Associating Maternal Depression To Stunting And Later Cognitive Deficits In Children- A Case Of Kitui, Kenya

Abstract

Maternal depressive symptoms are negatively associated with early child development and quality of parenting across different cultures and socioeconomic groups. A study conducted in Bangladesh revealed that maternal depressive symptoms were associated with infant stunting, perhaps related to unresponsive care giving. The association between stunting, maternal depression and cognitive deficits of children has not been comprehensively studied in Kenya. Literature revealed that the risk factors of maternal depression, such as poverty, low education, high stress, lack of empowerment, and poor social support are also risk factors for poor child development. Most of these risk factors are present in many low and middle income countries and they have adverse effects on both maternal and child health outcomes. The purpose of this research study was to be to study the link between stunting, maternal depression and later cognitive deficits amongst children between 4- 6 years attending early child hood education (ECD) in Kitui. The study was guided by two key research questions is there a link between maternal depression and stunting? Are stunted children more likely to have cognitive deficits compared to stunted children? The research study adopted a case- control design and the population of the study was all children attending ECD in Kitui County. The sample size was calculated with an alpha value of 0.05 and power 80%. The sampling method stratified proportionate sampling. The total sample size was 168. Stunting was measured by taking the height and age of children participating in the study which was then scored using the WHO reference. KABC- 2 was used to test xi intelligence of all the children taking place in the study. Mothers of children sampled in the study were tested for depression using PHQ 9-Swahili. For all mothers who were found to be currently depressed supplemental questions to score past depression when the child in the study was one and two years old were asked. Data on risk factors for maternal depression and stunting was collected using a researcher designed questionnaire. The results showed that global intelligence test scores of the stunted children were lower than the scores of the non stunted children. When comparing the global intelligence scores of the stunted and non stunted children the results showed the group mean of the non stunted children was 69.8 while the group mean of the stunted children was 50.7. A chi-square test was further carried out to determine how the global intelligence scores between the stunted children (cases) and the non stunted children (control) compared. The scores of the stunted children were significantly lower compared to those of the control group at p<0.001.The study also showed that there was a higher prevalence of severe depression among mothers whose children were stunted at 13.4% as compared to rates of 4.1% among mothers whose children were not stunted. Discussion: based on these findings, we can conclude that stunted children are more likely to have depressed mothers than non stunted children. 67.9 % of mothers with stunted children had mild depression as compared to only 28.4% of the non stunted children. The study also showed that the more severe the stunting the more the association with severe depression on the mother. Comparison between mothers with children with moderate stunting and those with severe stunting also showed higher prevalence among severely stunted (-3SD) at 17.1% as compared to 12.8% among the moderate stunted (-2SD). xii Conclusion: In most societies mothers are the primary providers of nutrition and care to young children. Therefore maternal depressive symptoms are likely to be negatively associated with early child development and quality of parenting across different cultures and socioeconomic groups. Child nutrition programmes that are aimed at dealing with stunting should include an element of the management and treatment of maternal depression.