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BackgroundMaternal depressive symptoms are negatively associated with early child growth in developing countries; however, few studies have examined this relation in developed countries or used a longitudinal design with data past the second year of the child’s life. We investigated if and when early maternal depressive symptoms affect average growth in young children up to age 6 in a nationally representative sample of US children.MethodsUsing data from 6,550 singleton births from the Early Childhood Longitudinal Study -- Birth Cohort (ECLS-B), we fit growth trajectory models with random effects to examine the relation between maternal depressive symptoms at 9 months based on the twelve-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) and child height and body mass index (BMI) to age 6 years.ResultsMothers with moderate/severe depressive symptoms at 9 months postpartum had children with shorter stature at this same point in time [average 0.26 cm shorter; 95% CI: 5 cm, 48 cm] than mothers without depressive symptoms; children whose mothers reported postpartum depressive symptoms remained significantly shorter throughout the child’s first 6 years.ConclusionsResults suggest that the first year postpartum is a critical window for addressing maternal depressive symptoms in order to optimize child growth. Future studies should investigate the role of caregiving and feeding practices as potential mechanisms linking maternal depressive symptoms and child growth trajectories.

Purpose To describe the development of pediatric family relationships measures, with versions for child self-report (8–17 years) and parent-report for children 5–17 years old. Measures were created for integration into the Patient Reported Outcomes Measurement Information System(PROMIS®). Methods Semi-structured interviews with 10 experts, 24 children, and 8 parents were conducted to elicit and clarify essential elements of family relationships. A systematic literature review was conducted to identify item concepts representative of each element. The concepts were transformed into items that were iteratively revised based on cognitive interviews (n = 43 children) and item translatability review. Psychometric studies involving 2846 children and 2262 parents were conducted to further refine and validate the instruments. Results Qualitative procedures supported the development of content valid Family Relationships item banks. Final child- and parent-report item banks each contain 47 items. Unidimensional item banks were calibrated using IRT-modeling to estimate item parameters representative of the US population and to enable computerized adaptive test administration. Four- and eight-item short forms were constructed for standard fixed format administration. All instruments have strong internal consistency, retest-reliability, and provide precise estimates of various levels of family relationship quality. Preliminary evidence of the instruments’ validity was provided by known-group comparisons and convergence with legacy measures. Conclusion The PROMIS pediatric Family Relationships measures can be applied in research focused on determinants, outcomes, and the protective effects of children’s subjective family relationship experiences.

Maternal depressive symptoms during infancy may affect physical growth in early childhood. Prevention, early detection, and treatment of maternal depressive symptoms during the first year postpartum may prevent childhood height-for-age ≤ 10th percentile among preschool- and school-aged children.

Background Beyond the sweeping physiological effects of COVID-19 infections in 2020 and 2021, the psychosocial impacts of lockdowns, social distancing, and the associated disruptions to daily life have brought on a simultaneous mental health crisis, particularly among many working mothers who are disproportionately balancing childcare, virtual schooling, and employment vulnerability. The aim of this study was to measure the mental health status of working mothers in the United States and associations with the provision of family-friendly employment benefits one year into the pandemic. Methods Cross-sectional data were collected from a sample of working mothers in the U.S. using an online survey of mental health status and the receipt of employer-provided family-friendly benefits. Mental health was measured with the Kessler 6 (K-6) and the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Perceived helpfulness of benefits was assessed through self-reported Likert-scale scores of 0 (not at all helpful) to 4 (extremely helpful) to determine mean helpfulness scores for benefit types. Multivariable logistic regression analyses were conducted to determine associations between receipt of employment benefits and serious mental illness (SMI). Results A total of 728 participants met the study criteria, 83.7% were non-Hispanic/Latino white and 61.1% were 35–44 years of age. Among study participants, 54.3% (n = 395) and 21.8% (n = 159) reported psychological distress levels associated with moderate mental illness (MMI) and serious mental illness (SMI), respectively. Not receiving benefits was associated with a 50% increase in odds of SMI (aOR = 1.50, 95% CI [1.03–2.20], p = 0.036). Benefits perceived to be the most helpful for participants were flexible hours/schedule (3.5; SD ± 0.9), flexible work location (3.3; SD ± 1.1), and supplemental paid time off (3.1; SD ± 1.1), with mean scores above very helpful. Conclusion Results suggest employment benefits may help support the mental health of working mothers and provide a call to action to employers and policy stakeholders to develop solutions addressing gaps in workplace benefits and mental health support for working parents, with sustainable reform in mind to mitigate employment benefit inequities exposed by the pandemic.

