Nondepressed Mothers Research Articles

Face Preferences for Infant- and Adult-Directed Speakers in Infants of Depressed and Nondepressed Mothers: Association with Infant Cognitive Development.

Face preferences for speakers of infant-directed and adult-directed speech (IDS and ADS) were investigated in 4- to 13.5-month-old infants of depressed and non-depressed mothers. Following 1-min of exposure to an ID or AD speaker (order counterbalanced), infants had an immediate paired-comparison test with a still, silent image of the familiarized versus a novel face. In the test phase, ID face preference ratios were significantly lower in infants of depressed than non-depressed mothers. Infants' ID face preference ratios, but not AD face preference ratios, correlated with their percentile scores on the cognitive (Cog) scale of the Bayley Scales of Infant & Toddler Development (3rd Edition; BSID III), assessed concurrently. Regression analyses revealed that infant ID face preferences significantly predicted infant Cog percentiles even after demographic risk factors and maternal depression had been controlled. Infants may use IDS to select social partners who are likely to support and facilitate cognitive development.

Postpartum depression in high-risk Brazilian women: psychosocial predictors and effects on maternal vocalization

ABSTRACTPsychosocial risk conditions can predict postpartum depression (PPD) which can reduce maternal investment into child. We examined, in high-risk Brazilian mothers, PPD predictors measured during pregnancy, and PPD effects on maternal behaviors measured at 4-5 months. 35 depressed (D) and 38 nondepressed (ND) mothers had four behaviors (gaze, smile, vocalization and touch) and three interaction styles (intrusive, withdrawn and good interaction) coded. At 4 months, 48% of mothers presented PPD. Lower levels of education, shorter pregnancy, higher marital conflict and greater prior history of depression were found as PPD predictors. D and ND mothers equally gazed, smiled and touched, while only D mothers vocalized less to their children. Thus, lower levels of education, shorter pregnancy, higher marital conflict and greater prior history of depression catalyzed PPD emergence. PPD reduced maternal investment through lower vocalization during early mother-infant interaction. Finally, both D and ND mothers mostly behaved as good interaction partners.

Maternal depressive symptoms and child nutritional status: A cross-sectional study in socially disadvantaged Pakistani community.

Malnutrition is a primary cause of child morbidity and mortality. The effects of maternal depressive symptoms on children's health, especially their nutritional status, have received less attention in developing countries but needs to be evaluated to understand the public health implications of maternal depression. The aim of the current study was to investigate the association between maternal depressive symptoms and children's nutritional status using data from low socioeconomic community in Pakistan. Maternal depressive symptoms defined as Aga Khan University Anxiety and Depression Scale score of 20 or greater was assessed for mothers with children under two years of age. Logistic regression models estimated the association between maternal depressive symptoms and stunting and underweight. Of 325 mothers, 40% scored positive on the depressive scale. The prevalence of stunting and underweight in children under two years was 36.6% and 35.4%, respectively. Maternal depressive symptoms were significantly associated with children being stunted and underweight. Mothers with depressive symptoms were more than three times likely to have stunted (odds ratio (OR) 3.15, 95% confidence interval (CI) 1.91-5.18, p value < .001) and underweight (OR 3.26, 95% CI 1.99-5.34, p value < .001) children compared to non-depressed mothers. Maternal-related factors such as poor education, unemployment, and low household income were found to be significantly associated with higher odds of children's short stature and underweight.

Children's Knowledge about Parental Exposure to Trauma.

The study aims to determine children's knowledge about their parents' exposure to traumatic events and factors associated with such knowledge. Children (ages 9-16) and their parents with a range of exposures to trauma, including the 9/11 attack, answered questions about parental exposure to life threatening events. A child's accurate knowledge about parental exposure was defined as an agreement between parent and child on lifetime presence or absence of traumatic events. The present study findings suggest that children were often unaware about their parents' exposures to life threatening events. Knowledge about fathers' exposure was more accurate when the child was older, fathers had direct exposure to 9/11, or had been a first responder. Children of mothers with depression were less likely to have accurate knowledge about their mothers' exposure compared to children of non-depressed mothers. Overall, findings indicated that children are generally unaware of parental (particularly maternal) exposure to traumatic events. The next step is to determine how knowledge about parental trauma exposure impacts children.

