CoChat
Sign Up
Cited by 4Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareInfant Development and Preterm Care

Maternal perinatal depression and health services utilisation in the first 2 years of life: a cohort study

Open access
Adler, Limor, Azuri, Joseph·2021·BMJ Open
DOI 10.1136/bmjopen-2021-052873PMC PMC8578984
Open this paper in CoChat — free accountOpen PDF

Abstract

Objectives: Maternal perinatal depression is a common phenomenon, influencing infants’ development. Studies have shown an inconsistent association between perinatal depression and healthcare resource utilisation. This study aimed to assess whether perinatal depression in mothers is associated with their infants’ healthcare utilisation, during the first 2 years of life. Design: A cohort study based on computerised medical records. Setting: Nationwide primary care clinics in the second largest health maintenance organisation in Israel. Participants: 593 children of women with depression (the exposed group) and 2310 children of women without depression. Primary and secondary outcome measures: Primary outcome variables included general practitioner/paediatrician (GP/Paed) visits (regular and telehealth), emergency room (ER) visits, hospital admission rates and child-development clinic visits. Secondary outcomes included antibiotic use and anaemia status. The exposure variable, perinatal depression, was based on Edinburgh Postnatal Depression Scale. A score of ≥10 was classified as depression. Results: Multivariable analysis of the number of regular visits and telehealth to the GP/Paed showed an adjusted incidence rate ratio (aIRR) of 1.08, 95% CI 1.03 to 1.13 and aIRR 0.95, 95% CI 0.82 to 1.10, respectively. Children of mothers with perinatal depression had more hospital admissions (aIRR 1.21, 95% CI 1.01 to 1.46) and more visits to child development clinics (aIRR 1.33, 95% CI 1.04 to 1.70). There was a non-significant increase in ER visits (IRR 1.26, 95% CI 0.66 to 2.42), and non-significant decrease in antibiotics prescriptions (IRR 0.95, 95% CI 0.86 to 1.05) and anaemia status (IRR 0.93, 95% CI 0.72 to 1.20). Conclusion: This study shows higher health services utilisation among children of mothers with perinatal depression, including regular GP/Paed visits, hospital admission rates, and child-development clinics.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/bmjopen-2021-052873

