Outcomes For Children Of Mothers Research Articles

Maternal depression and offspring mental health at age 5: MINA-Brazil cohort study.

To identify longitudinal patterns of maternal depression between three months and five years after child's birth, to examine predictor variables for these trajectories, and to evaluate whether distinct depression trajectories predict offspring mental health problems at age 5 years. We used data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3 and 6-8 months, and 1 and 2 years after delivery. Mental health problems in 5-year-old children were evaluated with the Strengths and Difficulties Questionnaire (SDQ) reported by parents. Trajectories of maternal depression were calculated using a group-based modelling approach. We identified four trajectories of maternal depressive symptoms: "low" (67.1%), "increasing" (11.5%), "decreasing" (17.4%), and "high-chronic" (4.0%). Women in the "high/chronic" trajectory were the poorest, least educated, and oldest compared with women in the other trajectory groups. Also, they were more frequently multiparous and reported smoking and having attended fewer prenatal consultations during pregnancy. In the adjusted analyses, the odds ratio of any SDQ disorder was 3.23 (95%CI: 2.00-5.22) and 2.87 (95%CI: 1.09-7.57) times higher among children of mothers belonging to the "increasing" and "high-chronic" trajectory groups, respectively, compared with those of mothers in the "low" depressive symptoms group. These differences were not explained by maternal and child characteristics included in multivariate analyses. We identified poorer mental health outcomes for children of mothers assigned to the "chronic/severe" and "increasing" depressive symptoms trajectories. Prevention and treatment initiatives to avoid the adverse short, medium, and long-term effects of maternal depression on offspring development should focus on women belonging to these groups.

Is breastfeeding duration related to the health of migrant mother-child dyads experiencing homelessness? The ENFAMS cross-sectional survey.

Literature from the general population shows a consensus about the health benefits associated with breastfeeding for both mothers and children. However, studies investigating these issues in the context of homelessness and migration are rare. This research aimed to examine the relations of any breastfeeding duration with health outcomes among migrant mother-child dyads experiencing homelessness. Data were collected among sheltered and mainly foreign-born mothers experiencing homelessness, and their children aged 6 months to 5 years, from the ENFAMS cross-sectional survey (n = 481, 2013-Great Paris area). Any breastfeeding duration, along with various health outcomes of both the mother and her child, was ascertained by face-to-face questionnaires administered by trained interviewers to mothers (perceived physical and emotional health and maternal depression) or by trained psychologists to children (adaptive behaviours). Nurses measured weight and height [thus allowing them to calculate body mass index (BMI)] and haemoglobin concentration (mother-child dyad) and maternal blood pressure. Multivariable linear and modified Poisson regression analyses were performed to examine outcome-wide associations between any breastfeeding duration ≥6 months and the various mother-child outcomes. Any breastfeeding ≥6 months was associated with lower systolic blood pressure in mothers (B = -0.40, 95% confidence interval = -0.68 to -0.12). No association was observed with the other outcomes. The relevance of supporting breastfeeding to improve mothers' physical health holds true in the context of migration and homelessness. It is therefore important to support breastfeeding in these settings. Moreover, given the documented social complexity of breastfeeding practices, interventions should take mothers' socio-cultural heritage and the structural barriers they face into account.

Neurodevelopmental Outcomes in Children of Mothers with Epilepsy Taking Antiepileptic Drugs

Previous research on teratogenicity of antiepileptic drugs (AEDs) has been limited in the drugs and doses studied. For example, in the

The effects of maternal eating disorders on child development

The evidence on the effects of maternal eating disorders (ED) on child development is growing and has provided insights on a series of psychopathology, eating and behavioral outcomes (Micali et al., 2014a; 2014b, Easter et al., 2013, 2014). I will firstly present data form my lab highlighting the effects of maternal eating disorders on child psychopathology and development in population-based samples (Micali et al., 2013; Micali et al., 2014). Secondly, I will focus on our work on children of mothers with ED in pregnancy and prior to pregnancy both in clinical samples and in population-based samples. Few studies have focused on the cognitive development of children born to women with ED (active and past). Our group was the first to study cognitive development in infancy and childhood in children born to women with ED as part of a large population-based study of ∼12,000 women (Kothari et al., 2013; 2014, 2015), and a longitudinal clinical sample (Barona et al., 2016). I will then touch upon weight outcomes in children of mothers with active ED behaviors in pregnancy. Altogether these studies highlight an important impact of maternal ED (both active and past) on cognitive and emotional development and weight outcomes. These findings might point to biomarkers of ED or specific effects of pregnancy ED. A summary and conclusion will summarize existing evidence, draw parallels with the literature available in other psychiatric disorders and highlight future research avenues.

The role of maternal anorexia nervosa and bulimia nervosa before and during pregnancy in early childhood wheezing: Findings from the NINFEA birth cohort study.

This study evaluates associations of maternal eating disorders (bulimia nervosa, anorexia nervosa, and purging behaviors) with infant wheezing and examines the effects of eating disorders on several wheezing determinants. We studied 5,150 singletons from the NINFEA birth cohort. Maternal bulimia nervosa and anorexia nervosa diagnoses were ascertained from the questionnaires completed in pregnancy and 6 months after delivery, and were analyzed as: ever diagnosis, only before pregnancy, and during pregnancy. Purging behaviors were assessed for 12 months before or during pregnancy. The associations with wheezing between 6 and 18 months of age were assessed in models adjusted for a priori selected confounders. Children born to mothers with lifetime eating disorders were at an increased risk of developing wheezing (adjusted OR 1.68; [95% CI: 1.08, 2.60]), and this risk further increased when the disorders were active during pregnancy (2.52 [1.23, 5.19]). Increased risk of offspring wheezing was observed also for purging behaviors without history of eating disorder diagnosis (1.50 [1.10, 2.04]). The observed associations were not explained by comorbid depression and/or anxiety. Bulimia nervosa and/or anorexia nervosa during pregnancy were also associated with several risk factors for wheezing, including maternal smoking, adverse pregnancy outcomes, shorter breastfeeding duration, and day-care attendance. The associations of maternal eating disorders with offspring wheezing suggest long-term adverse respiratory outcomes in children of mothers with eating disorders. A better understanding of mechanisms implicated is necessary to help reduce the respiratory disease burden in these children.

