Maternal depression stunts childhood growth, research suggests
Maternal depression is a familiar plight around the globe
— but its impact may be particularly acute in low-income
nations. An analysis by epidemiologist Pamela Surkan, PhD,
ScD, of Johns Hopkins Bloomberg School of Public Health,
and psychologist Maureen Black, PhD, of the University of
Maryland School of Medicine, and colleagues showed that
maternal depression in developing countries was linked to
growth problems in children (Bulletin of the World Health
The World Health Organization estimates the incidence of
depressive symptoms among women in developing countries
at anywhere from 15 percent to 57 percent — figures thought
to be notably higher, Black says, than incidence of depressive
mood in the United States. Childhood growth problems are
also common in those countries, and several studies have found
a link between growth and maternal depression.
To further investigate the connection, the researchers
conducted a meta-analysis of 17 recent studies. They found
that mothers with depressive symptoms were 40 percent
more likely to have underweight or height-stunted children
than mothers who were not depressed. Stunting under age 2
is important, Black says, because it’s an indicator of chronic
The concern extends beyond mere height. Children who
are undernourished are at greater risk of low educational
performance, reduced economic productivity and poorer
health in adulthood.
Importantly, Black says, most of the studies she included
in the analysis looked at depressive symptoms and depressive
mood, not just clinically diagnosed depression. Since depressive
symptoms are much more common than full-blown major
depression, the ramifications for children’s well-being could be
Most of the studies did not investigate the mechanism that
underlies the connection between maternal depression and
childhood stunting. The few that did suggested that depressive
symptoms might negatively affect a mother’s caregiving
ability. “Mothers who are depressed are less responsive to their
children and may have less energy to follow through with their
children, so caregiving suffers,” Black says.
Still, other mechanisms may be implicated as well.
Depressed women may be less likely to breastfeed, for instance.
And depression often goes hand-in-hand with factors such as
poor family support and financial stress, both of which can
undermine the health of a child. “It’s likely that there’s more
than one mechanism,” Black says.
More research is needed to flesh out the details, says Surkan.
Children of depressed mothers are more likely to be undernourished, putting their growth at risk.
But in the meantime, she adds, there are plenty of other reasons
to address maternal depression. “Even if confirmatory research
still needs to be done, I don’t think it would be too soon to
say that we should do something about maternal depressive
symptoms, both for the mothers and the children.”
The authors report that some low-cost approaches,
including social support, group therapy and home visits by
lay community workers, have been shown to ease depressive
symptoms among women in developing nations. But
establishing affordable, effective interventions will require
a multidisciplinary approach that draws on psychologists,
nutritionists and public health experts, Black says. “This is an
illustration of how psychology can work with broad health
issues,” she says.