Maternal common mental disorders and malnutrition in children: a case-control study.
BACKGROUND
Despite improvements in the nutritional status of Brazilian children, child malnutrition remains a public health issue. The objective of the present study was to analyse the effect of maternal common mental disorders (MCMD) on child malnutrition in a large Brazilian urban centre with low rates of child malnutrition. Furthermore, we explored the hypothesis that a reduction in the quality of maternal caregiving mediates the relationship between maternal mental health problems and child nutrition.


METHODS
A case-control study including 294 children aged between 0 and 5 years, with 147 cases and 147 age- and sex-matched controls, was conducted in the city of Salvador, northeastern Brazil. Mothers completed the Self-Report Questionnaire (SRQ-20), the family's socio-economic status was evaluated and the Home Observation for Measurement of the Environment (HOME) Inventory was applied. Children were diagnosed as moderately or severely malnourished when the weight-for-height z-score was below -2 SD. Conditional logistic regression was used in the analysis, and the final model was created using the backward technique.


RESULTS
MCMD doubled the risk of moderate or severe malnutrition in children (OR = 2.04; 95% CI: 1.10-3.78). Maternal caregiving can be an important factor mediating the relationship between maternal mental health and child malnutrition.


CONCLUSIONS
MCMD must be taken into account in programmes for the treatment and prevention of malnutrition, especially in areas of low malnutrition prevalence.
Santos
Dirlane S
DS
Institute of Collective Health, Federal University of Bahia, Bahia, Brazil. dirlly@ig.com.br
Santos
Darci Neves
DN
Silva
Rita de Cássia Ribeiro
Rde C
Hasselmann
Maria Helena
MH
Barreto
Maurício L
ML
D001938:Brazil; D016022:Case-Control Studies; D015362:Child Nutrition Disorders; D016241:Child of Impaired Parents; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors
Matern Child Nutr. 2007 Apr;3(2):94-107
17355442
Cad Saude Publica. 2007 Jan;23(1):147-56
17187113
Trop Med Int Health. 2008 Apr;13(4):579-83
18318697
Int J Epidemiol. 1996 Feb;25(1):128-33
8666480
Child Care Health Dev. 2004 Jan;30(1):21-7
14678308
World Health Organ Tech Rep Ser. 1995;854:1-452
8594834
J Trop Pediatr Environ Child Health. 1972 Dec;18(4):279
4495129
Lancet. 2007 Jan 13;369(9556):145-57
17223478
Child Dev. 1983 Oct;54(5):1286-96
6354634
J Indian Med Assoc. 2000 Sep;98(9):530-5
11291785
Rev Saude Publica. 1996 Jun;30(3):213-7
9110465
Rev Saude Publica. 2002 Apr;36(2):188-97
12045800
Cad Saude Publica. 2006 Nov;22(11):2311-8
17091168
Cad Saude Publica. 2008 Jul;24(7):1527-35
18670676
Rev Saude Publica. 2009 Feb;43(1):35-43
19169574
Am J Clin Nutr. 2009 Mar;89(3):963S-966S
19176734
Br J Psychiatry. 1986 Jan;148:23-6
3955316
Health Policy Plan. 2003 Sep;18(3):344-9
12917276
Cad Saude Publica. 2003;19 Suppl 1:S181-91
12886448
Arch Gen Psychiatry. 2004 Sep;61(9):946-52
15351773
J Epidemiol Community Health. 2005 Dec;59(12):1060-4
16286495
Soc Psychiatry Psychiatr Epidemiol. 2009 May;44(5):416-20
18974909
J Trop Pediatr. 2000 Oct;46(5):314
11077946
Cad Saude Publica. 1993;9 Suppl 1:14-27
15448817
Nutr Rev. 1991 Sep;49(9):259-68
1749535
Cad Saude Publica. 2005 Jan-Feb;21(1):73-9
15692640