The relationship between maternal depression and adverse infant health outcomes in Zambia: a cross-sectional feasibility study.
BACKGROUND
Post-partum depression affects many new mothers. In the developing world, there may be an association between post-partum depression and adverse mortality-related infant health. Such associations have been found in South Asia; however, findings are inconsistent in Africa. This study aimed to investigate the feasibility of such research in rural Zambia, and investigate associations between maternal depression and adverse infant health outcomes.


METHODS
A cross-sectional study was undertaken in a rural district of Zambia. Consecutive women with infants between 2 and 12 months were recruited from under five clinics in three locations. Depression was assessed using the Self-reporting Questionnaire. Outcomes of infant size (actual weight and length, and as ≤ 5th percentile) and infant health (serious illness, diarrhoeal episodes, incomplete vaccination) were obtained. Relative risk, step-wise logistic regression and linear regression were used to analyse the data.


RESULTS
Two hundred seventy-eight of 286 women agreed to take part (97.1%). The proportion with a high risk of depression was 9.7%. Adverse infant health outcomes were all proportionally greater in infants of 'depressed' mothers, and the associations with adjusted mean difference in weight (0.58 kg, CI 0.09-1.08) and length (1.95 cm, CI 0.49-3.50) were statistically significant. Other independent associations with episodes of diarrhoea (maternal education, older infant age, supplementary feeding) and incomplete vaccination (location, older infant age) were identified.


CONCLUSIONS
It is feasible to conduct a study on this subject in a rural area of Zambia. The results show that reduced infant weight and length were significantly associated with maternal 'depression'. Other adverse outcomes may be and need investigating in an appropriately powered study.
Ndokera
R
R
University of Birmingham, Edgbaston, Birmingham, UK. rsn4@le.ac.uk
MacArthur
C
C
D000293:Adolescent; D000328:Adult; D001827:Body Height; D001835:Body Weight; D002657:Child Development / Q000502:physiology*; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000523:psychology*; D003906:Developing Countries; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009034:Mother-Child Relations; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult; D015024:Zambia