ABSTRACT. Objectives. To determine the relationships between maternal depressive symptoms and the use of infant health services, parenting practices, and injury-prevention measures.Methods. A prospective, community-based survey of women attending Philadelphia public health centers between February 2000 and November 2001 was conducted. Women were surveyed at 3 time points before and after parturition. Depressive symptoms were determined with the Center for Epidemiologic Studies Depression Scale at each time point. We studied 6 outcomes, clustered into 3 categories: 1) infant health service use (adequate wellchild care and ever being hospitalized); 2) parenting practices (breastfeeding for >1 month and use of corporal punishment); and 3) injury-prevention measures (having a smoke alarm and using the back sleep position).Results. The sample consisted of 774 largely single (74%), uninsured (63%), African American (65%) women, with a mean age of 24 ؎ 6 years and a mean annual income of $8063. Forty-eight percent of women had depressive symptoms at 1 or 2 time points (ever symptoms) and 12% had depressive symptoms at all points (persistent symptoms). Compared with women who never had depressive symptoms (without symptoms), women with persistent symptoms were nearly 3 times as likely to have their child ever hospitalized (adjusted odds ratio: 2.89; 95% confidence interval: 1.61-5.07) and twice as likely to use corporal punishment (adjusted odds ratio: 1.90; 95% confidence interval: 1.08 -3.34). Mothers with persistent depressive symptoms were nearly three-quarters less likely to have smoke alarms in their homes (adjusted odds ratio: 0.28; 95% confidence interval: 0.11-0.70) and one-half as likely to use the back sleep position (adjusted odds ratio: 0.56; 95% confidence interval: 0.35-0.91), compared with women without symptoms. There was no association between maternal depressive symptoms and infant receipt of well-child care or the likelihood of breastfeeding for >1 month.Conclusions. Maternal depressive symptoms persisting from the prepartum to postpartum periods were associated with increased risks of infant hospitalization and use of corporal punishment and with lower likelihood of having a smoke alarm and using the back sleep position. Additional efforts are needed to identify and evaluate mothers with depressive symptoms to improve the health and safety of young infants. Pediatrics 2004; 113:e523-e529. URL: http://www.pediatrics.org/cgi/ content/full/113/6/e523; maternal depression, health services use, preventative health measures, safety, well-child care.ABBREVIATIONS. CES-D, Center for Epidemiologic Studies Depression Scale; MDD, major depressive disorder. D epression affects 12% to 48% of mothers with young children. [1][2][3][4][5] Although depression affects mothers of all socioeconomic groups, the highest rates of maternal depression are reported among low-income women. 1-5 Risk factors for maternal depression other than low income include young maternal age, low education levels, single marital status, no...

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High levels of chronic stress during pregnancy are associated with bacterial vaginosis. The effect of chronic maternal stress is independent of the effects of other established sociodemographic and behavioral risk factors for BV.

Significant differences were documented in breastfeeding intention in our sample of low-income, inner-city women. Most notable was the higher likelihood of anticipated breastfeeding among our immigrant sub-groups when compared with non-Hispanic white women. An unexpected finding was the higher likelihood of anticipated breastfeeding among native-born, non-Hispanic African American women than among non-Hispanic white respondents. Because intentions are important predictors of future behavior, more focus needs to be directed towards breastfeeding promotion during the prenatal period and towards a better understanding of why some mothers intend to breastfeed while others do not.

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