Pup-Associated Conditioned Place Preference Reaction and Maternal Care in Depressive WAG/Rij Rats

The acquisition of a conditioned place preference reaction (CPPR) associated with own pups and foster pups was compared in female WAG/Rij and Wistar rats, along with maternal behavior in a “place preference” chamber from day 2 to day 8 after birth. In addition, females’ behavior was assessed in the open field, elevated plus maze, and forced swimming tests before pregnancy and after birth of pups. Female WAG/Rij rats acquired the CPPR associated with their own pups (WAG/Rij) and foster pups (Wistar) less well. Thus, the number of females with increases in the time spent in the initial non-preferred sector after it was combined with pups and the number of females achieving the CPPR acquisition criterion were smaller in WAG/Rij rats than Wistar rats. Female WAG/Rij rats, as compared with female Wistar rats, showed lower levels of maternal care in the place preference chamber in relation to both their own pups and foster pups: the numbers of approaches to the pups were smaller, as were the numbers of retrievals, and the non-feeding-related times spent in contact with pups were shorter. The durations of immobility in the forced swimming test were greater in WAG/Rij females than Wistar females both before pregnancy and after delivery of pups, which is evidence for a stable depression-like state. Before pregnancy, there were no statistically significant interstrain differences in anxiety levels. After birth of pups, anxiety levels in WAG/Rij females decreased, while those in Wistar females showed no significant change. These results provide evidence that the worse acquisition of the CPPR and the decreased maternal care in depressed WAG/Rij females were not associated with the features of their own pups but were related to their depressive state. In other words, pups provided weaker reinforcement for depressed mothers than for “normal” (nondepressed) mothers.

Like mother like daughter: putamen activation as a mechanism underlying intergenerational risk for depression.

Having a depressed mother is one of the strongest predictors for developing depression in adolescence. Given the role of aberrant reward processing in the onset and maintenance of depression, we examined the association between mothers’ and their daughters’ neural response to the anticipation of reward and loss. Fifteen non-depressed mothers with a history of recurrent depression and their never-disordered daughters, and 23 mothers without past or current depression and their never-disordered daughters, underwent functional magnetic resonance imaging while performing the monetary incentive delay task. To assess mother-daughter concordance, we first identified ROIs involved in the anticipation of reward and loss across all mother-daughter pairs. Within each of these ROIs, we examined the association between mothers’ and daughters’ neural response, and the interaction between group status and mothers’ neural response in predicting daughters’ neural response. We found a significant association between mothers’ and daughters’ putamen response to the anticipation of loss, regardless of mother’s depression history. Furthermore, pubertal stage moderated the association between mother-daughter putamen concordance. Our findings suggest a unique role of the putamen in the maternal transmission of reward learning and have important implications for understanding disorders characterized by disturbances in reward learning and processing, such as major depression.

HOUSEHOLD CHAOS, MATERNAL DEPRESSION AND PRENATAL SSRI EXPOSURE INTERACT TO AFFECT EXECUTIVE FUNCTION OF 6 YEAR OLD CHILDREN

