Association of maternal depression and infant nutritional status among women living with HIV in Tanzania.
Antenatal and post-natal depression has demonstrated a significant burden in sub-Saharan Africa, with rates ranging from 10% to 35%. However, perinatal women living with HIV in Tanzania have reported an even greater prevalence of depression (43-45%). The primary goal of this study was to examine the relationship between maternal depression and infant malnutrition among women living with HIV. The design was a retrospective cohort study within the context of a randomised controlled trial among women living with HIV and their infants. Within this trial, 699 mother-child pairs were analysed for the present study. Although antenatal depression was not associated with infant malnutrition and post-natal depression was negatively associated [relative risk (RR = 0.80, P = 0.04], cumulative depression demonstrated a positive association with infant wasting (RR = 1.08, P < 0.01) and underweight (RR = 1.03, P < 0.01) after controlling for confounding factors. Variation in the association between depression and infant nutritional status was observed for episodic vs. chronic depression. These findings suggest that providing evidence-based services for persistent depression among women living with HIV may have an effect on infant malnutrition. In addition, other positive outcomes may be related to infant cognitive development as well as HIV disease prognosis and survival among women.
School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Sylvia
S
Kaaya
Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Maria E
ME
Garcia
Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA.
Nan
N
Li
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Jeffrey
J
Lienert
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
William
W
Twayigize
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
Donna
D
Spiegelman
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Mary C
MC
Smith Fawzi
D000293:Adolescent; D000328:Adult; D002657:Child Development; D002675:Child, Preschool; D002908:Chronic Disease; D003071:Cognition; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000150:complications / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology*; D015999:Multivariate Analysis; D009752:Nutritional Status; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
HIV-positive; antenatal; infant malnutrition; maternal depression; post-natal; prenatal; sub-Saharan Africa