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Maternal mental health, and child growth and development, in four low-income and middle-income countries
  1. Ian M Bennett1,
  2. Whitney Schott2,
  3. Sofya Krutikova3,
  4. Jere R Behrman2
  1. 1Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  2. 2The Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  3. 3Institute for Fiscal Studies, London, England
  1. Correspondence to Dr Ian M Bennett, University of Washington Department of Family Medicine, Box 453696, Seattle WA 98105-6099 ibennett{at}


Objective Extend analyses of maternal mental health and infant growth in low- and middle-income countries (LMICs) to children through age eight years, and broaden analyses to cognitive and psychosocial outcomes.

Design Community-based longitudinal cohort study in four LMICs (Ethiopia, India, Peru and Vietnam). Surveys and anthropometric assessments were carried out when the children were approximately ages 1, 5 and 8 years. Risk of maternal common mental disorders (rCMDs) was assessed with the Self-Reporting Questionnaire (SRQ)-20 (score ≥8).

Setting Rural and urban as well as low- and middle-income communities.

Participants 7722 mothers and their children.

Main outcome measures Child stunting and underweight (Z score ≤2 of height and weight for age), and <20th centile for: cognitive development (Peabody Picture Vocabulary Test), and the psychosocial outcomes self pride and life satisfaction.

Results A high rate of rCMD, stunting and underweight was seen in the cohorts. After adjusting for confounders, significant associations were found between maternal rCMDs and growth variables in the first year of life, with persistence to age 8 years in India and Vietnam, but not in the other countries. India and Vietnam also showed significant associations between rCMDs and lower cognitive development. After adjustment, rCMD was associated with low life satisfaction in Ethiopia but not in the other cohorts.

Conclusions Associations of maternal rCMD in the first year of life with child outcomes varied across the study cohorts and, in some cases, persisted across the first 8 years of life of the child, and included growth, cognitive development and psychosocial domains.


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