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Journal Article

Citation

McDonald SW, Kehler HL, Tough SC. BMJ Open 2016; 6(11): e012096.

Affiliation

Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Copyright

(Copyright © 2016, BMJ Publishing Group)

DOI

10.1136/bmjopen-2016-012096

PMID

28186930

PMCID

PMC5128911

Abstract

OBJECTIVE: To identify the combination of factors most protective of developmental delay at age 2 among children exposed to poor maternal mental health.

DESIGN: Observational cohort study. SETTING: Pregnant women were recruited from primary healthcare offices, the public health laboratory service and community posters in Calgary, Alberta, Canada. PARTICIPANTS: 1596 mother-child dyads who participated in the All Our Babies study and who completed a follow-up questionnaire when their child was 2 years old. Among participants who completed the 2-year questionnaire and had complete mental health data (n=1146), 305 women (27%) were classified as high maternal mental health risk. PRIMARY MEASURES: Child development at age 2 was described and a resilience analysis was performed among a subgroup of families at maternal mental health risk. The primary outcome was child development problems. Protective factors were identified among families at risk, defined as maternal mental health risk, a composite measure created from participants' responses to mental health life course questions and standardised mental health measures.

RESULTS: At age 2, 18% of children were classified as having development problems, 15% with behavioural problems and 13% with delayed social-emotional competencies. Among children living in a family with maternal mental health risk, protective factors against development problems included higher social support, higher optimism, more relationship happiness, less difficulty balancing work and family responsibilities, limiting the child's screen time to <1 hour per day and the child being able to fall asleep in <30 min and sleeping through the night by age 2.

CONCLUSIONS: Among families where the mother has poor mental health, public health and early intervention strategies that support interpersonal relationships, social support, optimism, work-life balance, limiting children's screen time and establishing good sleep habits in the child's first 2 years show promise to positively influence early child development.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.


Language: en

Keywords

child development; cohort study; maternal mental health; protective factors; resilience

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