Maternal Depressive Symptomatology: 16-Month Follow-up of Infant and Maternal Health-Related Quality of Life

Purpose: The purpose of this study was to document risk factors for depressive symptoms during the postpartum period among working mothers and to determine longitudinal effects of depressive symptoms on maternal health-related quality of life and infant health and development. Methods: Mother-infant dyads from a community-based cohort study of working mothers were recruited when infants were 4 months old and were interviewed every 4 months until infants were 16 months old. Depressive symptoms and health-related quality of life were assessed using the Center for Epidemiologic Studies Depression Scale and the Short Form-12 Health Survey, respectively. Infant development and health-related quality of life were measured with the Ages and Stages Questionnaire and the Infant-Toddler Quality of Life Questionnaire, respectively. Results: Depressive symptoms were elevated among mothers who were younger, less educated, African American, unmarried, and impoverished. Mothers with significant depressive symptoms had significantly poorer physical and mental health-related quality of life, reported greater pain for their infant, and had more health-related concerns about their child. Maternal depressive symptoms at 4 months predicted infant poorer health-related quality of life at 8, 12, and 16 months. Conclusions: Several characteristics, including age, education level, race, marital status, and poverty, can help primary care physicians identify working mothers at risk for depressive symptoms. Identification of these symptoms is important; they are correlated with poorer maternal health-related quality of life and they predict poorer children's health-related quality of life.

[1]  Bobbie Posmontier.  Functional status outcomes in mothers with and without postpartum depression. , 2008, Journal of midwifery & women's health.

[2]  K. Matthews,et al.  Employment and women's health: Effects of paid employment on women's mental and physical health. , 1989 .

[3]  M. Frone,et al.  Work-family conflict and employee psychiatric disorders: the National Comorbidity Survey. , 2000, The Journal of applied psychology.

[4]  N. Spencer,et al.  The development and validation of a measure of parent-reported child health and morbidity: the Warwick Child Health and Morbidity Profile. , 1996, Child: care, health and development.

[5]  Ian M. Bennett,et al.  Postpartum physical symptoms in new mothers: their relationship to functional limitations and emotional well-being. , 2008, Birth.

[6]  R. Motl,et al.  Factorial validity and invariance of the center for epidemiologic studies depression (CES-D) scale in a sample of black and white adolescent girls. , 2006, Ethnicity & disease.

[7]  A. Pickard,et al.  A comparison of depressive symptoms in stroke and primary care: applying Rasch models to evaluate the center for epidemiologic studies-depression scale. , 2006, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[8]  D. Slattery,et al.  Exposure to chronic pregnancy stress reverses peripartum-associated adaptations: implications for postpartum anxiety and mood disorders. , 2011, Endocrinology.

[9]  J. Culhane,et al.  Maternal depressive symptoms and infant health practices among low-income women. , 2004, Pediatrics.

[10]  Irritable Bowel Syndrome: A “Mesh” of a Situation , 2012, The Journal of the American Board of Family Medicine.

[11]  C. Chambers,et al.  Postpartum depression: a major public health problem. , 2006, JAMA.

[12]  B. Yawn,et al.  Postpartum Depression Screening: Importance, Methods, Barriers, and Recommendations for Practice , 2007, The Journal of the American Board of Family Medicine.

[13]  J. Ware,et al.  A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. , 1996, Medical care.

[14]  M. Frone,et al.  Workplace family-supportive programmes: Predictors of employed parents' importance ratings , 1996 .

[15]  M. O’Hara.  Postpartum depression: what we know. , 2009, Journal of clinical psychology.

[16]  H. Lovel,et al.  Impact of maternal depression on infant nutritional status and illness: a cohort study. , 2004, Archives of general psychiatry.

[17]  Pablo A. Mora,et al.  Racial and Ethnic Differences in Factors Associated With Early Postpartum Depressive Symptoms , 2005, Obstetrics and gynecology.

[18]  Y. Chan,et al.  Screening for Depressive Symptoms , 2008, Diabetes Care.

[19]  L. Radloff.  The CES-D Scale , 1977 .

[20]  J. Grzywacz,et al.  Return to Work, Economic Hardship, and Women's Postpartum Health , 2010, Women & health.

[21]  John G. Orme,et al.  Factorial and discriminant validity of the Center for Epidemiological Studies Depression (CES-D) scale. , 1986, Journal of clinical psychology.

[22]  D. Scharfstein,et al.  Maternal Depressive Symptoms and Children's Receipt of Health Care in the First 3 Years of Life , 2005, Pediatrics.

[23]  Alfred O. Berg,et al.  Screening for Depression: Recommendations and Rationale , 2002, Annals of Internal Medicine.

[24]  J. Grzywacz,et al.  Individual and job-related variation in infant feeding practices among working mothers. , 2010, American journal of health behavior.

[25]  L. Sharp,et al.  Screening for depression across the lifespan: a review of measures for use in primary care settings. , 2002, American family physician.

[26]  M. Gillman,et al.  Misperceived pre-pregnancy body weight status predicts excessive gestational weight gain: findings from a US cohort study , 2008, BMC pregnancy and childbirth.

[27]  Injury rates by industry 1970, BLS Report 406, Department of Labor, Bureau of Labor Statistics. , 1972, IMS, Industrial medicine and surgery.

[28]  Mark Olfson,et al.  Psychiatric disorders in pregnant and postpartum women in the United States. , 2008, Archives of general psychiatry.

[29]  Joseph G. Grzywacz,et al.  Work, Family, and Mental Health: Testing Different Models of Work‐Family Fit , 2003 .

[30]  N Gavin,et al.  Perinatal Depression : Prevalence , Screening Accuracy , and Screening Outcomes Summary , 2005 .

[31]  Ian M. Bennett,et al.  Distinct trajectories of perinatal depressive symptomatology: evidence from growth mixture modeling. , 2008, American journal of epidemiology.

[32]  J. Grzywacz,et al.  Characteristics of Mother-Provider Interactions Surrounding Postpartum Return to Work , 2009, The Journal of the American Board of Family Medicine.

[33]  Screening for depression: recommendations and rationale. , 2002 .

[34]  J. Squires,et al.  Revision of a parent-completed development screening tool: Ages and Stages Questionnaires. , 1997, Journal of pediatric psychology.

[35]  Pt Jr Costa.  Revised NEO Personality Inventory and NEO Five-Factor Inventory , 1992 .

[36]  L. Gold.  Postpartum disorders in primary care: diagnosis and treatment. , 2002, Primary care.

[37]  R. Mcgee,et al.  Psychometric properties of the Centre for Epidemiologic Studies Depression Scale (CES-D) in a sample of women in middle life. , 1997, Behaviour research and therapy.

[38]  E. Moses-Kolko,et al.  Antepartum and postpartum depression: healthy mom, healthy baby. , 2004, Journal of the American Medical Women's Association.

[39]  R A McCormick,et al.  Testing a tripartite model: II. Exploring the symptom structure of anxiety and depression in student, adult, and patient samples. , 1995, Journal of abnormal psychology.

[40]  L. Leung,et al.  Chronic Constipation: An Evidence-Based Review , 2011, The Journal of the American Board of Family Medicine.