Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-19T20:48:54.019Z Has data issue: false hasContentIssue false
  • English
  • Français

Increased mortality risk among offspring of mothers with postnatal depression: a nationwide population-based study in Taiwan

Published online by Cambridge University Press:  28 April 2011

Y.-H. Chen ,
S.-Y. Tsai  and
H.-C. Lin
Y.-H. Chen
Affiliation:
School of Public Health, Taipei Medical University, Taipei, Taiwan
S.-Y. Tsai
Affiliation:
Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
H.-C. Lin*
Affiliation:
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
*
*Address for correspondence: H.-C. Lin, Ph.D., School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing St, Taipei 110, Taiwan. (Email: henry11111@tmu.edu.tw)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There is compelling evidence that children of mothers with postnatal depression (PD) experience poor developmental outcomes. However, no studies have specifically ascertained the risk of mortality for offspring during preschool years, the most catastrophic outcome in the vulnerable period. This nationwide population-based study aimed to investigate whether maternal depression in the first year after giving birth was associated with increased mortality risk among their preschool children aged up to 5 years.

Method

Three nationwide population-based datasets [the National Health Insurance Research Database (NHIRD), birth certificate registry and death certificate registry] were linked in this study. A total of 10 236 offspring of mothers with PD were recruited, together with a comparison cohort of 81 888 births matched with the affected women in terms of maternal age and year of delivery. Each child was traced for 5 years from delivery between 2001 and 2003 until the end of 2008 to determine mortality during preschool years.

Results

During preschool years, 98 (0.96%) deaths were identified among the offspring of mothers with PD and 470 (0.57%) children in the comparison cohort died. For children up to 5 years old, exposure to maternal PD was independently associated with a 1.47-fold [95% confidence interval (CI) 1.16–1.87] increased mortality risk, after adjusting for family income, urbanization level and the characteristics of mother, father and infant. The risk of death by unnatural causes was even higher (about 2.23 times the risk, 95% CI 1.34–3.70) among exposed offspring.

Conclusions

PD places preschool children at significantly increased risk of mortality, especially from unnatural causes of death.

