Cited by 131Maternal Mental Health During Pregnancy and PostpartumChild and Adolescent Psychosocial and Emotional DevelopmentInfant Development and Preterm Care

Impact of postpartum anxiety and depression on child’s mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study

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Ali, Niloufer Sultan, Mahmud, Sadia, Khan, Asia, Ali, Badar Sabir·2013·BMC Psychiatry

Abstract

BACKGROUND: Postpartum anxiety and depression has detrimental effects on the overall mental development of children. This study aims to assess the impact of postpartum anxiety and depression on children's mental development on all sub-scales in a Pakistani population. METHODS: A quasi-experimental study was conducted in two peri-urban communities of Karachi, a mega city of Pakistan, to assess the impact of postpartum anxiety and depression on children's growth and mental development. A total of 420 women were enrolled, who had given consent out of 651 pregnant women identified, during February 2004 to December 2005. Data for socio-demographic, home environment and family relationship variables were collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother's levels of anxiety and depression were assessed at 1, 2, 6, 12, 18, 24, and 30 months of childbirth. An indigenous, validated screening instrument- Aga Khan University Anxiety and Depression scale was used and diagnostic confirmation was done through a psychologist's interview, based on DSM IV criteria. Children's growth and development was monitored in the same sequence using an Early Childhood Development tool that consists of five subscales; socio emotional, language, cognitive, gross motor and fine motor development. Physical growth was monitored by measuring height and weight of the child. Data was analyzed using SAS 9.2. Multivariable Generalized Estimating Equations (GEE) logistic regression was conducted to identify association of postpartum anxiety and depression with each early childhood development indicator, adjusting for parental and child factors. RESULTS: A significant association of postpartum anxiety and depression with delayed development on all five subscales of children's mental development was found in our study. Interestingly, our study found that higher maternal age had adverse effects on child's emotional whereas positive impact on child's cognitive development. Children's stunting had an adverse impact on all five subscales of children's development. Male children were at higher risk for delayed language and gross motor development relative to female children. CONCLUSIONS: Our study found that postpartum anxiety and depression is associated with adverse outcomes regarding children's mental development on all sub-scales. The impact was accentuated by low family income or child's increasing age.

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  • A child's language development is affected by maternal PPD only when the father's income is high (Pakistan).

    “The third study,94 conducted in Pakistan, showed that a child’s language development was affected by maternal PPD only when the father’s income was high.”

    From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]

    The Results (Child language development, Table 4) report the opposite income pattern: children of depressed mothers had significantly higher odds of language delay when the father's income was below 3500 rupees/month. The Results also state that maternal depression had no significant impact on language development when his income was at least 3500 rupees/month. (LLM, conf=0.90)

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  • Many studies indicated significant and negative associations between maternal postpartum depressive symptoms and infant cognitive development, language development, infant behaviors, overall infant health concerns, and quality of sleep.

    “Moreover, many studies indicated significant and negative associations between maternal postpartum depressive symptoms and infant cognitive development,94,95,99,101,102,107,141,147 language development,94,102,105,116,117,131,132,139 infant behaviors,49,52,110,114,120,121,131,133 overall infant health concerns,48,104,119,122–124,135,136,138 and quality of sleep.104,108”

    From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]

    The Results (Child cognitive development; page not provided) report significantly greater odds of delayed cognitive development among children of depressed mothers at 6 and 12 months. The Background and Discussion also report links with language problems and infant behavior. Our copy does not address overall infant health concerns or sleep quality, so it does not support those parts of the sentence. (LLM, conf=0.84)

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  • The impact of maternal PPD on infant motor development seemed to be controversial: some studies demonstrated a clear effect of PPD on children's gross and fine motor development, while other studies did not demonstrate this effect.

    “In contrast, the impact of maternal PPD on infant motor development seemed to be controversial: some studies94,95,97 demonstrated a clear effect of PPD on children’s gross and fine motor development, while other studies66,103,107 did not demonstrate this effect.”

    From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]

    The Discussion and conclusions report a significant association between maternal depression and delayed gross motor development at 12 months, but no significant association at 2 or 6 months. They also report a significant association with delayed fine motor development at 18 months. This supports mixed findings by age, but not a characterization of this study as finding no effect on motor development. (LLM, conf=0.86)

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  • Maternal depression has a significant impact on fine motor development at 18 months (Pakistan).

    “The third study94 showed a nonsignificant impact of maternal depression on the fine and gross motor development of children at 2 and 6 months that became significant at 12 months for gross motor development and at 18 months for fine motor development (Pakistan).”
  • Maternal depression has a significant impact on gross motor development at 12 months (Pakistan).

    “The third study94 showed a nonsignificant impact of maternal depression on the fine and gross motor development of children at 2 and 6 months that became significant at 12 months for gross motor development and at 18 months for fine motor development (Pakistan).”

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Research works printed but not linked: 1

  1. Care for development Appraisal tool for Assessing and Monitoring Child Development-First Three Years http://www.arnec.net/ntuc/slot/u2323/conference/presentations/Ghazala%20-%20Sanober%20ARNEC%20workshop%20-%20FINAL.pdf

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Authors
Ali, N. S., Mahmud, S., Khan, A., & Ali, B. S.
Affiliations
Aga Khan University (PK)
Corresponding author
Ali, Niloufer Sultan
Venue
BMC Psychiatry
Published
2013-10-22
Volume
13
Issue
1
Pages
274-274
ISSN
1471-244X (ISSN-L)
OpenAlex
W2130703322
Cited by
129
References
50
Citations by year
2026: 8 · 2025: 10 · 2024: 12 · 2023: 21 · 2022: 11 · 2021: 13 · 2020: 10 · 2019: 11 · 2018: 5 · 2017: 7 · 2016: 9 · 2015: 6 · 2014: 6
FWCI
7.16
Type
journal article
Language
en
Open access
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • eCommons - AKU (Aga Khan University) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Keywords
postpartum anxiety, postpartum depression, child psychological development, early childhood development, child growth, stunting, social-emotional development, language development, cognitive development, gross motor development, fine motor development, maternal age, sex differences, household income, Karachi
MeSH terms
Adult, Anxiety, Child, Child Development, Developmental Disabilities, Psychology, Child, Child, Preschool, Emotions, Female, Humans, Infant, Language Development, Male, Mothers, Pakistan, Poverty, Pregnancy, Psychiatric Status Rating Scales, Urban Population, Depression, Postpartum

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