In wealthy countries, postnatal depression affects between 10 to 15 per cent of women. It can affect a baby’s progress, especially its cognitive (mental) development. Is this true in developing countries? Can it also affect growth? Researchers from the Sangath Centre looked at the impact of postnatal depression on infant growth and development in Goa, India.

Depression is a very disabling disorder, which is often unrecognised and untreated in low income countries. Postnatal depression occurs within six weeks after childbirth. Common features include:

• fatigue and tiredness
• sleep difficulties
• poor appetite and weight loss
• reduced concentration
• loss of interest in daily activities.

Any of these may inhibit normal mothering and breastfeeding. Depressed women are also emotionally unavailable to their babies and this can lead to psychosocial deprivation and failure to thrive.

Researchers weighed and measured 171 babies six to eight weeks after birth at a district hospital in the Indian state of Goa. This public hospital serves urban and rural women from lower socioeconomic groups. They followed up 142 of the babies when they were six months old. The study showed that:

• At six to eight weeks old, 18 per cent of babies are underweight and nine per cent are short for their age. The figures at six months are 17 per cent and 13 per cent, respectively.
• 43 babies were born to mothers who developed postnatal depression.
• Babies with depressed mothers are similar to other babies in terms of gender, maternal employment status, maternal age and gravidity.
• But they are more likely than other babies to be underweight and have poor mental development scores, even after allowing for birth weight and maternal education.

The researchers suggest that the impact of postnatal depression on infant growth and mental development is likely to be due to direct exposure to the mother’s symptoms or to parenting difficulties resulting from the disorder.

Counselling is used to prevent and treat postnatal depression in wealthy countries. The researchers recommend that health planners tackle this issue in developing countries by:

• testing counselling strategies in these settings where the environment and culture is very different
• integrating mental health within the scope of maternal and child health (MCH) services
• providing training for MCH practitioners on the recognition and management of postnatal depression.

Source(s):
‘Postnatal depression and infant growth and development in low income countries: a cohort study from Goa, India’, Archives of Diseases of the Child 88: 34-37, by V. Patel, N. DeSouza and M. Rodrigues, 2003 Full document.

Funded by: MacArthur Foundation

id21 Research Highlight: 27 February 2003

Further Information:
Vikram Patel
Sangath Centre
841/1 Alto Porvorim
Goa 403521
India

Contact the contributor: vikpat@goatelecom.com

Sangath Society, Goa, India

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