Association of Early Maternal Depression and Childhood Obesity Development: Longitudinal Association in a Low-Income Sample

Background: Childhood obesity has become a primary social and public health concern. Over the past 30 years, rates of childhood overweight and obesity in the United States have increased dramatically from 6% to 32%. A potential risk factor that is often overlooked is maternal depression. To date, there are mixed findings available on the association between maternal depression and childhood obesity development. To address these gaps in the literature, this study used innovative statistical techniques to explore the association between early maternal depression and childhood obesity longitudinally.

Methods: Data and Sample: This study used data from the Fragile Families Child Well Being Study (FFCWS), which is a national dataset that has information on 4,898 women from predominantly non-marital, low-income, minority groups in the United States. This study used information collected at the birth of the child (wave 1) through age 9 (wave 5).  In the analytic sample, children with implausible BMI values or who resided with their mothers less than half the time were removed. The final analytic sample consisted of 3,500 mother-children dyads.

Measures: Maternal depression was defined as maternal depression at any time point, meaning the mother had depression when the child was one or when the child was three, and recurrent maternal depression was defined as the mother having depression when the child was one and also when the child was three. Child BMI growth was measured using child BMI z-scores from birth to age 9. Demographic and maternal health variables were included as controls.

Statistical analysis: Group-based trajectory modeling and multivariable logistic regression were used to test the association between early maternal depression and childhood obesity development.

Results: Overall, the results indicated that there was no association between maternal depression and childhood obesity development in this sample of low-income and mostly minority participants. Children of mothers with depression at one time point or with recurrent depression were not at an increased risk of following an at-risk trajectory.  Only maternal pre-pregnancy BMI and number of biological children were significant predictors of at-risk growth trajectories. Higher maternal pre-pregnancy BMI increased the risk of children following an at-risk trajectory. Higher number of children at home also increased the risk of children developing an at-risk trajectory.

Discussion:  Using innovative statistical methods, this study demonstrated that there are no associations between maternal depression and childhood obesity development in a sample of low-income, mostly minority women.  However, given the well-documented repercussions of maternal depression on the child and the mother, it is necessary to continue investigating the role that maternal depression plays in childhood obesity development in different samples. Moreover, it is essential to determine the role of maternal depression on the development of obesogenic behaviors. Although this study did not investigate the association between maternal depression and obesogenic behaviors (e.g. television viewing, sleep, and dietary intake), it is likely that children’s behaviors are more susceptible to maternal depression than is a biological measure such as BMI.