Effects of Maternal Suicidal Ideation on Child Cognitive Development: A Longitudinal Analysis

Abstract

This study aimed to assess the association between suicidal ideation among mothers living with HIV in Zimbabwe and the cognitive development of their children. Participants were mother-child dyads recruited from two rural districts in Zimbabwe. Data were collected at baseline and 12 months follow-up. Suicidal ideation was assessed using item-10 from the Edinburgh postnatal depression scale. Mixed-effects linear regression was used to assess the association of child cognitive outcomes at follow-up (using the Mullen scales of early learning) with maternal suicidal ideation. Mothers with suicidal ideation at baseline (n = 171) tended to be younger, unmarried, experienced moderate to severe hunger, had elevated parental stress and depression symptoms compared with non-suicidal mothers (n = 391). At follow-up, emerging maternal suicidal ideation was associated with poorer child cognitive outcomes (adjusted mean difference − 6.1; 95% CI − 10.3 to − 1.8; p = 0.03). Suicidal ideation affects child cognitive development and should be addressed, particularly in HIV positive mothers.

Review of suicidal ideation during pregnancy: risk factors, prevalence, assessment instruments and consequences

“…Having a major depressive episode, an anxiety disorder or a previous suicide attempt throughout life are also risk factors (Onah et al, 2017 ). Mebrahtu et al ( 2020 ) also identified high stress and symptoms of depression as risk factors. Pregnant women with insomnia and high rumination have higher rates of suicidal ideation than the general population (Kalmbach et al, 2020 ).…”

“…Musyimi et al ( 2020 ) also identified low economic status and intimate partner violence as consistently associated factors. Women who reported suicidal ideation tend to be young, single and experienced hunger (Mebrahtu et al, 2020 ). The religious belief that premarital sex is wrong is also related to a high risk of suicidal ideation (Chan et al, 2016 ).…”

“…Researchers used either item 10 of the Edinburgh Postnatal Depression Scale (EPDS) (Mebrahtu et al, 2020 ; Tabb et al, 2019 ) or item 9 of the Patient Health Questionnaire (PHQ-9; Gelaye et al, 2017 , 2019 ; Zhang et al, 2020 ; Zhong, Wells, et al, 2016 ) to detect suicidal ideation in pregnant women.…”

“…Scientific reasoning Item 6. Appropriate presentation of data Kalmbach et al, 2020 2 2 0 2 2 1 High (9) Tabb et al, 2019 1 2 0 1 2 2 Medium (8) Rodriguez et al, 2018 1 1 0 1 2 2 Medium (7) Zhang et al, 2020 2 1 1 1 1 2 Medium (8) O'Connor et al, 2018 1 2 2 2 1 1 High (9) Levey et al, 2019 1 1 0 1 2 1 Medium (6) Gelaye et al, 2016 2 2 2 1 1 2 High (10) Onah et al, 2017 1 2 1 1 2 1 Medium (8) Mebrahtu et al, 2020 2 1 1 1 1 1 Medium (7) Rodriguez et al, 2017 1 1 1 1 1 1 Medium (6) Chan et al, 2016 1 2 ...…”

Maternal Suicide Ideation and Behaviour During Pregnancy and the First Postpartum Year: A Systematic Review of Psychological and Psychosocial Risk Factors

“…Suicide prevention and risk reduction should be key intervention targets since maternal death by suicide has a profound effect on the woman’s child(ren), including loss of a primary care giver, feelings of separation and abandonment ( 8 ), increased rate of depressive symptoms ( 9 ), increased risk of bipolar disorder ( 10 ), and an increased risk of death by suicide themselves ( 11 ). Furthermore, maternal suicidal ideation alone has been associated with poorer child cognitive outcomes, including motor skills and language development ( 12 ).…”