity and stress levels were jointly associated with antenatal substance use and postnatal CMDs. We further investigated if blacks, Hispanics, and whites were differentially at risk. Results: We found that US-born mothers were at higher risk of substance use and CMDs than their foreign-born counterparts. In analyses combining nativity and stress, being US-born with high stress was associated with increased odds of antenatal substance use (adjusted odds ratio [aOR] = 14.91, 95% confidence interval [CI]: 12.09-18.39) and postnatal CMDs (aOR = 4.09, 95% CI: 2.72-6.15) compared with foreign-born mothers with low stress. The results of the subanalyses limited to black and Hispanic women separately were similar; high stress alone was associated with fourfold increased odds of CMDs among foreign-born Hispanic mothers (aOR = 4.27, 95% CI: 1.96-9.33). Conclusions: Findings suggest that identifying and alleviating high stress among pregnant women may reduce their risk of antenatal substance use and postnatal CMDs.

Common mental disorders in mothers of children attending out-patient malnutrition clinics in rural North-western Nigeria: a cross-sectional study

BackgroundChildren with uncomplicated severe acute malnutrition are managed routinely within out-patient malnutrition treatment programs. These programs do not offer maternal mental health support services, despite maternal mental health playing a significant role in the nutritional status of children. Additionally, the burden of maternal Common Mental Disorders (CMDs) is poorly described among mothers of children attending these programs.This study thus determined the burden and risk factors for maternal CMDs among children attending out-patient malnutrition clinics in rural North-western Nigeria.MethodsWe conducted a cross-sectional study among 204 mothers of children with severe acute malnutrition who attending eight out-patient malnutrition clinics in Jigawa, North-western Nigeria. We used the World Health Organization Self-Reporting Questionnaire-20 (WHO SRQ-20) screening tool, a recognised and validated proxy measure for CMDs to identify mothers with CMDs. The prevalence of maternal CMDs was determined by identifying the proportion of mothers with SRQ scores of ≥8. Risk factors for CMD were determined using multivariable logistic regression.ResultsMaternal CMD prevalence in children attending these facilities was high at 40.7%. Non-receipt of oral polio vaccine (OPV) (AOR 6.23, 95%CI 1.85 to 20.92) increased the odds for CMD. While spousal age above 40 (AOR 0.95, 95%CI 0.90 to 0.99) and long years spent married (AOR 0.92, 95%CI 0.85 to 0.98) decreased the odds for CMD.ConclusionsOur findings indicate maternal CMD burden is high in out-patient malnutrition clinics in North-western Nigeria. Maternal mental health services would need to be integrated into the community management of acute malnutrition programs to provide more holistic care, and possibly improve long-term outcomes after discharge from these programs.

Maternal mental health and its determinants - A community-based cross-sectional study in Aligarh, Uttar Pradesh.

Maternal mental health problems are one of the major public health challenges. Globally, depression and anxiety cause immense suffering and disability among mothers who later contribute to compromise parenting practices and increased unmet needs of their newborn and young children. The aim of this study is to determine the prevalence and determinants of maternal common mental disorders (CMDs) among the study population. A community-based cross-sectional study was conducted in Aligarh, Uttar Pradesh, India, from July 2016 to June 2017, among 415 women of child-bearing age who had one or more children in the age group of 0-23 months. A World Health Organization prequalified questionnaire Self-Reporting Questionnaire 20 was used to assess the CMD of mothers. Binary logistic regression was used for finding out predictors of mental disorders. Overall prevalence of maternal CMDs was 38.8%. The prevalence of maternal CMD was significantly higher among mothers in a higher age group, belonging to low socioeconomic class, nuclear type of family, living in the urban locality, having lower or no education, being single mothers, housewives, and having higher parity. Substantially, high prevalence of CMD among mothers suggests for further research to explore the factors affecting the mental health of mothers. Measures for the early identification, treatment, and prevention of maternal mental disorders should be taken.

Association of Maternal Common Mental Disorder and Young Children Acute Malnutrition among Mekelle Public Health Facilities, Northern Ethiopia, 2019 - a Case-control Study

Background: The World Health Organization has claimed that morbidity and disability of the global population due to child malnutrition has internationally become the chief cause of disability. However, in our country, its association with a young child’s nutritional outcomes is rarely studied. Objectives: To assess the effect of maternal common mental disorder and substance abuse on young child acute malnutrition. Methods: An institution's based case-control study was conducted among 192 women; 64 cases and 128 control in Mekelle public health facilities. Two hospitals and three health centers were included in this study. Self-Reporting Questionnaire 20-Item (SRQ-20) was used to assess the presence of maternal common mental disorder. Bivariate and multivariable logistic regression analysis was performed. The strength of association was measured through odds ratio at their 95% CI. The statistical significance was set at p&lt;0.05. Results: The result of this study revealed that young children who have a mother with a common mental disorder are 6.1 times [AOR= 6.11, 95%CI (1.18, 31.71)] more likely to develop acute malnutrition than children who have mothers with no common mental disorder. Mothers of acutely malnourished children should be evaluated early for the detection of maternal common mental disorder for appropriate referral and support. Conclusion: Maternal common mental disorder was an independent determinant of young children’s acute malnutrition. Mothers of acutely malnourished children should be evaluated early for the detection of maternal common mental disorder for appropriate referral and support.

