Impact of postpartum anxiety and depression on child’s mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study

Abstract

BackgroundPostpartum anxiety and depression has detrimental effects on the overall mental development of children. This study aims to assess the impact of postpartum anxiety and depression on children’s mental development on all sub-scales in a Pakistani population.MethodsA quasi-experimental study was conducted in two peri-urban communities of Karachi, a mega city of Pakistan, to assess the impact of postpartum anxiety and depression on children’s growth and mental development. A total of 420 women were enrolled, who had given consent out of 651 pregnant women identified, during February 2004 to December 2005. Data for socio-demographic, home environment and family relationship variables were collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother’s levels of anxiety and depression were assessed at 1, 2, 6, 12, 18, 24, and 30 months of childbirth. An indigenous, validated screening instrument- Aga Khan University Anxiety and Depression scale was used and diagnostic confirmation was done through a psychologist’s interview, based on DSM IV criteria. Children’s growth and development was monitored in the same sequence using an Early Childhood Development tool that consists of five subscales; socio emotional, language, cognitive, gross motor and fine motor development. Physical growth was monitored by measuring height and weight of the child. Data was analyzed using SAS 9.2. Multivariable Generalized Estimating Equations (GEE) logistic regression was conducted to identify association of postpartum anxiety and depression with each early childhood development indicator, adjusting for parental and child factors.ResultsA significant association of postpartum anxiety and depression with delayed development on all five subscales of children’s mental development was found in our study. Interestingly, our study found that higher maternal age had adverse effects on child’s emotional whereas positive impact on child’s cognitive development. Children’s stunting had an adverse impact on all five subscales of children’s development. Male children were at higher risk for delayed language and gross motor development relative to female children.ConclusionsOur study found that postpartum anxiety and depression is associated with adverse outcomes regarding children’s mental development on all sub-scales. The impact was accentuated by low family income or child’s increasing age.

Effect of an early perinatal depression intervention on long-term child development outcomes: follow-up of the Thinking Healthy Programme randomised controlled trial

“…Furthermore, we found a paucity of research on maternal depression and child development from South Asia. 23,48,49 Added value of this study…”

Cognitive and language performance in children is associated with maternal social anxiety disorder: A study of young mothers in southern Brazil

“…In literature, maternal schooling was significantly associated with cognitive and language performance in children [10,11,13,21,22]. Children whose mothers had fewer years of formal education showed poorer performance on both subscales.…”

“…Some studies show that poor maternal mental health has a negative effect on early childhood development. However, most of them evaluate the role of maternal depression (pregnancy and postpartum depression) and their effect on young children's (b 2 years old) cognitive function [11,13,22] and language abilities [12,16]. Studies evaluating the effect of maternal anxiety disorders on their children cognitive and language development is scare or inexistent, especially in those over 2 years.…”

“…It has been shown that this poor development is higher in male children [10][11][12][13][14], as well as in those born premature [8,15], who do not go to a daycare [14] and who spend less time with their mothers. In addition, maternal characteristics are also important predictors cognitive and language development.…”

“…In addition, maternal characteristics are also important predictors cognitive and language development. Children born to young mothers [11,16,20], of low socio economic status [13,[17][18][19], less educated [10,11,13,21,22], with no occupation [11,23] and poor mental health [4,24] are prone to have a poor performance in cognitive and language tests.…”