Maternal emotional states in relation to their offspring weight status and health-related quality of life: Tehran Lipid and Glucose Study

Abstract

Background: Maternal characteristics have been known to be associated with parenting practices that could eventually influence their child’s weight and health-related quality of life (HRQoL). This study aimed to assess the direct and indirect associations of maternal emotional states (depression, anxiety and stress) with body mass index (BMI) and HRQoL in their children. Methods: This study was conducted within the framework of Tehran Lipid and Glucose Study (TLGS). Participants were children (n=231) who participated in the TLGS during 2014-2016 with complete data on maternal emotional states. Body weight and height of children were measured using standard protocol and BMI-Z scores were determined using Anthroplus. HRQoL in children and emotional states in mothers were assessed using the Iranian version of the pediatric quality of life inventory (PedsQL TM 4.0) and the depression, anxiety and stress scales (DASS-21) respectively. Structural equations modeling (SEM) was used to assess the direct and indirect relations of maternal emotional states with children’s BMI Z score and HRQoL. Results: Mean age, BMI Z-score and HRQoL total score in children were 13.8±3.1 years, 0.74±1.5 and 84.7±11.3 respectively. In mothers, median scores (Interquartile ranges) of DASS-21 in three scales including depression, anxiety and stress were 4(0-10), 6(2-12) and 14(8-20) respectively. Maternal level of education was significantly associated with DASS-21 scores (β=-0.23, 95% CI: -0.37,-0.07). Maternal DASS-21 scores were significantly associated with BMI Z scores only in girls (β=0.25, 95% CI: 0.06, 0.53). Significant determinants of HRQoL in boys were child’s age (β=-0.21, 95% CI: -0.40, -0.01), maternal education (β=-0.24, 95%CI: -0.44, -0.02) and emotional state (β=-0.24, 95% CI: -0.44, -0.03). Child’s age (β=-0.33, 95%-CI: -0.53, -0.10) and maternal emotional state (β=-0.31, 95% CI: -0.54, -0.08) were significantly associated with HRQoL in girls. Conclusion: Our results indicate maternal emotional states to be the important determinants of HRQoL in children, regardless of their weight status. Further research is recommended to examine the current hypothesized model in rural and sub-urban populations taking ino consideration more influential factors.