Cites

5 of 5 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 25

  1. [1]Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and health predictors of national postpartum depression prevalence: a systematic review, meta-analysis, and meta-regression of 291 studies from 56 countries. Front Psychiatry 2017; 8: 248. 10.3389/fpsyt.2017.00248 29449816 PMC5799244 · DOI · Paper page
  2. [3]Walker LO, Murphey CL, Nichols F. The broken thread of health promotion and disease prevention for women during the postpartum period. J Perinat Educ 2015; 24: 81– 92. 10.1891/1058-1243.24.2.81 26957891 PMC4744339 · DOI
  3. [4]Nonnenmacher N, Noe D, Ehrenthal JC, et al. Postpartum bonding: the impact of maternal depression and adult attachment style. Arch Womens Ment Health 2016; 19: 927– 35. 10.1007/s00737-016-0648-y 27296356 · DOI
  4. [5]Alhusen JL. A literature update on maternal-fetal attachment. J Obstet Gynecol Neonatal Nurs 2008; 37: 315– 28. 10.1111/j.1552-6909.2008.00241.x PMC3027206 18507602 · DOI
  5. [6]Beck CT. The effects of postpartum depression on child development: a meta-analysis. Arch Psychiatr Nurs 1998; 12: 12– 20. 10.1016/S0883-9417(98)80004-6 9489170 · DOI · Paper page
  6. [7]Murray L, Arteche A, Fearon P, et al. The effects of maternal postnatal depression and child sex on academic performance at age 16 years: a developmental approach. J Child Psychol Psychiatry 2010; 51: 1150– 9. 10.1111/j.1469-7610.2010.02259.x 20840504 · DOI
  7. [8]Sutter-Dallay AL, Murray L, Dequae-Merchadou L, et al. A prospective longitudinal study of the impact of early postnatal vs. chronic maternal depressive symptoms on child development. Eur Psychiatry 2011; 26: 484– 9. 10.1016/j.eurpsy.2010.05.004 20621453 · DOI · Paper page
  8. [10]Stein A, Pearson RM, Goodman SH, et al. Effects of perinatal mental disorders on the fetus and child. Lancet 2014; 384: 1800– 19. 10.1016/S0140-6736(14)61277-0 25455250 · DOI · Paper page
  9. [11]Quevedo LA, Silva RA, Godoy R, et al. The impact of maternal post-partum depression on the language development of children at 12 months. Child Care Health Dev 2012; 38: 420– 4. 10.1111/j.1365-2214.2011.01251.x 21651606 · DOI · Paper page
  10. [12]Hay DF, Pawlby S, Sharp D, et al. Intellectual problems shown by 11-year-old children whose mothers had postnatal depression. J Child Psychol Psychiatry 2001; 42: 871– 89. 10.1111/1469-7610.00784 11693583 · DOI
  11. [13]Sills MR, Shetterly S, Xu S, et al. Association between parental depression and children’s health care use. Pediatrics 2007; 119: e829– 36. 10.1542/peds.2006-2399 17403826 · DOI
  12. [14]Dreyer K, Williamson RAP, Hargreaves DS, et al. Associations between parental mental health and other family factors and healthcare utilisation among children and young people: a retrospective, cross-sectional study of linked healthcare data. BMJ Paediatr Open 2018; 2: e000266. 10.1136/bmjpo-2018-000266 PMC6069921 30094348 · DOI
  13. [15]Lyngsøe BK, Rytter D, Munk-Olsen T, et al. Maternal depression and primary healthcare use for children: a population-based cohort study in Denmark. Br J Gen Pract 2019; 69: e182– 9. 10.3399/bjgp18X700733 30559112 PMC6400607 · DOI
  14. [17]Mandl KD, Tronick EZ, Brennan TA, et al. Infant health care use and maternal depression. Arch Pediatr Adolesc Med 1999; 153: 808– 13. 10.1001/archpedi.153.8.808 10437752 · DOI
  15. [18]Minkovitz CS, Strobino D, Scharfstein D, et al. Maternal depressive symptoms and children’s receipt of health care in the first 3 years of life. Pediatrics 2005; 115: 306– 14. 10.1542/peds.2004-0341 15687437 · DOI
  16. [19]Eilat-Tsanani S, Merom A, Romano S, et al. The effect of postpartum depression on women’s consultations with physicians. Isr Med Assoc J 2006; 8: 406– 10. 16833170
  17. [20]Farr SL, Dietz PM, Rizzo JH, et al. Health care utilisation in the first year of life among infants of mothers with perinatal depression or anxiety. Paediatr Perinat Epidemiol 2013; 27: 81– 8. 10.1111/ppe.12012 23215715 PMC4399813 · DOI
  18. [21]Moore Simas TA, Huang M-Y, Packnett ER, et al. Matched cohort study of healthcare resource utilization and costs in young children of mothers with postpartum depression in the United States. J Med Econ 2020; 23: 174– 83. 10.1080/13696998.2019.1679157 31597499 · DOI
  19. [23]Anderson LN, Campbell MK, daSilva O, et al. Effect of maternal depression and anxiety on use of health services for infants. Can Fam Physician 2008; 54: 1718– 9. 19074718 PMC2602631
  20. [24]Ververs TF, van Wensen K, Freund MW, et al. Association between antidepressant drug use during pregnancy and child healthcare utilisation. BJOG 2009; 116: 1568– 77. 10.1111/j.1471-0528.2009.02292.x 19681852 · DOI
  21. [25]Birmingham MC, Chou KJ, Crain EF. Screening for postpartum depression in a pediatric emergency department. Pediatr Emerg Care 2011; 27: 795– 800. 10.1097/PEC.0b013e31822c1454 21878826 · DOI
  22. [26]Stock A, Chin L, Babl FE, et al. Postnatal depression in mothers bringing infants to the emergency department. Arch Dis Child 2013; 98: 36– 40. 10.1136/archdischild-2012-302679 23148311 · DOI
  23. [27]Adler L, Tsamir J, Katz R, et al. Associations of sociodemographic and clinical factors with perinatal depression among Israeli women: a cross-sectional study. BMC Psychiatry 2019; 19: 331. 10.1186/s12888-019-2311-4 31675947 PMC6824132 · DOI · Paper page
  24. [28]Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 1987; 150: 782– 6. 10.1192/bjp.150.6.782 3651732 · DOI · Paper page
  25. [29]Ali G-C, Ryan G, De Silva MJ. Validated screening tools for common mental disorders in low and middle income countries: a systematic review. PLoS One 2016; 11: e0156939. 10.1371/journal.pone.0156939 27310297 PMC4911088 · DOI · Paper page

Cited by

Sorted by citations

Authors
Adler, L., & Azuri, J.
Affiliations
Tel Aviv University (IL)
Corresponding author
Adler, Limor
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2021-11
Volume
11
Issue
11
Pages
e052873
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2021-052873
PMC
PMC8578984
OpenAlex
W3212680978
Cited by
4
References
5
Citations by year
2025: 3 · 2022: 1
FWCI
0.22
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Kahn-Sagol-Maccabi Research and Innovation Institute (N/A)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Keywords
perinatal depression, primary care visits, telemedicine, hospitalization, emergency department visits, antibiotic use, infant anemia, child development, mother-infant relationship
MeSH terms
Facilities and Services Utilization, Depression, Female, Humans, Infant, Mothers, Patient Acceptance of Health Care, Pregnancy, Cohort Studies

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review