Intimate partner violence is associated with poorer maternal mental health and breastfeeding practices in Bangladesh.

Exposure to intimate partner violence (IPV) can have profound adverse consequences on maternal and child health. This study aimed to: (1) identify factors associated with IPV during pregnancy and postpartum in Bangladesh; and (2) assess the associations between IPV and maternal mental health and breastfeeding practices. We used data from a cross-sectional survey of 2000 mothers with children <6 months in four districts in Bangladesh. We applied multivariable logistic regression models to examine factors associated with IPV and structural equation modelling to assess the inter-relationships between IPV, maternal common mental disorders (CMD, measured by Self-reporting Questionnaire ≥7) and breastfeeding practices. Overall, 49.7% of mothers experienced violence during the last 12 months and 28% of mothers had high levels of CMD. Only 54% of women reported early initiation of breastfeeding and 64% reported exclusive breastfeeding. Women were more likely to experience IPV if living in food-insecure households, being of low socio-economic status, having low autonomy or experiencing inequality in education compared with husbands (OR ranged from 1.6 to 2.8). Women exposed to IPV were 2–2.3 times more likely to suffer from high levels of CMD and 28–34% less likely to breastfeed their babies exclusively. The indirect path (the indirect effects of IPV on breastfeeding through CMD) through maternal CMD accounted for 14% of the relationship between IPV on breastfeeding practice. In conclusion, IPV is pervasive in Bangladesh and is linked to increased risks of CMD and poor breastfeeding practices. Integrating effective interventions to mitigate IPV, along with routine maternal and child health services and involving men in counselling services, could help both to reduce exposure to IPV among women and to contribute to better health outcomes for women and children.

Parental mental health before and during pregnancy and offspring birth outcomes: A 20-year preconception cohort of maternal and paternal exposure.

BackgroundPreterm birth (PTB) and small for gestational age (SGA) are increasingly prevalent, with major consequences for health and development into later life. There is emerging evidence that some risk processes begin before pregnancy. We report on associations between maternal and paternal common mental disorders (CMD) before and during pregnancy and offspring PTB and SGA.Methods398 women with 609 infants and 267 men with 421 infants were assessed repeatedly for CMD symptoms before pregnancy between age 14 and 29 and during pregnancy. Associations between preconception and antenatal CMD symptoms and offspring gestational age/PTB and size for gestational age/SGA were estimated using linear and Poisson regression.FindingsIn men, persistent preconception CMD across adolescence and young adulthood predicted offspring PTB after adjustment for ethnicity, education, BMI and adolescent substance use (adjusted RR 7·0, 95% CI 1·8,26·8), corresponding to a population attributable fraction of 31% of preterm births. In women, antenatal CMD symptoms predicted offspring PTB (adjusted RR 4·4, 95% CI 1·4,14·1). There was little evidence of associations with SGA.InterpretationThis first report of an association between paternal preconception mental health and offspring gestational age, while requiring replication in larger samples, complements earlier work on stress in animals, and further strengthens the case for expanding preconception mental health care to both men and women.FundingNational Health and Medical Research Council (Australia), Victorian Health Promotion Foundation, Australian Rotary Health, Colonial Foundation, Perpetual Trustees, Financial Markets Foundation for Children (Australia), Royal Children's Hospital Foundation, Murdoch Children's Research Institute, Australian Research Council.

Maternal Common Mental Disorders symptoms influence associated with early childhood dental caries: A cross-sectional study in a southern Brazilian city.

Maternal mental problems can interfere with the overall health and care of the child; some oral health studies have been trying to elucidate whether there is a relationship between maternal common mental disorders (CMD) and children's oral health status. The aim was to investigate the influence of mothers that present CMD symptoms on their child's dental caries status. This cross-sectional study was carried out in Pelotas with 530 mother/child (aged 2-5years old) dyads recruited from an epidemiological survey in August 2015 during the national vaccination campaign. A questionnaire was used to determine mother's CMD symptoms using the Self-Reporting Questionnaire (SRQ-20) and socioeconomic/demographic variables which were used for adjustment. Dental caries examination was performed. The outcome was obtained using the dmfs (decayed, missing, filled surfaces) index, based on OMS guidelines. Poisson regression with robust variance was used to estimate the risk ratio and 95% confidence interval (CI). Maternal CMD was positively associated with dental caries prevalence in children; the adjusted relative risk for every 1 SRQ-20 score increase was 1.06 (95% CI 1.00-1.12). Our findings suggest that maternal mental health can impair children's oral health in relation to dental caries.