Mothers of undernourished Jamaican children have poorer psychosocial functioning and this is associated with stimulation provided in the home

Abstract

Objectives: To compare mothers of undernourished children with mothers of adequately nourished children on maternal depression, parenting self-esteem, social support and exposure to stressors and to determine if these variables are independently related to undernutrition and stimulation provided in the home after controlling for socio-economic status. Design: A case control study. Setting: Children and their mothers were recruited from 18 government health centres in the Kingston, St Andrew and St Catherine parishes of Jamaica. Subjects: One hundred and thirty-nine mothers of undernourished children (WAZrÀ1.5z scores) aged 9 -30 months and 71 mothers of adequately nourished children (WAZ 4 À1z scores) matched for sex and age group were enrolled into the study. Results: Mothers of undernourished children came from poorer homes but had similar social support to mothers of adequately nourished children. They were more depressed, had lower levels of parenting self-esteem (both Po0.01), reported higher levels of economic stress (Po0.001) and provided a less stimulating home environment (Po0.05). However, after controlling for social background variables there was no independent relationship between either psychosocial function or home stimulation and nutritional status. Undernutrition was found to be mainly explained by economic factors. The mothers' self-esteem was independently associated with the level of stimulation provided to the child. Conclusions: When caring for undernourished children attention should be paid to the psychosocial status of the mother as well as the physical condition of the child.

‘It's leaflet, leaflet, leaflet then, “see you later”’: black Caribbean women's perceptions of perinatal mental health care

“…Increasing evidence of the deleterious consequences of perinatal depression for women's life-long mental health as well as the physical, cognitive, emotional, and psychological development and wellbeing of their children suggests that this is a serious omission. 12,13 A policy focus on reducing health inequalities, 14 improving access to psychological therapy in primary care, 15 delivering race equality in mental health care, 16 and improving the psychosocial wellbeing of mothers and their children 17 suggests that research into the perinatal mental health of women in underserved communities is both necessary and timely.…”

Maternal depression and early childhood growth in developing countries: systematic review and meta-analysis

“…23,24,[29][30][31][32][33][34][36][37][38][39] Meta-analysis of these studies showed that the relationship between maternal depression and underweight (OR: 1.5; 95% CI: 1.2-1.8) remained similar to that in the meta-analysis of all studies and the heterogeneity persisted (Q = 37.83, P = 0.001). When the meta-analysis was restricted to the nine studies that used measures of depression or depressive symptoms, 24,25,29,31,[33][34][35]38,39 the relationship between maternal depression and underweight strengthened and remained statistically significant (OR: 1.7; 95% CI: 1.2-2.4), and the findings remained heterogeneous (Q = 18.70; P = 0.017). Finally, when the meta-analysis was restricted to the four longitudinal cohort studies, 31,33,35,38 the relationship strengthened further (OR: 2.2; 95% CI: 1.5-3.2) and high homogeneity was noted (Q: 2.47; P = 0.48).…”

“…1), [23][24][25][29][30][31][32][33][34][35][36][37][38][39] covering a combined study population of 13 923 mother and child pairs. The pooled data showed a moderate, statistically significant relationship between maternal depression and underweight (OR: 1.5; 95% confidence interval, CI: 1.2-1.8).…”

“…However, three studies reported outcomes as continuous variables. [23][24][25] We converted data from the first of these three studies to ORs using Comprehensive Meta-Analysis V2.2 software (Biostat Inc., Englewood, United States of America). For the other two studies, the original authors either re-analysed the primary data to generate ORs or provided data for us to calculate them.…”

Malnutrition in the second year of life and psychosocial care: a case-control study in an urban area of Southeast Brazil

“…The most similar study to the present one was conducted in Jamaica 22 . The authors also compared cases (children with mild to moderate malnutrition) and controls to investigate the role of various maternal and family characteristics -self-esteem, depression, social support, quality of the psychosocial environment (measured by the HOME inventory 15 ) and exposure to stress factors -in the determination of the child's nutritional status, conducting uni-and multivariate logistic regression and including socioeconomic factors in the analyses.…”