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Common mental disorders among women, social circumstances and toddler growth in rural V ietnam: a population‐based prospective study
Author(s) -
Fisher J.,
Tran T.,
Nguyen T. T.,
Nguyen H.,
Tran T. D.
Publication year - 2015
Publication title -
child: care, health and development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.832
H-Index - 82
eISSN - 1365-2214
pISSN - 0305-1862
DOI - 10.1111/cch.12235
Subject(s) - toddler , medicine , demography , anthropometry , prospective cohort study , population , overweight , cohort , pediatrics , psychology , developmental psychology , gerontology , body mass index , environmental health , sociology
Abstract Background Common mental disorders ( CMD ) and adverse social circumstances are widespread among mothers of infants and toddlers in resource‐constrained settings. These can undermine early childhood development through compromised caregiving and insufficient access to essential resources. The aim was to examine the effect of maternal CMD and social adversity in the post‐partum year on toddler's length‐for‐age index in a rural low‐income setting. Methods A population‐based prospective cohort study of women in H a N am province, V ietnam who completed baseline assessments in either late pregnancy or 4–6 weeks post partum and were followed up, with their toddlers, 15 months later. CMD were assessed at both points by psychiatrist‐administered S tructured C linical I nterviews for D iagnostic and S tatistical M anual of M ental D isorders, F ourth E dition D iagnoses. Anthropometric indices were calculated from toddler's age, sex, weight and length using W orld H ealth O rganization C hild G rowth S tandards. Social adversities were assessed by study‐specific questions and locally validated psychometric instruments. The hypothesized model of factors governing toddler's length‐for‐age Z score ( LAZ ) was tested using path analysis. Results In total, 211/234 (90.1%) mother–toddler pairs provided complete data. Baseline prevalence of CMD among women was 33.6% and follow‐up was 18.5%. The mean LAZ among toddlers was −1.03 and stunting prevalence ( LAZ < −2) was 15.6%. Maternal CMD at baseline were indirectly related to toddler LAZ via maternal CMD at follow‐up (regression coefficient = −0.05, 95% CI −0.11 to −0.01). Maternal CMD at follow‐up was associated significantly with toddler LAZ (regression coefficient = −0.15, 95% CI −0.28 to −0.05). Poorer quality of marital relationship, mothers' experiences of childhood abuse and <30 days dedicated post‐partum care were associated indirectly with lower toddler LAZ via maternal CMD . Conclusions Maternal post‐natal CMD are associated with child growth measured by LAZ in this resource‐constrained setting. Social adversities affect child growth indirectly through increasing the risk of maternal CMD . Interventions to reduce stunting in low‐income settings may need to address maternal CMD and social adversities in order to improve impact.