title: Maternal depression and early childhood growth in developing countries: systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate the relationship between maternal depression and child growth in developing countries through a systematic literature review and meta-analysis.
  
  
  METHODS
  Six databases were searched for studies from developing countries on maternal depression and child growth published up until 2010. Standard meta-analytical methods were followed and pooled odds ratios (ORs) for underweight and stunting in the children of depressed mothers were calculated using random effects models for all studies and for subsets of studies that met strict criteria on study design, exposure to maternal depression and outcome variables. The population attributable risk (PAR) was estimated for selected studies.
  
  
  RESULTS
  Seventeen studies including a total of 13,923 mother and child pairs from 11 countries met inclusion criteria. The children of mothers with depression or depressive symptoms were more likely to be underweight (OR: 1.5; 95% confidence interval, CI: 1.2-1.8) or stunted (OR: 1.4; 95% CI: 1.2-1.7). Subanalysis of three longitudinal studies showed a stronger effect: the OR for underweight was 2.2 (95% CI: 1.5-3.2) and for stunting, 2.0 (95% CI: 1.0-3.9). The PAR for selected studies indicated that if the infant population were entirely unexposed to maternal depressive symptoms 23% to 29% fewer children would be underweight or stunted.
  
  
  CONCLUSIONS
  Maternal depression was associated with early childhood underweight and stunting. Rigorous prospective studies are needed to identify mechanisms and causes. Early identification, treatment and prevention of maternal depression may help reduce child stunting and underweight in developing countries.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, United States of America. psurkan@jhsph.edu
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Surkan
authors.forename: Caitlin E
authors.initials: CE
authors.lastname: Kennedy
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Hurley
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Black
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D003863:Depression / Q000453:epidemiology*; D003906:Developing Countries; D005260:Female; D006801:Humans; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*