Maternal Postnatal Depression and Offspring Psychological Distress in South Africa: A 28-Year Study

• In Event: Family Context and Child Development in the Global South

Abstract

Background. Studies in high-income countries show long-term associations between maternal perinatal depression and offspring psychological distress, especially from families of low socioeconomic status. However, there is no evidence of such long-term associations in low-and-middle income countries, and specifically in environments with widespread economic stress, violence, and other adversities.
Objective. To investigate whether maternal depression is associated with offspring psychological distress from adolescence to adulthood, and whether the association is moderated by socioeconomic status.
Methods. The analysis used data from Birth to Twenty Plus, a prospective birth cohort based in Soweto-Johannesburg, South Africa (N=1078; 50% males). The cohort enrolled all singleton children born during a 7-week period in 1990 during an extremely volatile and violent time in South Africa’s history, both politically and socially. Postnatal depression was self-reported by mothers 6 months after childbirth. Psychological distress (anxiety, depression, and somatic symptoms) assessed at offspring ages 14, 22, and 28 years were modelled longitudinally using group-based trajectory modelling. Association between maternal postnatal depression and offspring psychological distress across adolescence and adulthood was investigated using multivariable regression. To test the moderating role of socioeconomic status, we tested the interaction between mother’s achieved years of schooling (used as a proxy of socioeconomic status) and postnatal depression.
Results. Eleven percent of children showed an atypically high trajectory of psychological distress from 14 to 28 years of age (vs low trajectory; 89%; Figure 1). Children exposed to postnatal depression were more likely to follow the high trajectory (adjusted OR,1.21; CI,1.03-1.43). The effect of postnatal depression differed according to mothers’ achieved years of schooling (p interaction=0.016; Figure 2): associations were significant among mothers who had only some secondary schooling (80% of the sample; OR,1.32; CI,1.09-1.59), but not for mothers with higher levels of schooling (i.e., some tertiary education; 8% of the sample) or very low levels of schooling (i.e., some primary education only; 12% of the sample).
Conclusions. Findings suggest that postnatal depression is associated with a higher risk of persistent psychological distress in offspring from adolescence to adulthood in a middle-income country, varying by socioeconomic status. Prevention of postnatal depression, particularly among women with less education may have positive effects in reducing psychological problems in the next generation.

Authors

• Massimiliano Orri, University of Bordeaux
  Presenting Author

• Sahba Besharati, University of Witwatersrand
  Non-Presenting Author

• Marilyn N Ahun, Harvard University
  Non-Presenting Author

• Linda Richter, University of Witwatersrand
  Non-Presenting Author