Depression is the leading cause of disease-related disability in women and adversely affects the health and well-being of mothers and their children. Studies have shown maternal depression as a risk factor for poor infant growth. Little is known about the situation in Sub-Saharan Africa. The aim of our study was to examine the association between maternal depression and severe acute malnutrition in Kenyan children aged 6–60 months.
A matched case-control study was conducted in general paediatric wards at the Kenyatta National Hospital. The cases were children admitted with severe acute malnutrition as determined by WHO criteria. The controls were age and sex-matched children with normal weight admitted in the same wards with acute ailments. Mothers of the cases and controls were assessed for depression using the PHQ-9 questionnaire. Child anthropometric and maternal demographic data were captured. Logistic regression analyses were used to compare the odds of maternal depression in cases and controls, taking into account other factors associated with child malnutrition status.
The prevalence of moderate to severe depression among mothers of malnourished children was high (64.1%) compared to mothers of normal weight children (5.1%). In multivariate analyses, the odds of maternal depression was markedly higher in cases than in controls (adjusted OR = 53.5, 95% CI = 8.5–338.3), as was the odds of having very low income (adjusted OR = 77.6 95% CI = 5.8–1033.2).
Kenyan mothers whose children are hospitalized with malnutrition were shown in this study to carry a significant mental health burden. We strongly recommend formation of self-help groups that offer social support, counseling, strategies to address food insecurity, and economic empowerment skills for mothers of children hospitalized for malnourishment.
Cummings EM, Kouros CD. Maternal depression and its relation to Children’s development and adjustment. In: Tremblay RE, Boivin M, RDeV P, editors. Encycl early child dev; 2007. p. 1–10.
Haas JD, Murdoch S, Rivera J, Martorell R. Early nutrition and later physical work capacity. Nutr Rev. 2009;54:S41–8. https://doi.org/10.1111/j.1753-4887.1996.tb03869.x. CrossRef
Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet (London, England). 2008;371:340–57. https://doi.org/10.1016/S0140-6736(07)61692-4. CrossRefPubMedCentral
Faruque ASG, Ahmed AMS, Ahmed T, Islam MM, Hossain MI, Roy SK, et al. Nutrition: basis for healthy children and mothers in Bangladesh. J Health Popul Nutr. 2008;26:325–39. http://www.ncbi.nlm.nih.gov/pubmed/18831228. Accessed 15 July 2017. PubMedPubMedCentral
Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371:243–60. https://doi.org/10.1016/S0140-6736(07)61690-0. CrossRefPubMed
Kessler RC. Epidemiology of women and depression. J Affect Disord. 2003;74:5–13. http://www.ncbi.nlm.nih.gov/pubmed/12646294. Accessed 15 July 2017. CrossRefPubMed
Husain N, Creed F, Tomenson B. Depression and social stress in Pakistan. Psychol Med. 2000;30:395–402. http://www.ncbi.nlm.nih.gov/pubmed/10824659. Accessed 15 July 2017. CrossRefPubMed
Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry. 2016;3:973–82. https://doi.org/10.1016/S2215-0366(16)30284-X. CrossRefPubMedPubMedCentral
WHO child growth standards and the identification of severe acute malnutrition in infants and children. http://apps.who.int/iris/bitstream/10665/44129/1/9789241598163_eng.pdf?ua=1. Accessed 15 July 2017.
Patel V, DeSouza N, Rodrigues M. Postnatal depression and infant growth and development in low income countries; a cohort study from Goa, India. Arch Dis Child. 2003;88(1):34–7.
Afzal S, Khalid R. Social Support and Postnatal Depression in Pakistani Context. Pakistan J Soc Clin Psychol. 2014;12(1):34–8. www.gcu.edu.pk/Fulltextjour/PJSCS/2014/5.sidra Afzal.pdf
Rahman A, Iqbal Z, Harrington R. Life events, social support and depression in childbirth: perspectives from a rural community in the developing world. Psychol Med. 2003;33:1161–7. http://www.ncbi.nlm.nih.gov/pubmed/14580070. Accessed 15 July 2017. CrossRefPubMed
The State of the world’s children 1998. 1998;16–9. https://www.unicef.org/sowc/archive/ENGLISH/The%20State%20of%20the%20World%27s%20Children%201998.pdf.
