title: Maternal perinatal depression is not independently associated with child body mass index in the Generation R Study: methods and missing data matter.
abstract: OBJECTIVE
  To advance the understanding of the relationship between maternal perinatal depression and child overweight, we used appropriate methodology to account for missing data; incorporated three exposure time points; and included adequate covariate adjustment in a large, sociodemographically diverse sample.
  
  
  METHODS
  We used data from 6,782 mother-child pairs in a prospective population-based study. Maternal depression was assessed with the Brief Symptom Inventory at midpregnancy and 2 and 6 months postpartum. Child height and weight were measured at 36 months of age and converted to body mass index (BMI) z-scores. We compared the complete-case and multiple imputation (MI) analyses.
  
  
  RESULTS
  Fully adjusted complete-case models showed a positive association between depression at 2 months postpartum and child BMI z-score (β=0.19 [95% confidence interval (CI)=0.03, 0.36]; n=1,732), and no association between prenatal depression or 6-month postpartum depression and child BMI. Using MI (n=6,782), there was no association between perinatal depression and child BMI at any time point.
  
  
  CONCLUSIONS
  Our study adds evidence that postpartum depression is not associated with child growth across the population in high-income countries. Our results highlight the importance of appropriate handling of missing data, adequate covariate control, and the value of studying the conditions that have produced conflicting evidence regarding perinatal depression and child weight.
authors.affiliation: Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst, Arnold House, 715 N. Pleasant Street, Amherst, MA 01003, USA. kertel@schoolph.umass.edu
authors.forename: Karen A
authors.initials: KA
authors.lastname: Ertel
authors.forename: Ken
authors.initials: K
authors.lastname: Kleinman
authors.forename: Lenie
authors.initials: L
authors.lastname: van Rossem
authors.forename: Sharon
authors.initials: S
authors.lastname: Sagiv
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.forename: Hein
authors.initials: H
authors.lastname: Raat
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002675:Child, Preschool; D019052:Depression, Postpartum / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D009426:Netherlands / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011446:Prospective Studies