ORIGINAL ARTICLES

Maternal depression, child behavior, and injury

K Phelan^1,2,4, J Khoury^2,3,4, H Atherton² and R S Kahn²

¹ Division of Health Policy & Clinical Effectiveness, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
² General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
³ Center for Epidemiology and Biostatistics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
⁴ Center for Children’s Environmental Health, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA

Correspondence to:
Dr K J Phelan, Assistant Professor of Pediatrics, Division of Health Policy & Clinical Effectiveness, Winslow Bldg, Rm 5117, MLC 7014, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA; kieran.phelan{at}cchmc.org

Background: Few data exist on the effect of maternal depression on child injury outcomes and mediators of this relationship.

Objective: To examine the relationship between mothers’ depressive symptoms and medically attended injuries in their children and the potential mediating role of child behavior.

Design/Methods: A cohort of mother–child dyads from the National Longitudinal Study of Youth followed from 1992 to1994. The primary exposure variable was maternal depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale in 1992. Child behavior was assessed by the Behavior Problems Index externalizing subscale. Logistic regression was used to examine the relationship between depressive symptoms, child behavior, and injury reported in the prior year in 1994.

Results: 94 medically attended injuries were reported in the 1106 children (8.5%); two-thirds were sustained in the home environment. Maternal depressive symptoms significantly increased the risk of child injury; injury risk increased 4% for every 1-point increase in depressive symptoms (adjusted OR 1.04, 95% CI 1.01 to 1.08, p = 0.02). Increasing maternal depressive symptoms also increased the risk of externalizing behavior problems (adjusted OR 1.06, 95% CI 1.03 to 1.09), but externalizing behavior problems did not significantly mediate the relationship between maternal symptoms and child injury.

Conclusions: Increasing depressive symptoms in mothers was associated with an increased risk of child injury. Child behavior did not significantly mediate the association between maternal depressive symptoms and child injury in this cohort. Greater recognition, referral, and treatment of depressive symptoms in mothers may have effects on child behavior and injury risk.

Abbreviations: BPI, Behavior Problems Index; CES-D, Center for Epidemiologic Studies Depression Scale; NLSY, National Longitudinal Study of Youth

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This article has been cited by other articles:

• Schwebel, D. C., Brezausek, C. M. (2008). Chronic Maternal Depression and Children's Injury Risk. J Pediatr Psychol 33: 1108-1116 [Abstract] [Full Text]