BACKGROUND: Cognitive development and childhood behaviour is affected by maternal mood disorders during pregnancy. Concurrent maternal mood has been associated with disrupted home environments - both are independently associated with less effective executive functions in children. OBJECTIVES: We examined relationships between household chaos and self-regulation in children of depressed mothers and how prenatal selective serotonin reuptake inhibitor (SSRI) exposure may mediate this relationship. DESIGN/METHODS: Regression modeling examined the impact of maternal report of depressed mood symptoms (3rd trimester and 6 years) and a measure of household environmental confusion (Confusion, Hubbub, and Order Scale [CHAOS]) on child behavioral self-regulation (Behaviour Rating Inventory of Executive Function [BRIEF]) at age 6 years (N=118 [47 prenatally SSRI exposed, 71 non-exposed]. Confirmatory regression models were conducted to examine if children were susceptible to household CHAOS (differential susceptibility) or positively influenced by lower household CHAOS (vantage sensitivity). RESULTS: Prenatal SSRI exposure, 3rd trimester maternal depressed mood symptoms and home chaos predicted measures of self-regulation within a model of strong differential susceptibility. Analysis of this interaction revealed that when CHAOS scores were low (< 23.64), children of non-prenatally depressed mothers were better off than children of prenatally depressed mothers (regardless of prenatal SSRI treatment, or maternal mood at 6 years). However, when home chaos was high (> 23.64), these children (of non-depressed mothers and exposed to an SSRI namely children of mothers whose symptoms remitted) were worse off than children of prenatally depressed mothers (Figure 1). CONCLUSION: The degree of susceptibility to household CHAOS depended on whether mothers were prenatally depressed and whether mothers were treated with an SSRI. Children who had prenatally symptomatic mothers were not affected by home chaos. Children of not particularly symptomatic mothers were affected by home chaos - the degree to which they were affected depended on prenatal exposure to an SSRI. Children exposed to SSRIs prenatally were more susceptible to higher levels of home chaos, reflecting that they had better self-regulation in low levels of CHAOS and poorer self-regulation with high levels of CHAOS than the children not exposed to SSRIs prenatally, suggesting a “vantage sensitivity”. In this way prenatal depressed maternal mood may “buffer” a child against a subsequently chaotic home environment. Moreover, prenatal SSRI exposure appeared to increase a susceptibility to home CHAOS especially when the mothers were not particularly symptomatic during pregnancy.(Fig 4)

Affective facial expression in sub-clinically depressed and non-depressed mothers during contingent and non-contingent face-to-face interactions with their infants

BackgroundDepression in the postpartum period involves feelings of sadness, anxiety and irritability, and attenuated feelings of pleasure and comfort with the infant. Even mild- to- moderate symptoms of depression seem to have an impact on caregivers affective availability and contingent responsiveness. The aim of the present study was to investigate non-depressed and sub-clinically depressed mothers interest and affective expression during contingent and non-contingent face-to-face interaction with their infant. MethodsThe study utilized a double video (DV) set-up. The mother and the infant were presented with live real-time video sequences, which allowed for mutually responsive interaction between the mother and the infant (Live contingent sequences), or replay sequences where the interaction was set out of phase (Replay non-contingent sequences). The DV set-up consisted of five sequences: Live1-Replay1-Live2-Replay2-Live3. Based on their scores on the Edinburgh Postnatal Depression Scale (EPDS), the mothers were divided into a non-depressed and a sub-clinically depressed group (EPDS score≥6). ResultsA three-way split-plot ANOVA showed that the sub-clinically depressed mothers displayed the same amount of positive and negative facial affect independent of the quality of the interaction with the infants. The non-depressed mothers displayed more positive facial affect during the non-contingent than the contingent interaction sequences, while there was no such effect for negative facial affect. ConclusionsThe results indicate that sub-clinically level depressive symptoms influence the mothers’ affective facial expression during early face-to-face interaction with their infants. One of the clinical implications is to consider even sub-clinical depressive symptoms as a risk factor for mother-infant relationship disturbances.

Stress, coping, executive function, and brain activation in adolescent offspring of depressed and nondepressed mothers

ABSTRACTThis study examined the associations among chronic stress, activation in the prefrontal cortex (PFC), executive function, and coping with stress in at-risk and a comparison sample of adolescents. Adolescents (N = 16; age 12–15) of mothers with (n = 8) and without (n = 8) a history of depression completed questionnaires, neurocognitive testing, and functional neuroimaging in response to a working memory task (N-back). Children of depressed mothers demonstrated less activation in the anterior PFC (APFC) and both greater and less activation than controls in distinct areas within the dorsal anterior cingulate cortex (dACC) in response to the N-back task. Across both groups, activation of the dorsolateral PFC (DLPFC; Brodmann area [BA9]) and APFC (BA10) was positively correlated with greater exposure to stress and negatively correlated with secondary control coping. Similarly, activation of the dACC (BA32) was negatively correlated with secondary control coping. Regression analyses revealed that DLPFC, dACC, and APFC activation were significant predictors of adolescents’ reports of their use of secondary control coping and accounted for the effects of stress exposure on adolescents’ coping. This study provides evidence that chronic stress may impact coping through its effects on the brain regions responsible for executive functions foundational to adaptive coping skills.

