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Maternal depression, child behavior, and injury
  1. K Phelan1,2,4,
  2. J Khoury2,3,4,
  3. H Atherton2,
  4. R S Kahn2
  1. 1
    Division of Health Policy & Clinical Effectiveness, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
  2. 2
    General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
  3. 3
    Center for Epidemiology and Biostatistics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
  4. 4
    Center for Children’s Environmental Health, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
  1. 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

Abstract

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.

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Footnotes

  • Funding support: KP was supported by a career development award from the National Institutes of Child Health and Human Development (NICHD) 1K23HD045770-01A2. RK was supported by NICHD 1K23 HD40362.

  • Competing interests: None.

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

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