Keywords

Mortality riskoffspringpostnatal depressionunnatural causes of death
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 11 , November 2011 , pp. 2287 - 2296
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (DSM-IV-TR). American Psychiatric Association: Washington, DC.Google Scholar
Bennedsen, BE, Mortensen, PB, Olesen, AV, Henriksen, TB (2001). Congenital malformations, stillbirths, and infant deaths among children of women with schizophrenia. Archives of General Psychiatry 58, 674–679.CrossRefGoogle ScholarPubMed
Carter, AS, Garrity-Rokous, FE, Chazan-Cohen, R, Little, C, Briggs-Gowan, MJ (2001). Maternal depression and comorbidity: predicting early parenting, attachment security, and toddler social-emotional problems and competencies. Journal of the American Academy of Child and Adolescent Psychiatry 40, 18–26.CrossRefGoogle ScholarPubMed
Chaudron, LH, Szilagyi, PG, Kitzman, HJ, Wadkins, HI, Conwell, Y (2004). Detection of postpartum depressive symptoms by screening at well-child visits. Pediatrics 113, 551–558.CrossRefGoogle ScholarPubMed
Chen, XK, Wen, SW, Krewski, D, Fleming, N, Yang, Q, Walker, MC (2008). Paternal age and adverse birth outcomes: teenager or 40+, who is at risk? Human Reproduction 23, 1290–1296.CrossRefGoogle ScholarPubMed
Chen, YH, Chiou, HY, Tang, CH, Lin, HC (2010). Risk of death by unnatural causes during early childhood in offspring of parents with mental illness. American Journal of Psychiatry 167, 198–205.CrossRefGoogle ScholarPubMed
Dietz, PM, Williams, SB, Callaghan, WM, Bachman, DJ, Whitlock, EP, Hornbrook, MC (2007). Clinically identified maternal depression before, during, and after pregnancies ending in live births. American Journal of Psychiatry 164, 1515–1520.CrossRefGoogle ScholarPubMed
Epperson, CN (1999). Postpartum major depression: detection and treatment. American Family Physician 59, 2247–2254, 2259–2260.Google ScholarPubMed
Field, T (2010). Postpartum depression effects on early interactions, parenting, and safety practices: a review. Infant Behavior and Development 33, 1–6.CrossRefGoogle ScholarPubMed
Field, T (2011). Prenatal depression effects on early development: a review. Infant Behavior and Development 34, 1–14.CrossRefGoogle ScholarPubMed
Field, T, Diego, M (2008). Cortisol: the culprit prenatal stress variable. International Journal of Neuroscience 118, 1181–1205.Google Scholar
Field, T, Diego, M, Hernandez-Reif, M (2006). Prenatal depression effects on the fetus and newborn: a review. Infant Behavior and Development 29, 445–455.Google Scholar
Forman, DR, O'Hara, MW, Stuart, S, Gorman, LL, Larsen, KE, Coy, KC (2007). Effective treatment for postpartum depression is not sufficient to improve the developing mother-child relationship. Development and Psychopathology 19, 585–602.CrossRefGoogle Scholar
Gavin, NI, Gaynes, BN, Lohr, KN, Meltzer-Brody, S, Gartlehner, G, Swinson, T (2005). Perinatal depression: a systematic review of prevalence and incidence. Obstetrics and Gynecology 106, 1071–1083.CrossRefGoogle ScholarPubMed
Gjerdingen, DK, Yawn, BP (2007). Postpartum depression screening: importance, methods, barriers, and recommendations for practice. Journal of the American Board of Family Medicine 20, 280–288.Google Scholar
Grace, SL, Evindar, A, Stewart, DE (2003). The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature. Archives of Women's Mental Health 6, 263–274.CrossRefGoogle ScholarPubMed
Lagan, M, Knights, K, Barton, J, Boyce, PM (2009). Advocacy for mothers with psychiatric illness: a clinical perspective. International Journal of Mental Health Nursing 18, 53–61.CrossRefGoogle ScholarPubMed
Lovejoy, MC, Graczyk, PA, O'Hare, E, Neuman, G (2000). Maternal depression and parenting behavior: a meta-analytic review. Clinical Psychology Review 20, 561–592.CrossRefGoogle ScholarPubMed
Lyons-Ruth, K, Wolfe, R, Lyubchik, A (2000). Depression and the parenting of young children: making the case for early preventive mental health services. Harvard Review of Psychiatry 8, 148–153.CrossRefGoogle ScholarPubMed
MacCabe, JH, Martinsson, L, Lichtenstein, P, Nilsson, E, Cnattingius, S, Murray, RM, Hultman, CM (2007). Adverse pregnancy outcomes in mothers with affective psychosis. Bipolar Disorders 9, 305–309.Google Scholar
Marcus, SM (2009). Depression during pregnancy: rates, risks and consequences – Motherisk Update 2008. Canadian Journal of Clinical Pharmacology 16, e15–e22.Google ScholarPubMed
Misri, S, Reebye, P, Kendrick, K, Carter, D, Ryan, D, Grunau, RE, Oberlander, TF (2006). Internalizing behaviors in 4-year-old children exposed in utero to psychotropic medications. American Journal of Psychiatry 163, 1026–1032.CrossRefGoogle ScholarPubMed
Munk-Olsen, T, Laursen, TM, Pedersen, CB, Mors, O, Mortensen, PB (2006). New parents and mental disorders: a population-based register study. Journal of the American Medical Association 296, 2582–2589.Google Scholar
Murray, L, Fiori-Cowley, A, Hooper, R, Cooper, P (1996). The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome. Child Development 67, 2512–2526.Google Scholar
Nilsson, E, Lichtenstein, P, Cnattingius, S, Murray, RM, Hultman, CM (2002). Women with schizophrenia: pregnancy outcome and infant death among their offspring. Schizophrenia Research 58, 221–229.CrossRefGoogle ScholarPubMed
Oberlander, TF, Reebye, P, Misri, S, Papsdorf, M, Kim, J, Grunau, RE (2007). Externalizing and attentional behaviors in children of depressed mothers treated with a selective serotonin reuptake inhibitor antidepressant during pregnancy. Archives of Pediatrics and Adolescent Medicine 161, 22–29.CrossRefGoogle ScholarPubMed
Orhon, FS, Ulukol, B, Soykan, A (2007). Postpartum mood disorders and maternal perceptions of infant patterns in well-child follow-up visits. Acta Paediatrica 96, 1777–1783.CrossRefGoogle ScholarPubMed
Paulson, JF, Dauber, S, Leiferman, JA (2006). Individual and combined effects of postpartum depression in mothers and fathers on parenting behavior. Pediatrics 118, 659–668.Google Scholar
Ramchandani, P, Psychogiou, L (2009). Paternal psychiatric disorders and children's psychosocial development. Lancet 374, 646–653.CrossRefGoogle ScholarPubMed
Repetti, RL, Taylor, SE, Seeman, TE (2002). Risky families: family social environments and the mental and physical health of offspring. Psychological Bulletin 128, 330–366.CrossRefGoogle ScholarPubMed
Riecher-Rossler, A, Hofecker Fallahpour, M (2003). Postpartum depression: do we still need this diagnostic term? Acta Psychiatrica Scandinavica 108 (Suppl. 418), 51–56.Google Scholar
Sohr-Preston, SL, Scaramella, LV (2006). Implications of timing of maternal depressive symptoms for early cognitive and language development. Clinical Child and Family Psychology Review 9, 65–83.CrossRefGoogle ScholarPubMed
Vesga-Lopez, O, Blanco, C, Keyes, K, Olfson, M, Grant, BF, Hasin, DS (2008). Psychiatric disorders in pregnant and postpartum women in the United States. Archives of General Psychiatry 65, 805–815.CrossRefGoogle ScholarPubMed
Webb, R, Abel, K, Pickles, A, Appleby, L (2005). Mortality in offspring of parents with psychotic disorders: a critical review and meta-analysis. American Journal of Psychiatry 162, 1045–1056.CrossRefGoogle ScholarPubMed
Webb, RT, Abel, KM, Pickles, AR, Appleby, L, King-Hele, SA, Mortensen, PB (2006). Mortality risk among offspring of psychiatric inpatients: a population-based follow-up to early adulthood. American Journal of Psychiatry 163, 2170–2177.CrossRefGoogle ScholarPubMed
Webb, RT, Pickles, AR, Appleby, L, Mortensen, PB, Abel, KM (2007). Death by unnatural causes during childhood and early adulthood in offspring of psychiatric inpatients. Archives of General Psychiatry 64, 345–352.CrossRefGoogle ScholarPubMed
Weissman, MM, Wickramaratne, P, Nomura, Y, Warner, V, Pilowsky, D, Verdeli, H (2006). Offspring of depressed parents: 20 years later. American Journal of Psychiatry 163, 1001–1008.CrossRefGoogle ScholarPubMed
Wisner, KL, Parry, BL, Piontek, CM (2002). Clinical practice. Postpartum depression. New England Journal of Medicine 347, 194–199.CrossRefGoogle ScholarPubMed
Wisner, KL, Perel, JM, Findling, RL (1996). Antidepressant treatment during breast-feeding. American Journal of Psychiatry 153, 1132–1137.Google ScholarPubMed