Individual differences in non-clinical maternal depression impact infant affect and behavior during the still-face paradigm across the first year

Maternal depression can significantly impact mothers’ sensitivity to their infants’ needs as well as infants’ social and emotional development. The still-face paradigm (SFP) is widely used to assess infants’ understanding of the contingency between their own behavior and that of their caregivers, as well as infants’ ability to self-regulate arousal levels during sudden changes in maternal responsiveness. Infants of clinically depressed mothers display blunted levels of negative affect compared to infants of non-depressed mothers during the still-face (SF) phase. However, little is known about whether individual differences in elevated, non-clinical levels of maternal depression similarly affect mother-infant interactions. The current study examines the longitudinal effects of non-clinical maternal depression on infant and maternal behaviors during the SFP. Infants (N=63) were assessed at 5 and 9 months and maternal depression was assessed at 5 months using the Beck Depression Inventory (BDI). Infants of mothers with elevated levels of depression displayed less negative engagement during the SF phase compared to infants of mothers with lower levels of depression. This effect was present at 5 months, but not at 9 months. Findings demonstrate that non-clinical levels of maternal depressive symptomatology can have a significant impact on infants’ affective regulation during the first half of the first year of life, but this does not necessarily have a long-lasting influence later in infancy. Interventions may want to target mothers with non-clinical depression to promote healthy infant social and emotional development.

Response to Infant Cry in Clinically Depressed and Non-Depressed Mothers.

BackgroundBowlby and Ainsworth hypothesized that maternal responsiveness is displayed in the context of infant distress. Depressed mothers are less responsive to infant distress vocalizations (cry) than non-depressed mothers. The present study focuses on acoustical components of infant cry that give rise to responsive caregiving in clinically depressed (n = 30) compared with non-depressed mothers (n = 30) in the natural setting of the home.MethodsAnalyses of infant and mother behaviors followed three paths: (1) tests of group differences in acoustic characteristics of infant cry, (2) tests of group differences of mothers’ behaviors during their infant’s crying, and (3) tree-based modeling to ascertain which variable(s) best predict maternal behaviors during infant cry.Results(1) Infants of depressed mothers cried as frequently and for equal durations as infants of non-depressed mothers; however, infants of depressed mothers cried with a higher fundamental frequency (f0) and in a more restricted range of f0. (2) Depressed mothers fed, rocked, and touched their crying infants less than non-depressed mothers, and depressed mothers were less responsive to their infants overall. (3) Novel tree-based analyses confirmed that depressed mothers engaged in less caregiving during their infants’ cry and indicated that depressed mothers responded only to cries at higher f0s and shorter durations. Older non-depressed mothers were the most interactive with infants.ConclusionsClinical depression affects maternal responsiveness during infant cry, leading to patterns of action that appear poorly attuned to infant needs.

Postpartum depression and infant feeding practices in a low income urban settlement in Nairobi-Kenya.

