The Effect of Early Stimulation on Maternal Depression: a Cluster Randomised Controlled Trial

Overview

Journal Arch Dis Child

Specialty Pediatrics

Date 2005 Sep 15

PMID 16159905

Citations 35

Authors

H Baker-Henningham

C Powell

S Walker

S Grantham-McGregor

Affiliations

Soon will be listed here.

Abstract

Aim: To determine the effect of early childhood stimulation with undernourished children and their mothers on maternal depression.

Methods: Mothers of 139 undernourished children (weight for age < or =-1.5 z-scores) aged 9-30 months were recruited from 18 government health centres in the parishes of Kingston, St Andrew, and St Catherine, Jamaica. They received weekly home visits by community health aides for one year. Mothers were shown play activities to do with their child using home made materials, and parenting issues were discussed. Frequency of maternal depressive symptoms was assessed by questionnaire. Child development was also measured.

Results: Mothers in the intervention group reported a significant reduction in the frequency of depressive symptoms (b = -0.98; 95% CI -1.53 to -0.41). The change was equivalent to 0.43 SD. The number of home visits achieved ranged from 5 to 48. Mothers receiving > or =40 visits and mothers receiving 25-39 visits benefited significantly from the intervention (b = -1.84, 95% CI -2.97 to -0.72, and b = -1.06, 95% CI -2.02 to -0.11, respectively) while mothers receiving <25 visits did not benefit. At follow up, maternal depression was significantly negatively correlated with children's developmental quotient for boys only.

Conclusions: A home visiting intervention with mothers of undernourished children, with a primary aim of improving child development, had significant benefits for maternal depression. Higher levels of maternal depression were associated with poorer developmental levels for boys only.

Citing Articles

Parenting with nutrition education and unconditional cash reduce maternal depressive symptoms and improve quality of life: findings from a cluster randomised controlled trial in urban Bangladesh.

Hossain S, Tofail F, Rahman A, Fisher J, Hamadani J, Rahman S Glob Health Action. 2024; 17(1):2426784.

PMID: 39560615 PMC: 11578405. DOI: 10.1080/16549716.2024.2426784.

Child play and caregiver support to promote convalescence following severe acute malnutrition in Zimbabwe: The Tamba-SAM pilot study.

Kabongo J, Mudawarima L, Majo F, Dzikiti A, Tome J, Chasekwa B Matern Child Nutr. 2024; 21(1):e13726.

PMID: 39267583 PMC: 11650049. DOI: 10.1111/mcn.13726.

Associations between Difficulty in Accessing Maternal and Child Health Services and Stress Responses among Mothers Raising Young Children during the COVID-19 Pandemic in Japan.

Toyama N, Hokama C, Takahara M, Toyama Y Nurs Rep. 2024; 14(1):506-515.

PMID: 38535711 PMC: 10975029. DOI: 10.3390/nursrep14010039.

Comparing the effectiveness of mother-focused interventions to that of mother-child focused interventions in improving maternal postpartum depression outcomes: A systematic review.

Kumar D, Hameed W, Avan B PLoS One. 2023; 18(12):e0295955.

PMID: 38117801 PMC: 10732407. DOI: 10.1371/journal.pone.0295955.

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries.

Purgato M, Prina E, Ceccarelli C, Cadorin C, Abdulmalik J, Amaddeo F Cochrane Database Syst Rev. 2023; 10:CD014722.

PMID: 37873968 PMC: 10594594. DOI: 10.1002/14651858.CD014722.pub2.

References

Lovejoy M, Graczyk P, OHare E, Neuman G . Maternal depression and parenting behavior: a meta-analytic review. Clin Psychol Rev. 2000; 20(5):561-92. DOI: 10.1016/s0272-7358(98)00100-7. View

Duggan A, McFarlane E, Windham A, Rohde C, Salkever D, Fuddy L . Evaluation of Hawaii's Healthy Start Program. Future Child. 1999; 9(1):66-90; discussion 177-8. View

Petterson S, Albers A . Effects of poverty and maternal depression on early child development. Child Dev. 2002; 72(6):1794-813. DOI: 10.1111/1467-8624.00379. View

Cooper P, Landman M, Tomlinson M, Molteno C, Swartz L, Murray L . Impact of a mother-infant intervention in an indigent peri-urban South African context: pilot study. Br J Psychiatry. 2002; 180:76-81. DOI: 10.1192/bjp.180.1.76. View

Patel V, DeSouza N, Rodrigues M . Postnatal depression and infant growth and development in low income countries: a cohort study from Goa, India. Arch Dis Child. 2002; 88(1):34-7. PMC: 1719257. DOI: 10.1136/adc.88.1.34. View

Baker-Henningham H, Powell C, Walker S, Grantham-McGregor S . Mothers of undernourished Jamaican children have poorer psychosocial functioning and this is associated with stimulation provided in the home. Eur J Clin Nutr. 2003; 57(6):786-92. DOI: 10.1038/sj.ejcn.1601611. View

Anoop S, Saravanan B, Joseph A, Cherian A, Jacob K . Maternal depression and low maternal intelligence as risk factors for malnutrition in children: a community based case-control study from South India. Arch Dis Child. 2004; 89(4):325-9. PMC: 1719856. DOI: 10.1136/adc.2002.009738. View

Powell C, Baker-Henningham H, Walker S, Gernay J, Grantham-McGregor S . Feasibility of integrating early stimulation into primary care for undernourished Jamaican children: cluster randomised controlled trial. BMJ. 2004; 329(7457):89. PMC: 449816. DOI: 10.1136/bmj.38132.503472.7C. View

Rauh V, Achenbach T, NURCOMBE B, Howell C, Teti D . Minimizing adverse effects of low birthweight: four-year results of an early intervention program. Child Dev. 1988; 59(3):544-53. View

10.

Osofsky J, Culp A, WARE L . Intervention challenges with adolescent mothers and their infants. Psychiatry. 1988; 51(3):236-41. DOI: 10.1080/00332747.1988.11024397. View

11.

Powell C, Grantham-McGregor S . Home visiting of varying frequency and child development. Pediatrics. 1989; 84(1):157-64. View

12.

Johnson Z, Howell F, Molloy B . Community mothers' programme: randomised controlled trial of non-professional intervention in parenting. BMJ. 1993; 306(6890):1449-52. PMC: 1677859. DOI: 10.1136/bmj.306.6890.1449. View

13.

Grantham-McGregor S, Powell C, Walker S, Chang S, Fletcher P . The long-term follow-up of severely malnourished children who participated in an intervention program. Child Dev. 1994; 65(2 Spec No):428-39. View

14.

Sharp D, Hay D, Pawlby S, Schmucker G, Allen H, Kumar R . The impact of postnatal depression on boys' intellectual development. J Child Psychol Psychiatry. 1995; 36(8):1315-36. DOI: 10.1111/j.1469-7610.1995.tb01666.x. View

15.

Kitzman H, Olds D, Henderson Jr C, HANKS C, Cole R, Tatelbaum R . Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. A randomized controlled trial. JAMA. 1997; 278(8):644-52. View

16.

Beck C . Maternal depression and child behaviour problems: a meta-analysis. J Adv Nurs. 1999; 29(3):623-9. DOI: 10.1046/j.1365-2648.1999.00943.x. View

17.

Klebanov P, Brooks-Gunn J, McCormick M . Maternal coping strategies and emotional distress: results of an early intervention program for low birth weight young children. Dev Psychol. 2001; 37(5):654-67. View