Child Physical Wellbeing in the Context of Maternal Depression: Understanding the Influence of Risk and Protective Factors

Background and Purpose: Ensuring that all children have a healthy start in life is an important national priority (Hawkins et al., 2015), as poor physical health in childhood is one of the most robust predictors of adverse outcomes in adolescence and adulthood (Hardie & Landale, 2013; Shonkoff et al., 2009). While the majority of parents report their child is in excellent or very good health, about one in six children are reported as not having optimal overall health (US Department of Health and Human Services, 2014). Additionally, nearly 33% children are overweight or obese (Ogden et al., 2014) and about 14% have a diagnosis of asthma (Bloom et al., 2012). Understanding the factors in childhood associated with poor physical health is essential for improving overall health and functioning throughout the life course. For young children, the family, particularly the mother, has the largest influence on overall child wellbeing, including physical health (Maternal & Child Health Bureau, 2010). Maternal depression has been linked to negative outcomes in children, mainly focusing on psychological and emotional wellbeing with less known about the impact to the physical health of her child (Gladstone et al., 2015; Goodman et al., 2011). Thus, we examined the relationship between maternal depression and child physical wellbeing at age 9, accounting for multiple risk and protective factors. Methods:

Data were from the Fragile Families and Child Wellbeing survey (N=2965 mothers). Logistic regression analyses were conducted to examine the relationship between three indicators child physical wellbeing (overall health status, overweight, including obesity, and asthma) and maternal depression, controlling for sociodemographic characteristics, child health and health behaviors, maternal health, and the maternal-child relationship. First, unadjusted logistic regression analyses were conducted between the individual factors and each outcome. Significant factors were included in the final models.

Results:

Maternal depression was associated with increased rates of poor overall health (OR=1.50, 95% CI 1.24-1.80), overweight (OR=1.30, 95% CI 1.06 -1.60), and asthma (OR=1.25, 95% CI 1.01-1.53). When controlling for the maternal-child relationship, maternal depression was no longer a risk factor for overall poor health, and when controlling for sociodemographic characteristics, was no longer a risk factor for asthma. In contrast, after adjustment maternal depression remained a significant risk factor for childhood overweight (OR=1.35; 95% CI 1.06-1.72). Additional, risk factors of overweight also included increased fast food consumption (OR=1.26, 95% CI 1.01-1.58) and maternal overweight (OR=1.89, 95% CI 1.50-2.38) or obesity (OR=3.20, 95% CI 2.58-3.98), whereas breastfeeding for more than four months (OR=.77, 95% CI .62-.97) was identified as a protective factor.

Conclusion and Implications:

These findings contribute to the lack of knowledge regarding the impact of maternal depression on child physical wellbeing. Additionally, it suggests that when maternal depression is identified, mothers should be supported in maintaining a positive maternal-child relationship, as way to attenuate any risk to overall child health. However, the relationship between maternal depression and overweight remained significant, highlighting the need for future research as to the pathways through which maternal depression may lead to childhood overweight.