BackgroundPostpartum depression can compromise caregiving activities, including infant feeding practices, resulting in child malnutrition. The purpose of this study was to examine the effects of postpartum depression on infant feeding practices and malnutrition among women in an urban low income settlement in Nairobi-Kenya. We conducted a cross-sectional study based in Kariobangi North Health Centre in Nairobi County. The study sample included 200 mother-infant pairs visiting the Maternal and Child Health clinics for infant immunization at 6–14 weeks postpartum. We assessed postpartum depression using the Edinburgh Postpartum Depression Scale. Infant feeding practices were assessed based on World Health Organization infant and young child feeding guidelines. Nutritional status (weight for age) was ascertained using infants’ growth monitoring card (percentiles and z-score). We conducted logistic regression analyses to determine the relative odds of non-exclusive breast feeding and infant underweight among mothers with postpartum depression.ResultsThe prevalence of PPD was 13.0% (95% CI 8.3–17.7%). Taking into account differences in socioeconomic status of depressed and non-depressed mothers, non-depressed mothers had a 6.14 (95% CI 2.45–13.36) times higher odds of practicing exclusive breastfeeding than mothers who were depressed. Mothers with PPD had a 4.40 (95% CI 1.91–11.93) time higher odds of having an underweight infant than mothers without depression.ConclusionsThis study contributes towards filling the knowledge gap regarding the adverse effects of postpartum depression on infant health in sub-Saharan Africa. We recommend more research on PPD using longitudinal designs to establish temporal ordering of these important public health problems and development of community-based interventions to address post-partum depression.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2307-9) contains supplementary material, which is available to authorized users.

Genome-wide DNA methylation in 1-year-old infants of mothers with major depressive disorder.

A genome-wide methylation study was conducted among a sample of 114 infants (M age = 13.2 months, SD = 1.08) of low-income urban women with (n = 73) and without (n = 41) major depressive disorder. The Illumina HumanMethylation450 BeadChip array with a GenomeStudio Methylation Module and Illumina Custom model were used to conduct differential methylation analyses. Using the 5.0 × 10-7 p value, 2,119 loci were found to be significantly different between infants of depressed and nondepressed mothers. Infants of depressed mothers had greater methylation at low methylation sites (0%-29%) compared to infants of nondepressed mothers. At high levels of methylation (70%-100%), the infants of depressed mothers were predominantly hypomethylated. The mean difference in methylation between the infants of depressed and infants of nondepressed mothers was 5.23%. Disease by biomarker analyses were also conducted using GeneGo MetaCore Software. The results indicated significant cancer-related differences in biomarker networks such as prostatic neoplasms, ovarian and breast neoplasms, and colonic neoplasms. The results of a process networks analysis indicated significant differences in process networks associated with neuronal development and central nervous system functioning, as well as cardiac development between infants of depressed and nondepressed mothers. These findings indicate that early in development, infants of mothers with major depressive disorder evince epigenetic differences relative to infants of well mothers that suggest risk for later adverse health outcomes.

Association between maternal depression and child stunting in Northern Ghana: a cross-sectional study.

BackgroundStunting indicates failure to attain genetic potential for height and is a well-documented indicator for poor growth. Depression is common in women of reproductive age and women’s mental health problems may affect the growth of young children. We examined the association between maternal depression and stunting in mother-child pairs attending Child Welfare Clinic (CWC) in Northern Ghana.MethodsAn analytical cross-sectional study was performed involving mothers (15–45 years) and their children (0–59 months) who attended CWC at Bilpeila Health Centre, Tamale, Ghana. Socio-demographic data were collected using a semi-structured questionnaire, maternal depression was measured using Centre for Epidemiological Studies Depression Screening Scale, and anthropometry was conducted on children following standard procedures. The association between maternal depression and child stunting was examined in logistic regression adjusting for potential confounders.ResultsPrevalence rates of child stunting and maternal depression were estimated at 16.1 and 27.8 % respectively in Northern Ghana. Mothers with depression when compared with those without depression tended to be younger, be currently unmarried, belong to the poorest household wealth tertile, and were more likely to have low birth weight babies, so these characteristics were adjusted for. In an adjusted multivariate logistic regression model, children of depressed mothers were almost three times more likely to be stunted compared to children of non-depressed mothers (Adjusted OR = 2.48, 95 % CI 1.29–4.77, p = 0.0011).ConclusionsThere is a high prevalence of depression among mothers in Northern Ghana which is associated with child stunting. Further studies are needed to identify the determinants of maternal depression and to examine its association with child stunting to inform nutrition programming.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3558-z) contains supplementary material, which is available to authorized users.

