Academic journal article Bulletin of the World Health Organization

Maternal Depression and Early Childhood Growth in Developing Countries: Systematic Review and Meta-Analysis

Academic journal article Bulletin of the World Health Organization

Maternal Depression and Early Childhood Growth in Developing Countries: Systematic Review and Meta-Analysis

Article excerpt

Objective To investigate the relationship between maternal depression and child growth in developing countries through a systematic literature review and meta-analysis.

Methods Six databases were searched for studies from developing countries on maternal depression and child growth published up until 2010. Standard meta-analytical methods were followed and pooled odds ratios (ORs) for underweight and stunting in the children of depressed mothers were calculated using random effects models for all studies and for subsets of studies that met strict criteria on study design, exposure to maternal depression and outcome variables. The population attributable risk (PAR) was estimated for selected studies.

Findings Seventeen studies including a total of 13 923 mother and child pairs from 11 countries met inclusion criteria. The children of mothers with depression or depressive symptoms were more likely to be underweight (OR: 1.5; 95% confidence interval, CI: 1.2-1.8) or stunted (OR: 1.4; 95% CI: 1.2-1.7). Subanalysis of three longitudinal studies showed a stronger effect: the OR for underweight was 2.2 (95% CI: 1.5-3.2) and for stunting, 2.0 (95% CI: 1.0-3.9). The PAR for selected studies indicated that if the infant population were entirely unexposed to maternal depressive symptoms 23% to 29% fewer children would be underweight or stunted.

Conclusion Maternal depression was associated with early childhood underweight and stunting. Rigorous prospective studies are needed to identify mechanisms and causes. Early identification, treatment and prevention of maternal depression may help reduce child stunting and underweight in developing countries.

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Resume

Depression maternelle et croissance de la petite enfance dans les pays en developpement: examen systematique et meta-analyse

Objectif Etudier la relation entre depression maternelle et croissance infantile dans les pays en developpement par un examen systematique de la documentation et une meta-analyse.

Methodes Six bases de donnees ont ete consultees pour les etudes sur la depression maternelle et la croissance des enfants dans les pays en developpement, publiees jusqu'en 2010. Les methodes standard de meta-analyse ont ete suivies et les odds ratios (OR, rapports des chances) mis en commun pour l'insuffisance ponderale et le retard de croissance des enfants de meres deprimees ont ete calcules en utilisant des modeles a effets aleatoires pour toutes les etudes et pour les sous-ensembles d'etudes qui repondaient aux criteres stricts de conception d'etude, d'exposition a la depression matemelle et de variables de resultat. Le risque attribuable dans la population (RAP) a ete estime pour des etudes selectionnees.

Resultats Dix-sept etudes, incluant un total de 13 923 paires de mere et enfant de 11 pays, remplissaient les criteres d'inclusion. Les enfants de meres souffrant de depression ou de symptomes depressifs etaient plus susceptibles de presenter une insuffisance ponderale (IP: 1,5; intervalle de confiance, IC, de 95%: 1,2-1,8) ou un retard de croissance (IP: 1,4; IC de 95%: 1,2-1,7). La sous-analyse de trois etudes longitudinales a montre un effet plus important: l'OR pour insuffisance ponderale etait de 2,2 (IC de 95%: 1,5-3,2) et pour retard de croissance, de 2,0 (IC de 95%: 1,0-3,9). Le RAP des etudes selectionnees a indique que si la population infantile etait entierement non-exposee 9, des symptomes depressifs maternels, 23 a 29% d'enfants en moins souffriraient d'insuffisance ponderale ou de retard de croissance.

Conclusion La depression maternelle est associee a l'insuffisance ponderale et au retard de croissance de la petite enfance. De rigoureuses etudes prospectives sont necessaires pour en identifier les mecanismes et les causes. L'identification precoce, le traitement et la prevention de la depression maternelle peuvent aider a reduire le retard de croissance et l'insuffisance ponderale des enfants dans les pays en developpement. …

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