Maternal postpartum depression and infant social withdrawal among human immunodeficiency virus (HIV) positive mother–infant dyads

Abstract

Maternal postpartum depression poses significant risks for mother-child interaction and long-term infant outcomes. Human immunodeficiency virus (HIV) status has also been implicated in the development of postpartum depression, but the association between maternal depression and infant social behavior in the context of HIV infection has not been fully investigated. First, we examined the relationship between maternal postpartum depression and infant social withdrawal at 10-12 months of age in HIV-infected mothers and infants. Second, we ascertained whether infant social withdrawal could be significantly predicted by maternal postpartum depression. The sample consisted of 83 HIV-infected mother-infant dyads. Mothers were assessed for postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS), and infant social withdrawal behavior was rated using the Modified Alarm Distress Baby Scale (m-ADBB). 42.2% of the mothers scored above the cut-off point for depression on the EPDS, and a third of infants (31%) were socially withdrawn. Notably, maternal depression did not predict infant social withdrawal as measured by the m-ADBB. Infant social withdrawal was also not significantly associated with failure to thrive or gender. These preliminary findings need further investigation with respect to the impact on long-term neurodevelopmental and behavioral outcomes.

Prevalence of postnatal depression and associated factors among HIV-positive women in primary care in Nkangala district, South Africa

“…Alcohol use in the current study was not associated with depressed mood in multivariate analysis, although it reached significance in the bivariate analysis. This concurs with the results of Hartley et al 5 Other factors that were significantly associated with a depressed mood in the current study in bivariate analysis included having an HIV-positive partner and inconsistent condom use with the primary partner. This seems to indicate that partner dynamics may influence the wellbeing of HIVinfected mothers.…”

“…Overall, 45.1% of women reported depressed mood in the postnatal period in the present study compared with 42.2% found in the study conducted by Hartley et al 5 in Cape Town and 54% meeting DSM-IV criteria for depression among urban primary clinic attendees in Zimbabwe. 28 The study found that the strongest predictors of depressed mood among postnatal women were having had an STI in the past 12 months, internalised stigma, discrimination experiences and lack of social support.…”

“…In the multivariate analysis, lack of social support remained significantly associated with depressed mood, and this finding concurs with other studies. 5,14,31,32 Having an unintended unplanned pregnancy, the infant being HIV positive and preterm delivery were not associated with a depressed mood in the current study. Tomlinson et al 33 also found that having an unintended pregnancy was associated with a depressed mood.…”

“…25 The present study uses the threshold of 14 as a basis for interpretation. 5 Cronbach's alpha for EPDS in this sample was 0.84. hiV/AidS discrimination experiences. To assess AIDS-related discrimination, we asked participants if they had experienced seven discrimination-related events.…”

“…In a study conducted in an urban setting in South Africa, maternal postpartum depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) among 83 HIV-infected mother infant dyads and 42.2% of the women scored above the cut-off point for depression. 5 HIV-infected mothers are at high risk for a range of emotional and psychiatric problems that may impact on immunity and HIV disease progression. 4,[6][7][8] Preterm delivery 9 and difficulties with partners 10 have been found to be associated with postpartum depression.…”