Empathic Responses to Mother's Emotions Predict Internalizing Problems in Children of Depressed Mothers.

Recent theories posit that empathy, typically an adaptive characteristic, may be associated with internalizing problems when children are chronically exposed to mother's depression. We tested this postulation in a sample of children (N=82, M age=5years). Children witnessed their mothers express sadness, anger, and happiness during a simulated phone conversation, and researchers rated children's negative affective empathy, positive affective empathy, and information-seeking (cognitive empathy) in response to their mother's emotions. The chronicity of mother's depression during the child's lifetime moderated associations between children's empathy and internalizing problems. As predicted, all three empathy measures were related to greater mother-rated internalizing problems in children of chronically (i.e., 2-3years) depressed mothers. Greater positive empathy was related to lower internalizing problems in children of nondepressed mothers. Positive empathy may contribute to adaptive processes when mothers are not depressed, and positive, negative, and cognitive empathy may contribute to maladaptive processes when mothers are chronically depressed.

Developmental changes in electroencephalographic frontal asymmetry in young children at risk for depression.

A number of studies have reported that depression is associated with lower relative left frontal activity in the alpha band (i.e. frontal asymmetry, or FA), as measured by electroencephalogram. FA has also been hypothesized to be a vulnerability marker for depression. If this is the case, FA should be evident in offspring of depressed mothers, a group at elevated risk for depression. However, the results of previous offspring studies have been inconsistent and none of these studies has considered whether the relationship between FA and risk changes over development in children. We assessed FA twice, at ages 3 and 6, in 253 never depressed children from a community sample. Maternal history of depressive disorders was determined by a diagnostic interview completed by the mothers at the first assessment. There was a significant interaction between maternal depression and offspring age at assessment, indicating that FA exhibits different developmental trajectories depending on level of familial risk for depression. Offspring of depressed mothers exhibited a decreasing relative left FA over the course of early childhood, while offspring of nondepressed mothers exhibited relatively similar, symmetrical, levels of frontal alpha activity at both assessment points. These results suggest that changes in FA from early to middle childhood distinguish those at risk for depression and that cross-sectional assessment of FA may have limited value in understanding risk. These results highlight the importance of considering development in understanding the role of FA in depression.

"The sun has set even though it is morning": Experiences and explanations of perinatal depression in an urban township, Cape Town.

This study examined experiences and explanations of depression amongst Xhosa-speaking pregnant women, mothers, and health workers in an urban township in Cape Town, South Africa. The study was conducted as part of formative research for a randomised controlled trial to develop and evaluate a task-sharing counselling intervention for maternal depression in this setting. We conducted qualitative semi-structured interviews with 12 depressed and 9 nondepressed pregnant women and mothers of young babies, and 13 health care providers. We employed an in-depth framework analysis approach to explore the idioms, descriptions, and perceived causes of depression particular to these women, and compared these with the ICD-10 and DSM-5 criteria for major depression. We found that symptoms of major depression are similar in this township to those described in international criteria (withdrawal, sadness, and poor concentration), but that local descriptions of these symptoms vary. In addition, all the symptoms described by participants were directly related to stressors occurring in the women's lives. These stressors included poverty, unemployment, lack of support from partners, abuse, and death of loved ones, and were exacerbated by unwanted or unplanned pregnancies and the discovery of HIV positive status at antenatal appointments. The study calls attention to the need for specifically designed counselling interventions for perinatal depression that are responsive to the lived experiences of these women and grounded in the broader context of poor socioeconomic conditions and living environments in South Africa, all of which have a direct impact on mental health.

Maternal perinatal mental health and offspring academic achievement at age 16: the mediating role of childhood executive function.

