Mothers' mental health and infant growth: a case-control study from Rawalpindi, Pakistan.
BACKGROUND
Epidemiological studies in Pakistan show high rates of depression in women, while rates of malnutrition in children are also high. This study aimed to determine whether poor maternal mental health is associated with an increased risk of infant undernutrition.


METHODS
Clinic-based case-control study. A total of 172 consecutive infants and their mothers attending for 9-month measles immunization were recruited over a 3-month period. Eighty-two undernourished infants [weight for age below the National Centre for Health Statistics (NCHS)/World Health Organization (WHO) third centile] were matched to 90 controls (weight for age above 10th centile), and their mothers interviewed for mental distress using the Self-Reporting Questionnaire (WHO SRQ-20, a psychiatric screening instrument). Infants' exposure to maternal distress (score > or = 10 on SRQ-20) and other potential risk or protective biological, social, socio-economic and family factors were measured.


RESULTS
Mental distress determined by WHO SRQ-20 was associated with increased risk of undernutrition in infants (odds ratio 3.91, 95% confidence interval 1.95-7.86). This association remained significant after controlling for birthweight and social factors.


CONCLUSIONS
Exposure to maternal mental distress is associated with undernutrition in 9-month infants in urban Pakistan. These mothers may represent a group whose children are at higher risk of ill health, and potentially be a specific target for advice on infant care. Early recognition and treatment of mental health problems in mothers may help reduce morbidity and mortality rates in children.
Rahman
A
A
University of Manchester Department of Child Psychiatry, Royal Manchester Children's Hospital, Manchester School of Primary Care, Rusholme Health Centre, Manchester, UK. atif.rahman@ntlworld.com
Lovel
H
H
Bunn
J
J
Iqbal
Z
Z
Harrington
R
R
D016022:Case-Control Studies; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000453:epidemiology* / Q000209:etiology; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D009035:Mothers; D010154:Pakistan / Q000453:epidemiology; D012647:Self-Assessment; D011795:Surveys and Questionnaires