Perinatal depression has been found to be a strong and independent risk factor for poor child growth and development in low-income South Asian populations. The authors aimed to study if there was a similar association in first and second-generation British women of Pakistani origin.
A prospective cohort study.
The study was conducted in the North-West of England, in areas with high density of Pakistani-origin population. The subjects were recruited from Central Manchester Hospital in the City of Manchester and East Lancashire Hospital in Lancashire.
704 physically healthy women were assessed in two phases (screening and detailed assessment of high scorers and a proportion of low scorers) during the third trimester of pregnancy to obtain at birth a cohort of 63 infants of depressed mothers and 173 infants of psychologically well mothers.
Primary and secondary outcome measures
All infants were weighed and measured at birth and 6 months, and their development was assessed using the Bayley Scales of Infant Development–Third Edition.
There was no difference in the birth weight or weight and height at 6 months of infants of depressed mothers versus infants of psychologically well mothers. The only significant difference between the two groups was in the infants' adaptive behaviour; infants of depressed mothers scored significantly lower than those of psychologically well mothers (mean difference 4.6, t=2.81, df 195, p=0.006). The associations remained significant after adjustment for socio-demographic factors by multivariate analyses.
Prenatal depression is not associated with impaired growth in this sample of British Pakistani women. There is, however, an association of prenatal depression with parent-reported problems in the infants' adaptive behaviour. Further research is needed to understand various pathways through which maternal depression affects infant outcomes in low- and high-income settings.
In South Asian countries, maternal depression has been identified as a strong risk factor for undernutrition and stunted growth in infants.
Maternal depression has also been associated with insecure attachment styles and deficiencies in cognitive development.
In a longitudinal cohort design, this article examines the potential association between prenatal maternal depression and infant development, in a sample of British women of Pakistani origin.
The present sample of British Pakistani women show lower rates of depression as compared with the women living in Pakistan.
Prenatal depression was not found to be associated with infant undernutrition or stunted growth. On the other hand, there was a significant association between prenatal depression and the infant's adaptive behaviour, as measured by Bayley Scales of Infant Development–Third Edition.
Strengths and limitations of this study
The longitudinal prospective cohort design employed in this study was well suited to address the research question. Engaging the prospective sample through culturally appropriate channels and informants helped to achieve high follow-up rates.
Due to resource and time limitations, the required sample size for the group of depressed women could not be achieved.