BackgroundElucidating risk pathways for under‐achieving at school can inform strategies to reduce the number of adolescents leaving school without passing grades in core subjects. Maternal depression can compromise the quality of parental care and is associated with multiple negative child outcomes. However, only a few small studies have investigated the association between perinatal maternal depression and poor academic achievement in adolescence. The pathways to explain the risks are also unclear.MethodProspective observational data from 5,801 parents and adolescents taking part in a large UK population cohort (Avon‐Longitudinal‐Study‐of‐Parents‐and‐Children) were used to test associations between maternal and paternal depression and anxiety in the perinatal period, executive function (EF) at age 8, and academic achievement at the end of compulsory school at age 16.ResultsAdolescents of postnatally depressed mothers were 1.5 times (1.19, 1.94, p = .001) as likely as adolescents of nondepressed mothers to fail to achieve a ‘pass’ grade in math; antenatal anxiety was also an independent predictor of poor math. Disruption in different components of EF explained small but significant proportions of these associations: attentional control explained 16% (4%, 27%, p < .001) of the association with postnatal depression, and working memory explained 17% (13%, 30%, p = .003) of the association with antenatal anxiety. A similar pattern was seen for language grades, but associations were confounded by maternal education. There was no evidence that paternal factors were independently associated with impaired child EF or adolescent exams.ConclusionMaternal postnatal depression and antenatal anxiety are risk factors for adolescents underachieving in math. Preventing, identifying, and treating maternal mental health in the perinatal period could, therefore, potentially increase adolescents’ academic achievement. Different aspects of EF partially mediated these associations. Further work is needed, but if these pathways are causal, improving EF could reduce underachievement in math.

Community health workers can improve child growth of antenatally-depressed, South African mothers: a cluster randomized controlled trial.

BackgroundMaternal antenatal depression has long-term consequences for children’s health. We examined if home visits by community health workers (CHW) can improve growth outcomes for children of mothers who are antenatally depressed.MethodsA cluster randomized controlled trial of all pregnant, neighbourhood women in Cape Town, South Africa. Almost all pregnant women (98 %, N = 1238) were recruited and assessed during pregnancy, two weeks post-birth (92 %) and 6 months post-birth (88 %). Pregnant women were randomized to either: 1) Standard Care (SC), which provided routine antenatal care; or 2) an intervention, The Philani Intervention Program (PIP), which included SC and home visits by CHW trained as generalists (M = 11 visits). Child standardized weight, length, and weight by length over 6 months based on maternal antenatal depression and intervention condition.ResultsDepressed mood was similar across the PIP and SC conditions both antenatally (16.5 % rate) and at 6 months (16.7 %). The infants of depressed pregnant women in the PIP group were similar in height (height-for-age Z scores) to the children of non-depressed mothers in both the PIP and the SC conditions, but significantly taller at 6 months of age than the infants of pregnant depressed mothers in the SC condition. The intervention did not moderate children’s growth. Depressed SC mothers tended to have infants less than two standard deviations in height on the World Health Organization’s norms at two weeks post-birth compared to infants of depressed PIP mothers and non-depressed mothers in both conditions.ConclusionsA generalist, CHW-delivered home visiting program improved infant growth, even when mothers’ depression was not reduced. Focusing on maternal caretaking of infants, even when mothers are depressed, is critical in future interventions.Trial registrationClinicalTrials.gov registration # NCT00996528. October 15, 2009

Maternal depression and the learning-promoting effects of infant-directed speech: Roles of maternal sensitivity, depression diagnosis, and speech acoustic cues

The hypothesis that the associative learning-promoting effects of infant-directed speech (IDS) depend on infants’ social experience was tested in a conditioned-attention paradigm with a cumulative sample of 4- to 14-month-old infants. Following six forward pairings of a brief IDS segment and a photographic slide of a smiling female face, infants of clinically depressed mothers exhibited evidence of having acquired significantly weaker voice–face associations than infants of non-depressed mothers. Regression analyses revealed that maternal depression was significantly related to infant learning even after demographic correlates of depression, antidepressant medication use, and extent of pitch modulation in maternal IDS had been taken into account. However, after maternal depression had been accounted for, maternal emotional availability, coded by blind raters from separate play interactions, accounted for significant further increments in the proportion of variance accounted for in infant learning scores. Both maternal depression and maternal insensitivity negatively, and additively, predicted poor learning.