Maternal common mental disorders and infant development in Ethiopia : the P-MaMiE Birth Cohort

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dc.contributor.authorServili, Chiara
dc.contributor.authorMedhin, Girmay
dc.contributor.authorHanlon, Charlotte
dc.contributor.authorTomlinson, Mark
dc.contributor.authorWorku, Bogale
dc.contributor.authorBaheretibeb, Yonas
dc.contributor.authorDewey, Michael
dc.contributor.authorAlem, Atalay
dc.contributor.authorPrince, Martin
dc.date.accessioned2010-12-14T08:10:37Z
dc.date.available2010-12-14T08:10:37Z
dc.date.issued2010-11
dc.date.updated2010-12-01T07:05:03Z
dc.description.abstractBackground: Chronicity and severity of early exposure to maternal common mental disorders (CMD) has been associated with poorer infant development in high-income countries. In low- and middle-income countries (LAMICs), perinatal CMD is inconsistently associated with infant development, but the impact of severity and persistence has not been examined. Methods: A nested population-based cohort of 258 pregnant women was identified from the Perinatal Maternal Mental Disorder in Ethiopia (P-MaMiE) study, and 194 (75.2%) were successfully followed up until the infants were 12 months of age. Maternal CMD was measured in pregnancy and at two and 12 months postnatal using the WHO Self-Reporting Questionnaire, validated for use in this setting. Infant outcomes were evaluated using the Bayley Scales of Infant Development. Results: Antenatal maternal CMD symptoms were associated with poorer infant motor development ( β ^ -0.20; 95% CI: -0.37 to -0.03), but this became non-significant after adjusting for confounders. Postnatal CMD symptoms were not associated with any domain of infant development. There was evidence of a dose-response relationship between the number of time-points at which the mother had high levels of CMD symptoms (SRQ ≥ 6) and impaired infant motor development ( β ^ = -0.80; 95%CI -2.24, 0.65 for ante- or postnatal CMD only, β ^ = -4.19; 95%CI -8.60, 0.21 for ante- and postnatal CMD, compared to no CMD; test-for-trend χ213.08(1), p < 0.001). Although this association became non-significant in the fully adjusted model, the β ^ coefficients were unchanged indicating that the relationship was not confounded. In multivariable analyses, lower socio-economic status and lower infant weight-for-age were associated with significantly lower scores on both motor and cognitive developmental scales. Maternal experience of physical violence was significantly associated with impaired cognitive development. Conclusions: The study supports the hypothesis that it is the accumulation of risk exposures across time rather than early exposure to maternal CMD per se that is more likely to affect child development. Further investigation of the impact of chronicity of maternal CMD upon child development in LAMICs is indicated. In the Ethiopian setting, poverty, interpersonal violence and infant undernutrition should be targets for interventions to reduce the loss of child developmental potential.en_ZA
dc.description.versionPeer Reviewed
dc.format.extent12 p.
dc.identifier.citationServili, C, Medhin, G, Hanlon, C, Tomlinson, M, Worku, B, Baheretibeb, Y, Dewey, M, Alem, A & Prince, M 2010, 'Maternal common mental disorders and infant development in Ethiopia: the P-MaMiE Birth Cohort', BMC Public Health, 10(1):693.en_ZA
dc.identifier.issn1471-2458
dc.identifier.otherhttp://dx.doi.org/10.1186/1471-2458-10-693
dc.identifier.urihttp://hdl.handle.net/10019.1/5082
dc.language.isoen_ZAen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.rights.holderServili et al.; licensee BioMed Central Ltd.en_ZA
dc.subjectCommon mental disorders (CMD)en_ZA
dc.subjectInfant development -- Ethiopiaen_ZA
dc.subjectPerinatal Maternal Mental Disorder in Ethiopia (P-MaMiE)en_ZA
dc.subjectMothers -- Mental health -- Ethiopiaen_ZA
dc.subjectMother and infant -- Psychological aspects
dc.titleMaternal common mental disorders and infant development in Ethiopia : the P-MaMiE Birth Cohorten_ZA
dc.typeArticleen_ZA
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