Disability due to maternal common mental disorders (CMDs) as a risk factor for chronic childhood malnutrition
cross-sectional study
Keywords:
Child nutrition disorders, Disability evaluation, Mental health, Maternal health services, PovertyAbstract
CONTEXT AND OBJECTIVE: The disability associated with maternal common mental disorders (CMDs) is among the possible explanations for the association between chronic childhood malnutrition and CMDs. CMDs may impair the mother’s ability to perform her role, particularly in deprived environments. The present study aimed to evaluate whether disability relating to CMDs could be part of the pathway of the association between childhood malnutrition and maternal CMDs. DESIGN AND SETTING: Cross-sectional study conducted in two institutions: one for malnourished children and another for eutrophic children living in a low-income community in the state of Alagoas, Brazil. METHOD: The cases consisted of 55 malnourished children aged from 12 to 60 months who were attending a nutritional rehabilitation center, with height-for-age z-scores < 2. The controls were 70 eutrophic children of the same age who were attending a day care center in the same area as the cases. The SelfReport Questionnaire made it possible to identify likely cases of maternal CMD. The Sheehan Disability Scale enabled evaluation of the associated disability. RESULTS: Chronic childhood malnutrition was significantly associated with maternal disability relating to CMDs (OR = 2.28; 95% CI: 1.02-5.1). The best logistic regression model using chronic childhood malnutrition as the dependent variable included the following independent variables: higher number of people living in the household; absence of the biological father from the household; and maternal disability relating to CMDs. CONCLUSIONS: If confirmed, the association between chronic childhood malnutrition and maternal disability relating to CMDs may be useful in helping to identify the causal chain between childhood malnutrition and maternal CMDs and to indicate environmental risk factors associated with chronic childhood malnutrition.
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References
Surkan PJ, Kennedy CE, Hurley KM, Black MM. Maternal depression and early childhood growth in developing countries: systematic review and meta-analysis. Bull World Health Organ. 2011;89(8):607-15.
Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R. Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry. 2004;61(9):946-52.
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.
de Miranda CT, Turecki G, Mari Jde J, et al. Mental health of the mothers of malnourished children. Int J Epidemiol. 1996;25(1):128-33.
Rahman A, Lovel H, Bunn J, Iqbal Z, Harrington J. Mothers’ mental health and infant growth: a case-control study from Rawalpindi, Pakistan. Child Care Health Dev. 2004;30(1):21-7.
Santos DS, Santos DN, Silva Rde C, Hasselmann MH, Barreto ML. Maternal common mental disorders and malnutrition in children: a case-control study. Soc Psychiatry Psychiatr Epidemiol. 2011;46(7):543-8.
Surkan PJ, Kawachi I, Ryan LM, et al. Maternal depressive symptoms, parenting self-efficacy, and child growth. Am J Public Health. 2008;98(1):125-32.
Carvalhaes MA, Benício MH. Desnutrição no segundo ano de vida e cuidado psicossocial: estudo caso-controle em área urbana do Sudeste brasileiro [Malnutrition in the second year of life and psychosocial care: a case-control study in an urban area of Southeast Brazil]. Cad Saude Publica. 2006;22(11):2311-8.
World Health Organization. World report on disability. Geneva: World Health Organization; 2011. Available from: http://www.who.int/disabilities/world_report/2011/report.pdf. Accessed in 2016 (Feb 15).
Ormel J, VonKorff M, Ustun TB, et al. Common mental disorders and disability across cultures. Results from the WHO Collaborative Study on Psychological Problems in General Health Care. JAMA. 1994;272(22):1741-8.
Miranda CT, Paula CS, Santos L, et al. Association between mother- child interaction and mental health among mothers of malnourished children. J Trop Pediatr. 2000;46(5):314.
World Health Organization. Child growth standards. WHO Anthro (version 3.2.2, January 2011) and macros. Available from: http://www.who.int/childgrowth/software/en/. Accessed in 2016 (Feb 15).
Mari JJ, Williams P. A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of Sao Paulo. Br J Psychiatry. 1986;148(:23-6.
Sheehan DV, Harnnet-Sheehan K, Raj BA. The measurement of disability. Int Clin Psychopharmacol. 1996;11 Suppl 3:89-95.
Associação Brasileira de Empresas de Pesquisa. Critério de Classificação Econômica Brasil (CCEB 2003 – Base LSE 2000). Associação Brasileira de Empresas de Pesquisa; 2003. Available from: http://www.abep.org/criterio-brasil. Accessed in 2016 (Feb 15).
Almeida-Filho N, Lessa I, Magalhães L, et al. Social inequality and depressive disorders in Bahia, Brazil: interactions of gender, ethnicity, and social class. Soc Sci Med. 2004;59(7):1339-53.
Parsons CE, Young KS, Rochat TJ, Kringelbach ML, Stein A. Postnatal depression and its effects on child development: a review of evidence from low-and middle-income countries. Br Med Bull. 2012;101:57-79.
Harpham T, Huttly S, De Silva MJ, Abramsky T. Maternal mental health and child nutritional status in four developing countries. J Epidemiol Community Health. 2005;59(12):1060-4.
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(1):21-7.
Shah SM, Selwyn BJ, Luby S, Merchant A, Bano R. Prevalence and correlates of stunting among children in rural Pakistan. Pediatr Int. 2003;45(1):49-53.
Sandoval-Priego AA, Reyes-Morales H, Pérez-Cuevas R, Abrego-Blas R, Orrico-Torres ES. Estrategias familiares de vida y su relación con desnutrición en niños menores de dos años [Family life strategies associated with malnutrition in children aged under two years]. Salud Publica Mex. 2002;44(1):41-9.
de B L Carvalhaes MA, D’Aquino Benício MH, Barros, AJ. Social support and infant malnutrition: a case-control study in an urban area of Southeastern Brazil. Br J Nutr. 2005;94(3):383-9.
Carlson GJ, Kordas K, Murray-Kolb LE. Associations between women’s autonomy and child nutritional status: a review of the literature. Matern Child Nutr. 2015;11(4):452-82.
