Background: Globally, maternal depression impacts over a hundred million women, with developmental consequences for children. How timing of exposure to maternal depression influences developmental outcomes is not well understood. Outside the antenatal period, the impact in low- and middle-income countries has received little attention. Hypothesis: Chronic exposure to maternal depression throughout childhood has a greater impact on adolescent socio-emotional functioning than either early exposure or exposure at school age alone. Methods: Maternal depression data were available for 1283 children from urban Chilean neighborhoods, recruited as infants (1991-1996) in an iron supplementation study. Maternal mood was assessed with the CES-D at 6mo, 5y, 10y and 16y. Adolescent behavior was assessed at 16y with the Youth Self Report and Child Behavioral Checklist. Written consent was obtained from primary care giver and assent from the youth; University of Michigan and INTA IRBs approved the study. Analysis: We used latent class growth analysis to empirically determine maternal depression exposure trajectories, and ANCOVA to compare mean z-scores of each trajectory on behavioral assessments, adjusted for child sex and indicators of family socioeconomic status. Findings: The analysis generated five maternal depression exposure trajectories: 1) none (n=704), 2) none in infancy, moderate at 5y and 16y (n=244), 3) low in infancy, high at 5y and 16y (n=61), 4) high throughout (n=110), 5) high in infancy, moderate at 5y and 10y, high again at 16y (n=164). Internalizing behavior z-scores were highest for Group 3 by both youth and parental report, with no significant difference between Groups 3 and 4. Externalizing and total problem z-scores were also higher in Groups 3 and 4, with no significant difference between Groups 3, 4 and 5 (p<0.05 for all comparisons). Interpretation: By both maternal report and youth self-reporting, chronic exposure to maternal depressed mood was associated with increased adolescent internalizing behavior. Neither exposure during an "early sensitive window" nor concurrent exposure was as strongly associated with adolescent behavior problems. Chronic exposure to maternal depression may have long-lasting behavioral consequences for children in LMICs. The results point to potential child health benefits of reducingmaternal depression postpartumand beyond.
Hickson, M., Kaciroti, N., Castillo, M., & Lozoff, B. (2016). The impact of chronic maternal depression on adolescent socio-emotional functioning in a sample of Chilean youth. Annals of Global Health, 82(3), 423. https://doi.org/10.1016/j.aogh.2016.04.176