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Impact of postpartum anxiety and depression on child’s mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study
Open accessAbstract
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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“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]
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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“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]
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“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).”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
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“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).”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
The cited source says what the claim attributes to it.
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“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).”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
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“However, the impact of maternal depression on delayed cognitive development of the child was approximately three-fold at the 6-month follow-up (adjusted OR = 3.3, 95% CI = 1.1, 9.9)”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
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“and approximately seven-fold at the 12-month follow-up (adjusted OR = 6.8, 95% CI = 3.0, 15.7).”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
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“Children of depressed mothers whose husband’s income was <3500 rupees/month had more than a five-fold risk of delayed language development relative to children whose mothers were not depressed and whose father’s income was ⩾3500 rupees/month (adjusted OR = 5.4, 95% CI = 2.3, 12.4).”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
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“At the 2-month follow-up, maternal depression showed no significant impact on children’s cognitive development.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
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“There was a significant interaction between a mother’s depression and her husband’s income.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
The cited source says what the claim attributes to it.
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“Among women whose husband’s income was ⩾3500 rupees/month, there was no significant impact of maternal depression on children’s language development.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
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“When other variables were adjusted in the model, maternal depression placed children at an approximately six-fold risk of delayed emotional development (adjusted OR = 5.9, 95% CI = 3.0, 11.9).”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
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“Therefore, the prevalence of PPD varied among these studies, from 2.7% in a population of Pakistani mothers at 18 months postpartum94 to 68.8% in a population of Australian mothers at 4 months postpartum.64”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [94]
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Citations
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Cited by
Sorted by citations
Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes
Slomian, J., Honvo, G., Emonts, P., Reginster, J.-Y., & Bruyère, O. (2019) · Women's Health · doi:10.1177/1745506519844044 · Cited by 1,496
Gelaye, B., Rondon, M. B., Araya, R., & Williams, M. A. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30284-x · Cited by 1,155
Shorey, S., Chee, C. Y. I., Ng, E. D., Chan, Y. H., Tam, W. W. S., & Chong, Y. S. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.08.001 · Cited by 1,055
Poverty and disability in low- and middle-income countries: A systematic review
Banks, L. M., Kuper, H., & Polack, S. (2017) · PLoS ONE · doi:10.1371/journal.pone.0189996 · Cited by 613
Postnatal anxiety prevalence, predictors and effects on development: A narrative review
Field, T. (2018) · Infant Behavior and Development · doi:10.1016/j.infbeh.2018.02.005 · Cited by 333
Metadata
- 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)
- PMC
- PMC3819469
- 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
- gold
- doi.org
- Licence
- 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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