Anoop S, Saravanan B, Joseph A, Cherian A, Jacob KS. Maternal depression and low maternal intelligence as risk factors for malnutrition in children: a community based case-control study from South India. Arch Dis Child. 2004;89:325–9. http://www.ncbi.nlm.nih.gov/pubmed/15033840. Accessed 15 Jul 2017 CrossRefPubMedPubMedCentral
Rahman A, Creed F. Outcome of prenatal depression and risk factors associated with persistence in the first postnatal year: prospective study from Rawalpindi, Pakistan. J Affect Disord. 2007;100:115–21. https://doi.org/10.1016/j.jad.2006.10.004. CrossRefPubMedPubMedCentral
Hassan BK, Werneck GL, Hasselmann MH. Maternal mental health and nutritional status of six-month-old infants. Rev Saude Publica. 2016;50:7. https://doi.org/10.1590/S1518-8787.2016050006237. CrossRefPubMedPubMedCentral
Madise NJ, Matthews Z, Margetts B. Heterogeneity of child nutritional status between households: a comparison of six sub-saharan African countries. Popul Stud (NY). 53:331–43. https://doi.org/10.2307/2584703.
Gwatkin DR, Rutstein S, Johnson K, Suliman E, Wagstaff A, Amouzou A. Socio-economic differences in health, nutrition, and population within developing countries: an overview. https://siteresources.worldbank.org/INTPAH/Resources/IndicatorsOverview.pdf. Accessed 15 July 2017.
Owor M, Tumwine JK, Kikafunda JK. Socio-economic risk factors for severe protein energy malnutrition among children in Mulago hospital, Kampala. East Afr Med J. 2000;77:471–5. http://www.ncbi.nlm.nih.gov/pubmed/12862136. Accessed 15 July 2017. PubMed
Pongou R, Ezzati M, Salomon JA. Household and Community Socioeconomic and Environmental Determinants of Child Nutritional Status in Cameroon. 2006. https://doi.org/10.1186/1471-2458-6-98.
Adewuya AO, Ola BO, Aloba OO, Mapayi BM, Okeniyi JAO. Impact of postnatal depression on infants’ growth in Nigeria. J Affect Disord. 2008;108:191–3. https://doi.org/10.1016/j.jad.2007.09.013. CrossRefPubMed
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13. http://www.ncbi.nlm.nih.gov/pubmed/11556941. Accessed 15 July 2017 CrossRefPubMedPubMedCentral
Gelaye B, Williams MA, Lemma S, Deyessa N, Bahretibeb Y, Shibre T, et al. Validity of the patient health questionnaire-9 for depression screening and diagnosis in East Africa. Psychiatry Res. 2013;210:653–61. https://doi.org/10.1016/j.psychres.2013.07.015. CrossRefPubMed
Ross J, Hanlon C, Medhin G, Alem A, Tesfaye F, Worku B, et al. Perinatal mental distress and infant morbidity in Ethiopia: a cohort study. Arch Dis Child - Fetal Neonatal Ed. 2010;96:F59–64. https://doi.org/10.1136/adc.2010.183327.
Ejaz M, Sarwat A, Aisha T. Maternal psychiatric morbidity and childhood malnutrition. Pak J Med Sci. 2012;28:874–8. http://pjms.com.pk/index.php/pjms/article/viewFile/2747/942. Accessed 15 July 2017.
Rahman A, Lovel H, Bunn J, Iqbal Z, Harrington R. Mothers’ mental health and infant growth: a case-control study from Rawalpindi, Pakistan. Child Care Health Dev. 2004;30:21–7. https://doi.org/10.1111/j.1365-2214.2004.00382.x. CrossRefPubMed
Makoka D. The Impact of Maternal Education on Child Nutrition : Evidence from Malawi,Tanzania and Zimbabwe. DHS Work Pap. 2013;84:1–32. www.dhsprogram.com/pubs/pdf/WP84/WP84.pdf
Martins C, Gaffan EA. Effects of early maternal depression on patterns of infant-mother attachment: a meta-analytic investigation. J Child Psychol Psychiatry. 2000;41:737–46. http://www.ncbi.nlm.nih.gov/pubmed/11039686. Accessed 15 July 2017. CrossRefPubMed
Rahman A, Patel V, Maselko J, Kirkwood B. The neglected “m” in MCH programmes - why mental health of mothers is important for child nutrition. Trop Med Int Heal. 2008;13:579–83. https://doi.org/10.1111/j.1365-3156.2008.02036.x. CrossRef
Thinking healthy: A manual for psychosocial management of perinatal depression WHO generic field-trial version 1.0, 2015 Series on Low-Intensity Psychological Interventions – 1. http://apps.who.int/iris/bitstream/10665/152936/1/WHO_MSD_MER_15.1_eng.pdf?ua=1&ua=1. Accessed 15 July 2017.
- Maternal depression and child severe acute malnutrition: a case-control study from Kenya
M. W. Kuria
A. Vander Stoep
- BioMed Central
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