Original Article

Post-Partum Depression Effect on Child Health and Development

Abstract

While studies have shown the disastrous effects of post-partum depression (PPD) on children's behaviors, there is relatively lack of reliable data in Asian countries. This study examined the relative significance of maternal PPD in children's developmental disabilities at age four. In a longitudinal study design (2009), 1801 pregnant women attending in primary health centers of Mazandaran province in the north of Iran provided self-reports of depression from two to twelve postpartum weeks using Edinburgh Postnatal Depression Scale (EPDS). Approximately four years later, the women experiencing PPD and twice as the ones who did not experience this disorder were considered as case (N=204) and control (N=467) groups. The association between maternal depression at different times and childhood developmental disabilities based on Ages and Stages Questionnaire (ASQ) and other health problems reported by the child were analyzed using two-sample t-test, chi-square test, and logistic regression models. The presence of PPD only was not a predictor of child's developmental disabilities at age four. Childhood developmental disabilities in communication, gross motor and personal-social domains of ASQ were associated with the current and concurrent maternal depressive symptoms (OR=2.59, 95% CI=1.16-5.78; OR=4.34, 95% CI=2.10-8.96; OR=5.66, 95% CI=1.94-16.54 and OR=3.35, 95% CI=1.31-8.58; OR=4.15, 95% CI=2.72-13.87; OR=6.17, 95% CI=1.95-19.53 respectively). PPD, the current depressive symptoms, and depression at both occasions were associated with more health problems in children. Childhood developmental disabilities in some domains of ASQ were significantly related to the maternal depression chronicity or recurrence. Also, child's difficulties were more prevalent in association with maternal depression regardless of onset time.

Halbreich U, Karkun S. Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. J Affect Disord 2006;91:97-111.

Rahman A, Creed F. Outcome of prenatal depression and risk factors associated with persistence in the first postnatal year: Prospective study from Rawalpindi, Pakistan. J Affect Disord 2007;100:115-21.

Glasser S, Barell V, Boyko V, Ziv A, Lusky A, Shoham A, Hart S. Postpartum depression in an Israeli cohort: demographic, psychosocial and medical risk factors. J Psychosom Obstet Gynaecol 2000;21:99-108.

Martins C, Gaffan EA. Effects of early maternal depression on patterns of infant mother attachment: a meta analytic investigation. J Child Psychol Psychiatry 2000;41:737-46.

Patel V, DeSouza N, Rodrigues M. Postnatal depression and infant growth and development in low income countries: a cohort study from Goa, India. Arch Dis Child2003;88:34-7.

Carter AS, Garrity-Rokous FE, Chazan-Cohen R, Little C, Briggs-Gowan MJ. Maternal depression and comorbidity: predicting early parenting, attachment security, and toddler social-emotional problems and competencies. J Am Acad Child Adolesc Psychiatry 2001;40:18-26.

Lilja G, Edhborg M, Nissen E. Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum. Scand J Caring Sci 2011;26:245-53.

Grace SL, Evindar A, Stewart DE. The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature. Arch Womens Ment Health 2003;6:263-74.

Whitaker RC, Orzol SM, Kahn RS. Maternal mental health, substance use, and domestic violence in the year after delivery and subsequent behavior problems in children at age 3 years. Arch Gen Psychiatry 2006;63:551-60.

Newport DJ, Hostetter A, Arnold A, Stowe ZN. The treatment of postpartum depression: minimizing infant exposures. J Clin Psychiatry 2002;63:31-44.

Josefsson A, Sydsjö G. A follow-up study of postpartum depressed women: recurrent maternal depressive symptoms and child behavior after four years. Arch Womens Ment Health 2007;10:141-5.

Lusskin SI, Pundiak TM, Habib SM. Perinatal depression:hiding in plain sight. Canad J Psychiatry 2007;52:479-88.

Grote V, Vik T, von Kries R, Luque V, Socha J, Verduci E, Carlier C, Koletzko B. Maternal postnatal depression and child growth: a European cohort study. BMC Pediatr 2010;10:14.

Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782-6.

Abdollahi F, Zarghami M, Azhar MZ, Sazlina SG, Lye MS. Predictors and incidence of post-partum depression: A longitudinal cohort study. J Obstet Gynaecol Res 2014;40:2191-200.

Squires J, Potter L, Bricker D. 2 ed. Baltimore: Paul H.Brookes Publishing Co; 1999.

Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry1987;150:782-6.

Beck CT, Gable RK. Further Validation of the Postpartum Depression Screening Scale. Nurs Res2001;50:155-64.64.

Rychnovsky JD, Brady MA. Choosing a postpartum depression screening instrument for your pediatric practice. J Pediatr Health Care 2008;22:64-7.

Boyd RC, Le HN, Somberg R. Review of screening instruments for postpartum depression. Arch Womens Ment Health 2005;8:141-53.

Namazi S. Risk factors of postpartum depression. J Hormozgan Med 2000;3:17-24.

Tsai H, McClelland M, Pratt C, Squires J. Adaptation of the 36-Month Ages and Stages Questionnaire in Taiwan:results from a preliminary study. J Early Interv 2006;28:213-25.

Sajedi F, Vameghi R, Habibollahi A, Lornejad H, Delavar B. Standardization and validation of the ASQ developmental disorders screening tool in children of Tehran city. Tehran Univ Med J 2012;70:245-9.

Goldberg D. The detection of psychiatric illness by questionnaire. London: Oxford University Press, 1972.

Agnafors S, Sydsjà G, Svedin CGr. Symptoms of depression postpartum and 12 years later-associations to child mental health at 12 years of age. Matern Child Health J 2013;17:405-14.

Brennan PA, Hammen C, Andersen MJ, Bor W, Najman JM, Williams GM. Chronicity, severity, and timing of maternal depressive symptoms: relationships with child outcomes at age 5. Dev Psychol 2000;36:759-66.

Dennis CL. Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh Postnatal Depression Scale? J Affect Disord 2004;78:163-9.

Van der Toorn SLM, Huizink AC, Utens EMWJ, Verhulst FC, Ormel J, et al. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother child reporting discrepancies of internalizing problems in children: a report on the TRAILS Study. Eur Child Adoles Psychiatry2010;19:379-88.

Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R.Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry2004;61:946-52.

Essex MJ, Klein MH, Cho E, Kraemer HC. Exposure to maternal depression and marital conflict: Gender differences in children's later mental health symptoms. J Am Acad Child Adolesc Psychiatry 2003;42:728-37.

Zubaran C, Foresti K, Schumacher M, Amoretti A, Thorell M, Müller L. The Correlation between Postpartum Depression and Health Status. Matern Child Health J 2010;14:751-7.

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IssueVol 55, No 2 (2017) QRcode
SectionOriginal Article(s)
Keywords
Child Development Depression Health Post-partum

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How to Cite
1.
Abdollahi F, Rezai Abhari F, Zarghami M. Post-Partum Depression Effect on Child Health and Development. Acta Med Iran. 2017;55(2):109-114.