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PACEs in Maternal Health

Maternal Depression and Intimate Partner Violence: Impacts on Children [aappublications.org]

 

Among the many adverse childhood experiences, one must consider are the effects of maternal depression and of mothers being the victim of physical or sexual violence. What is the toll of these on children?  Neamah et al. (10.1542/peds.2017-3457) decided to evaluate this by looking at the strength of such an association on the cognitive development as well as physical growth of over a thousand toddlers between 18 to 36 months living in Tanzania. These children underwent developmental testing using the Bayley Scales of Infant Development and had their growth parameters measured.  Mothers completed the valid and reliable Patient Health Questionnaire-9 (PHQ-9) and the Tanzania Demographic and Health Survey Questionnaire.  The results of the data collected are quite troubling and show that when both depression and intimate partner violence (IPV) were present in a mother, there was developmental delay in multiple cognitive modalities.  In addition, IPV even without maternal depression was associated with expressive communication delay.  While depression did not show an association with poor growth, IPV did increase the odds of a child showing stunted growth compared to toddlers whose mothers did not experience IPV.  The authors provide an accompanying discussion of how maternal depression and IPV can play a role in developmental delay and nutritional growth that is well worth your attention.  It is becoming increasingly more important for those of us caring for infants and toddlers to recognize how maternal adversity can contribute to those experiences.  Doing so in turn should further strengthen our obligation to refer these mothers to clinical, psychological, and social service supports that will not only help them develop strengths to overcome these adversities but in doing so, provide their children with the strengths and resiliencies to help them further their growth and development.  Check out this article and learn more.

[For more on this story by Lewis First, go to http://www.aappublications.org...n-pediatrics-6-11-18]

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