title: Maternal depressive symptoms and infant health practices among low-income women.
abstract: OBJECTIVE
  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 well-child care and ever being hospitalized); 2) parenting practices (breastfeeding for > or =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 dollars. 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 > or =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.
authors.affiliation: Division of General Pediatrics, A.I. duPont Hospital for Children and Thomas Jefferson Medical College, Philadelphia, Pennsylvania, USA.
authors.forename: Esther K
authors.initials: EK
authors.lastname: Chung
authors.forename: Kelly F
authors.initials: KF
authors.lastname: McCollum
authors.forename: Irma T
authors.initials: IT
authors.lastname: Elo
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Lee
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Culhane
mesh_terms: D000328:Adult; D044383:Black People; D002662:Child Health Services / Q000706:statistics & numerical data*; D003863:Depression / Q000208:ethnology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D009035:Mothers; D016487:Parenting / Q000523:psychology; D011203:Poverty; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States; D001741:Black or African American