(SDAS) Maternal depressive symptoms and early childhood growth
Grantee: Johns Hopkins Bloomberg School of Public Health
Principal Investigator: Pamela J. Surkan
Project Number: R40MC17175
Project Date: 02/01/2010
Final Report
(SDAS) Maternal depressive symptoms and early childhood growth Final Report (PDF)
Age group(s)
- Perinatal/Infancy (0-12 months)
- Early Childhood (3-5 years)
Abstract
Childhood underweight persists as a problem in the US with over 10% prevalence. Poor growth during childhood is associated with reduced adult stature, low educational performance, less economic productivity as well as higher risk for morbidity and mortality. Maternal depressive symptoms have been suggested as a possible contributor to inadequate growth in children. Other factors such as low birthweight (LBW) and poverty are risk factors for a child not attaining his/her growth potential, implying that the combined effects of maternal depressive symptoms with these conditions may amplify adverse growth outcomes. Maternal depressive symptoms compromise caregiving and attachment to the child, suggesting that caregiver-child interactions may be on the pathway between depressive symptoms and inadequate childhood growth. To date, findings regarding this relation have been mixed, varying by region of the world, with the majority of studies from developing countries. Results from one US study showed that children of mothers with higher depressive symptoms were more likely to have shorter stature, but only in low- to middle-income families. Given the 10-20% prevalence of depressive symptoms following childbirth, the topic merits further attention. We propose to use data from the Early Childhood Longitudinal Study - Birth Cohort (ECLS-B) a US nationally representative sample of approximately 9,700 children with growth measurements at several ages in young children. The specific aims are to 1) explore the relation between maternal depressive symptoms and early child growth and undernutrition 2) investigate whether the effect of maternal depressive symptoms on undernutrition is more pronounced in vulnerable subgroups and 3) examine how parent-child interactions may mediate this relation. Data sources include birth certificates, parent interviews, and direct child assessment. We will evaluate maternal depressive symptoms at 9 months and 4 years postpartum in relation to growth over time (9 months, 4 years, 5-6 years). To do this, we will use weighted multivariable growth trajectory models to adjust for covariates and to account for oversampling of vulnerable subgroups in the study design. In the analysis, the dependent variables will be weight, weightfor-length(height) and length(height) adjusted for age. Depressive symptoms at 9 months and 4 years will also be examined in relation to undernutrition (as defined by stunting, wasting, and underweight) at 4 and 5-6 years, using weighted multivariable logistic regression models. Stratified analyses as well as interactions between maternal depressive symptoms and LBW, multiple birth, and low SES will be tested for effect modification in relation to undernutrition. We will assess whether caregiver-child interactions mediate the relation between maternal depressive symptoms and child undernutrition. Direct observations on the Two Bag Task and the Nursing Child Assessment Teaching Scale will assess caregiver-child interactions. While most research has focused on children under two in developing countries, the ECLS-B provides longitudinal data representative of the US population which extends to preschool and kindergarten children. The study addresses MCHB's Strategic Research Issue IV to promote the healthy development of MCH populations. It explores the effects of maternal depressive symptoms on early childhood growth and undernutrition within vulnerable subgroups and assesses maternal-child interaction as a mediator. Study findings will help inform prevention strategies to prevent inadequate growth in early childhood. The study team is well qualified; investigators have led previous studies about maternal depressive symptoms and childhood growth, and have extensive experience with the ECLS-B data source and expertise in growth trajectory analysis.Publications
Listed is descending order by year published.
Surkan PJ, Ettinger AK, Ahmed S, Minkovitz CS, Strobino D. Impact of maternal depressive symptoms on growth of preschool- and school-aged children. Pediatrics. 2012;130(4):e847-e855.
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