Stunting-Related Knowledge: Exploring Sources of and Factors Associated with Accessing Stunting-Related Knowledge among Mothers in Rural Indonesia

Background: Stunting in young children continues to be a major concern in developing country settings, including middle income countries like Indonesia. Early intervention is critical to prevent increased morbidity and mortality, lower cognitive functioning, and diminished productivity in adulthood. Mothers may benefit from knowledge and information related to stunting causes and effects. Indonesia has readily adopted a variety of platforms, which are now being used to disseminate health information. The purpose of this study was to address two related research questions: 1) What are the primary sources of Indonesian mothers’ stunting-related knowledge? 2) What factors are associated with using these various platforms to access stunting-related information? Method: Mothers (n = 745) responded to questions about demographics and the source of stunting knowledge, which included hospitals, the Internet, midwives, posyandu (community health posts), and puskesmas (public health centers). Multivariate logistic regression was used to identify factors associated with mothers’ reported use of the three most common sources to acquire information about stunting, including posyandu, puskesmas and the Internet. Results: Eighty percent of mothers in this study sample used posyandu, 31.7% puskesmas, and 16.9% used the Internet as a source for stunting-related knowledge. For the three most common sources, factors associated with each included not accessing the other sources. Conclusions: Indonesian mothers are using a variety of platforms and services to acquire information about stunting. These sources are different one from another and each may be an important resource for disseminating health information, especially outside of urban centers. Results from this study may help to identify characteristics of Indonesian mothers who could benefit from acquiring stunting-related information in these formats. Each of these sources of information appears to be utilized by different groups of mothers. This is an important finding as it suggests that each may continue to be a resource for mothers that might not otherwise access stunting information. The Indonesian health system in rural settings has a history of support for posyandu and puskesmas. Moving forward, the Internet may also be used to improve outcomes for children of mothers that do not access information through these more traditional means.

Heterogeneity in perinatal depression: how far have we come? A systematic review.

Despite perinatal depression (PND) being a common mental disorder affecting pregnant women and new mothers, limited attention has been paid to the heterogeneous nature of this disorder. We examined heterogeneity in PND symptom profiles and symptom trajectories. Literature searches revealed 247 studies, 23 of which were included in the final review. The most common statistical approaches used to explore symptom and trajectory heterogeneity were latent class model and growth mixture model. All but one study examined PND symptom trajectories and provided collective evidence of at least three heterogeneous patterns: low, medium, or chronic-high symptom levels. Social and psychological risk factors were the most common group of predictors related to a higher burden (high sum of score) of depressive symptoms. These studies were consistent in reporting poorer health outcomes for children of mothers assigned to high burden symptom trajectories. Only one study explored heterogeneity in symptom profile and was the only one to describe the specific constellations of depressive symptoms related to the PND heterogeneous patterns identified. Therefore, there is limited evidence on the specific symptoms and symptom configurations that make up PND heterogeneity. We suggest directions for future research to further clarify the PND heterogeneity and its related mechanisms.

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

The Relation Between Maternal Symptoms of Attention-Deficit/Hyperactivity Disorder and Mother–Infant Interaction

The relationship between maternal symptoms of attention-deficit/hyperactivity disorder (ADHD) and specific maternal behaviors was examined in a community sample of 40 mothers of infants aged 3–8 months. It was hypothesized that maternal ADHD symptoms would be related to lower levels of maternal sensitivity, and higher levels of maternal intrusiveness and negative regard. Mothers and their infants were observed and video-recorded in their homes while interacting in a feeding, play, and task situation. A series of hierarchical regressions partially supported the hypothesized relations: Of the specific maternal ADHD symptoms, maternal inattentive symptoms significantly predicted maternal insensitivity, intrusiveness, and negative regard above and beyond maternal symptoms of anxiety and maternal ratings of infant activity. These findings suggest that mothers reporting ADHD symptoms, particularly the inattentive cluster of symptoms, may experience difficulties in interactions with their infants. Early interventions that address these difficulties may be warranted to facilitate development and reduce the likelihood of adverse outcomes in children of mothers with symptoms of ADHD.

Neuropsychological outcomes in children of mothers with epilepsy

The study investigated the nature of the effects of maternal epilepsy on cognitive performance of the offspring. One hundred fifty-four children of mothers with epilepsy aged 5 to 11 years (study group), along with 130 control children, comparable with respect to IQ, socio-economic status, age, and gender underwent a neuropsychological assessment using subtests from the NEPSY: A Developmental Neuropsychological Assessment, tapping attentional, auditory-verbal, visuomotor, fine motor, and memory abilities. The study group scored significantly lower than the controls on measures of attention, memory, and fine-motor function. Deficits were more marked in but not limited to the subset of the study group exposed to maternal medication in utero. Group differences on auditory attention were found only in younger children. Valproate-exposed children obtained lower scores on sentence repetition, as well as on the more demanding part of a test of auditory attention, than other children in the study group, suggesting weaknesses in working memory in the former subgroup. Confounding by maternal epilepsy type and polytherapy complicate interpretation of this finding. Differences between subsets of children not exposed to anti-epileptic drugs in utero and controls suggest that both drug exposure and genetic factors may contribute to cognitive deficits associated with maternal epilepsy.