title: Health care utilisation in the first year of life among infants of mothers with perinatal depression or anxiety.
abstract: BACKGROUND
  Limited information is available on associations between maternal depression and anxiety and infant health care utilisation.
  
  
  METHODS
  We analysed data from 24 263 infants born between 1998 and 2007 who themselves and their mothers were continuously enrolled for the infant's first year in Kaiser Permanente Northwest. We used maternal depression and anxiety diagnoses during pregnancy and postpartum to categorise infants into two depression and anxiety groups and examined effect modification by timing of diagnosis (pregnancy only, postpartum only, pregnancy and postpartum). Using generalised estimating equations in multivariable log-linear regression, we estimated adjusted risk ratios (RR) between maternal depression and anxiety and well baby visits (<5 and ≥ 5), up to date immunisations (yes/no), sick/emergency visits (<6 and ≥ 6) and infant hospitalisation (any/none).
  
  
  RESULTS
  Infants of mothers with perinatal depression or anxiety were as likely to attend well baby visits and receive immunisations as their counterparts (RR = 1.0 for all). Compared with no depression or anxiety, infants of mothers with prenatal and postpartum depression or anxiety, or postpartum depression or anxiety only were 1.1 to 1.2 times more likely to have ≥ 6 sick/emergency visits. Infants of mothers with postpartum depression only had marginally increased risk of hospitalisation (RR = 1.2 [95% confidence interval 1.0, 1.4]); 70% of diagnoses occurred after the infant's hospitalisation.
  
  
  CONCLUSIONS
  An understanding of the temporality of the associations between maternal depression and anxiety and infant acute care is needed and will guide strategies to decrease maternal mental illness and improve infant care for this population.
authors.affiliation: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. sfarr@cdc.gov
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Farr
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Dietz
authors.forename: Joanne H
authors.initials: JH
authors.lastname: Rizzo
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Vesco
authors.forename: William M
authors.initials: WM
authors.lastname: Callaghan
authors.forename: F Carol
authors.initials: FC
authors.lastname: Bruce
authors.forename: Joanna E
authors.initials: JE
authors.lastname: Bulkley
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hornbrook
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Berg
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001008:Anxiety Disorders / Q000523:psychology*; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D019052:Depression, Postpartum / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000706:statistics & numerical data*; D008875:Middle Aged; D009922:Oregon; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D014861:Washington; D055815:Young Adult