Brief report
Impact of postnatal depression on infants' growth in Nigeria

https://doi.org/10.1016/j.jad.2007.09.013Get rights and content

Abstract

Background

The contribution of maternal postnatal depression to infant growth and under-nutrition in Africa has not been well studied. This study aims to examine the impact of postnatal depression (PND) on infants' physical growth in the first 9 months of life in Nigeria.

Methods

A longitudinal case controlled study in which 242 women (consisting of 120 depressed and 122 matched non-depressed postpartum women) had their infants' weight and length measured at the 6th week, 3rd month, 6th month and 9th month after delivery. Discontinuation with breastfeeding and illnesses like diarrhoea, persistent vomiting, fever and cough were also recorded at these periods.

Results

Infants of depressed mothers had statistically significant poorer growth than infants of non-depressed mothers at the 3rd month (weight OR 3.41, 95% CI 1.30–8.52; length OR 3.28, 95% CI 1.03–10.47) and the 6th month postpartum (weight OR 4.21, 95% CI 1.36–13.20; length OR 3.34, 95% CI 1.18–9.52). Depressed mothers were more likely to stop breastfeeding earlier and their infants more likely to have episodes of diarrhoea and other infectious illnesses.

Limitations

Psychiatric interview was conducted only once (at 6 weeks postpartum), our sample size was moderate and we did not account for mothers who had been depressed in pregnancy.

Conclusion

Prevention of postnatal depression and close monitoring of the growth of infants of depressed mothers should be integrated into maternal and child health policies in this region.

Introduction

Postnatal depression (PND) occurs in about 10–20% of mothers by 3 months postpartum both in western culture (O'Hara and Swain, 1996) and Africa (Adewuya et al., 2005, Cooper et al., 1999, Uwakwe and Okonkwo, 2003). Studies in the western culture have shown that apart from the effect on the mother and partners, it has adverse effects upon cognitive, social, and emotional developments in the infants (Murray and Cooper, 1996). These studies have neglected physical growth probably because poor infant growth and under-nutrition are rare in western countries. Studies in developing countries in Asia have found that maternal depression in postnatal period predicts poorer growth and mental developments in infants (Patel et al., 2003, Rahman et al., 2004). Poor infant growth and under-nutrition is prevalent in Africa, especially in Nigeria (Onayade et al., 2004). The contribution of the maternal mood to this problem needs to be thoroughly examined. This study aimed to examine the effect of maternal depression on infant physical growth in the first 9 months of life.

Section snippets

Subjects

The subjects were recruited from the postpartum women and their infants (n = 876) who participated in an earlier study on the prevalence of postnatal depression in Nigeria (Adewuya et al., 2005). They were attending the infant immunisation clinics at the 5 health centres in Ilesa Township. Excluded from the study were women who were critically ill, do not speak the local language or English, or unable to give informed consent. On the 6th week postpartum the mothers were assessed for depression by

Results

Out of the 128 depressed postpartum women recruited for the index group, only 120 (93.8%) participated till the 9th month postpartum. Of the 132 non-depressed postpartum women recruited for the control group, 4 who later met the criteria for depression at the 3rd and 6th months were excluded from the study. Out of the remaining 130, only 122 (93.9%) were able to complete the study till the 9th month postpartum. Therefore data from a total of 242 subjects (consisting of 120 from the index group

Discussion

This study, to our knowledge is the first longitudinal study to examine the impact of maternal depression on infant growth in Nigeria. Our main finding was the poorer growth of infants of depressed mothers compared to non-depressed mothers from the 6th week until the 9th month postpartum reaching statistically significant differences at the 3rd and 6th month postpartum. This is in agreement with studies in other low-income countries (Patel et al., 2003, Rahman et al., 2004).

In agreement with

Role of funding source

Nothing declared.

Conflict of Interest

No conflict declared.

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