Is the rate of postnatal depression the same in the developing world as in Western cultures? Does it have a similar adverse impact on the mother-child relationship? Researchers from the UK University of Reading and the University of Cape Town, South Africa, examined these questions in Khayelitsha, South Africa.

The study found that depression among these new mothers is nearly three times more common than in the developed world, and is associated with disturbances in the mother-infant relationship. High rates of postnatal depression combined with widespread poverty could put children at especially high risk for developmental problems. Policies should address these twin threats through poverty alleviation and targeted interventions for depressed mothers.

Postnatal depression occurs in about 10 percent of new mothers in wealthier countries, where it has an adverse impact on the relationship between mother and baby. This can have a negative effect on the children’s emotional development and their ability to learn. Studies in developed nations show that postnatal depression is due to psychological and social causes rather than biological factors.

Khayelitsha is a settlement on the fringes of Cape Town. Unemployment, poverty and overcrowding are rife. The researchers interviewed 147 women who had given birth two months earlier. Mothers were also filmed interacting with their babies.

Important findings of this research include:

• Over a third of new mothers suffer from postnatal depression - around three times as many as in developed countries.
• Social adversity is endemic in Khayelitsha but is not a risk factor for postnatal depression in this context.
• Instead, maternal depression is related to poor emotional and practical support from the partner. The absence of the partner in the home also has an adverse effect on the mother-child relationship.
• Postnatal depression is associated with higher levels of maternal insensitivity and lower levels of infant positive engagement in mother-infant interactions.
• The quality of mother-child interaction in Khayelitsha is rated as poorer than in Britain. This may be due to high levels of social adversity which exist in this peri-urban context.

In settlements like Khayelitsha, where social adversity and postnatal depression are high, children are likely to be at special risk, since both factors have a negative effect on child development. Thus, maternal health programmes could also improve the welfare of children by:

• addressing the problem of postnatal depression
• targeting social and economic risk factors for maternal depression
• improving the quality of mother-child interactions in peri-urban settlements.

Source(s):
'Postpartum depression and the mother-infant relationship in a South African peri-urban settlement' by P. J. Cooper, M. Tomlinson, L. Schwartz, M. Woolgar, L. Murray and C. Molteno, British Journal of Psychiatry 175 (1999)

Funded by: The Wellcome Trust, UK

id21 Research Highlight: 1 May 2001

Further Information:
Peter Cooper
Department of Psychology
University of Reading
Earley Gate
Reading
RG6 6AL
UK

Tel: +44 (0)118 931 6617
Fax: +44 (0)118 931 6665
Contact the contributor: p.j.cooper@rdg.ac.uk

University of Reading

Other related links:
WHO's Mental Health Program provides information on research and events as well as links to related resources.

The Knowledge Exchange Network website holds information on a range of mental health issues.

See this issue of the Bulletin of the WHO on mental health.