Background The degree to which children experience unmet need for dental care during the COVID-19 pandemic, and its association with pandemic-related household job or income loss, is unknown. Methods The authors performed a cross-sectional household survey of 348 families in Pittsburgh, PA during the week June 25 to July 2, 2020. Unmet need for child dental care and pandemic-related household job or income loss were assessed using caregiver self-report. Results Caregivers reported that the greatest unmet child health care need during the COVID-19 pandemic was dental care (16%) followed by medical care for a well visit or vaccination (5%). Approximately 40% of caregivers reported job loss or a decrease in household income due to the COVID-19 pandemic. We found a significant association between the probability of unmet child dental care and pandemic-related household job or income loss ( P=.022 ). Losing a job or experiencing a decrease in income due to the COVID-19 pandemic was associated with unmet child dental care (Relative Risk, 1.77; 95% confidence interval, 1.08 to 2.88). Conclusions In our sample, three times as many households reported unmet dental care for a child compared to unmet medical care. Unmet child dental care was more common in households where pandemic-related job or income loss occurred. Practical Implications If unmet dental care continues as a result of the COVID-19 pandemic, non-traditional strategies for delivering dental care can be considered to improve access to dental care for children, such as teledentistry and oral health prevention services in primary care settings.

Objective To identify unmet health and social resource needs during a county-wide COVID-19 stay-at-home order and phased re-opening in Western Pennsylvania. Methods With public health, social service, and community partners connected through an ongoing academic-community collaborative, we developed and fielded a weekly repeated cross-sectional electronic survey assessing usage of and unmet need for health and social service resources. Using ten weeks of surveys (April 3-June 11, 2020) by Allegheny County residents, we examined variation in responses by week and by sociodemographic characteristics using chi-square tests. We shared written reports weekly and discussed emerging trends with community partners. Results Participants ranged from 229-1,001 per week. Unmet need for at least one health or health-related social need resource varied by week, ranging from 55% (95% confidence interval (CI) 50-59%) of participants in week 2 to 43% (95% CI 37-49%) of participants in week 9 (p=0.006). Increased use of at least one resource ranged from 53% (95% CI 47-58%) of participants in week 3 to 36% (95% CI 31-42%) in week 9 (p<0.001). Unmet need for food and financial assistance peaked early during the stay-at-home order, while unmet need for mental health care rose later. Unmet need for food assistance varied significantly by race and ethnicity and by household pre-pandemic income. Conclusions Over half of families with children reported unmet health or social service needs during the first month of a county-wide COVID-19 stay-at-home order. Unmet needs varied with race, ethnicity, and income and with duration of the stay-at-home order.

Maternal employment is associated with child overweight/obesity, but the mechanisms influencing this relationship are not clear among diverse populations. We examined the effects of employment and parenting variables on child overweight/obesity among low-income Black and Latino families. Using longitudinal data from the Three-City Study, we analyzed the effects of maternal employment and nonstandard work schedule on child overweight/obesity and examined time away from children, parenting stress, and parenting practices as potential mediators. Mothers who increased their work hours during preschool years had children with approximately 2.6 times the odds of overweight/obesity compared to mothers who did not change their work status. Time away from children partially mediated the association between employment and child overweight/obesity. More consistent family routines were associated with a 61% decline in odds of child overweight/obesity. Early increases in maternal employment elevated the odds of child overweight/obesity, but regular family routines reduced the odds of overweight/obesity among school-age children in low-income Black and Latino families.