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ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD (MMB); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (AHB and REB); and the International Center Diarrheal Disease Research, Bangladesh (AHB, KZ, and SEA). 2 Presented at the symposium "Maternal and Child Mental Health: Role of Nutrition," held at Experimental Biology 2008, San Diego, CA, 8 April 2008. 3 Supported by the US Agency for International Development (USAID), Nutricia Foundation, National Institute of Child Health and Human Development (NICHD). 4 Reprints not available. Address correspondence to MM Black, Department of Pediatrics, University of Maryland, 737 West Lombard Street, Room 161, Baltimore, MD 21201. E-mail: mblack{at}peds.umaryland.edu.
Background: Depressive disorders are a major source of disability among low-income mothers in developing countries.
Objectives: The objectives were to examine the association of maternal depressive symptoms and infant growth among infants in rural Bangladesh and to examine how the relation is affected by infant irritability and caregiving practices.
Design: Infant growth was measured among 221 infants at 6 and 12 mo. Mothers reported their depressive symptoms and perceptions of their infant's temperament, and a home observation of caregiving was conducted.
Results: At 6 mo, 18% of infants were stunted (length-for-age <–2 z scores). At 12 mo, 36.9% of infants were stunted; infants of mothers with depressive symptoms had a 2.17 higher odds of being stunted (95% CI: 1.24, 3.81; P = 0.007) than did infants of mothers with few symptoms (45.3% compared with 27.6%). In a multivariate regression analysis, maternal depressive symptoms were associated with 12-mo length-for-age, adjusted for 6-mo length-for-age, maternal education, infant sex, birth order, receipt of iron and zinc, months breastfed, maternal perception of infant temperament, and caregiving observations. Maternal depressive symptoms were not related to 12-mo weight-for-length. The relation between depressive symptoms and infant growth was not moderated by maternal perceptions of infant temperament, but was partially mediated by caregiving.
Conclusions: The finding that infants of mothers with depressive symptoms in Bangladesh experience poor linear growth may extend to other low-income countries with high rates of food insecurity. Interventions to promote growth in infants should include prevention or treatment of maternal depressive disorders and strategies to ensure adequate food security.
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