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PEDIATRICS Vol. 113 No. 5 May 2004, pp. 1242-1247

Postnatal Depression and Faltering Growth: A Community Study

Louise Margaret O’Brien, PhD*, Elizabeth Gardner Heycock, MBChB*, Mariam Hanna, MBChB{ddagger}, Peter Watts Jones, PhD§ and John Lee Cox, MD, MBChB{ddagger}

* Academic Department of Paediatrics, North Staffordshire Hospital, Stoke on Trent, United Kingdom
{ddagger} Academic Department of Psychiatry, North Staffordshire Hospital, Stoke on Trent, United Kingdom
§ Department of Mathematics, Keele University, Keele, Staffordshire, United Kingdom

Objective. To investigate the association between faltering growth in children and maternal postnatal depression.

Methods. Children aged ≤2 years were identified from community child health surveillance records if their weights fell across 2 centile channels on standardized growth charts or fell below the second centile. Mothers of these index children were invited to complete the Edinburgh Postnatal Depression Scale and the anxiety subscale of the Hospital Anxiety and Depression Scale. Those who scored above threshold values on either scale were interviewed with the revised Clinical Interview Schedule. Matched control children were obtained from health visitor records, and records of their weights were obtained. Mothers of control children completed the same questionnaires.

Results. A total of 196 index children and 567 control children were studied. Significantly more mothers in the index group scored above the threshold for both the Edinburgh Postnatal Depression Scale (33% vs 22%; odds ratio [OR]: 1.71; 95% confidence interval [CI]: 1.16-2.53) and the Hospital Anxiety and Depression Scale (24% vs 13%; OR: 2.08; 95% CI: 1.33-3.25) questionnaires. Furthermore, clinical interviews with these mothers demonstrated that 21% of the index group and 11% of the control group fulfilled criteria for depressive episode (OR: 1.88; 95% CI: 1.21-2.94).

Conclusions. Depression in mothers of children with faltering growth during the first 2 years of life is significantly greater than in mothers of children who are gaining weight appropriately. In view of the high rates of maternal depression in children with poor weight gain, clinical management at presentation of either problem should focus on both members of the mother–child dyad and on the interaction between mother and child. These findings have implications for all professionals who work in primary and secondary health care.

Key Words: postnatal depression • faltering growth • failure to thrive

Abbreviations: FTT, failure to thrive • PND, postnatal depression • EPDS, Edinburgh Postnatal Depression Scale • HADS, Hospital Anxiety and Depression Scale • CIS-R, Revised Clinical Interview Schedule • OR, odds ratios • CI, confidence interval

Received for publication Feb 24, 2003; Accepted Jul 7, 2003.




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