Associations Between Social Support and Symptoms of Antenatal Depression with Infant Growth and Development Among Mothers Living with HIV in Tanzania.

Journal: AIDS and behavior

Volume: 27

Issue: 11

Year of Publication: 

Affiliated Institutions:  Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA. asaleh@hsph.harvard.edu. Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA. Africa Academy for Public Health, Dar es Salaam, Tanzania. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA. Management and Development for Health, Dar es Salaam, Tanzania. Department of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Department of Pediatrics and Child Health, Muhimbili University Health and Allied Sciences, Dar es Salaam, Tanzania.

Abstract summary 

Children born to mothers living with HIV may experience greater risk of poor growth and development outcomes than their HIV-unexposed peers. Few studies have examined the relationship between maternal depression and social support with infant growth and development in the context of HIV. We conducted a prospective cohort study of 2,298 pregnant women living with HIV in Dar es Salaam, Tanzania, assessing antenatal depression (Hopkins Symptoms Checklist-25) and social support (Duke-UNC Functional Social Support Questionnaire) at 12-27 weeks of gestation. At one-year age, infant anthropometry and caregiver-reported infant development were assessed. Generalized estimating equations were used to assess mean differences (MD) and relative risks (RR) for growth and developmental outcomes. Symptoms consistent with maternal antenatal depression had 67% prevalence and were associated with infant wasting (RR 2.61; 95% confidence interval (CI) 1.03-6.65; z = 2.02; p = 0.04), but no other growth or developmental outcomes. Greater maternal social support was not associated with infant growth outcomes. Greater affective support was associated with better cognitive (MD 0.18; CI 0.01-0.35; z = 2.14; p = 0.03) and motor (MD 0.16; CI 0.01-0.31; z = 2.04; p = 0.04) development scores. Greater instrumental support was associated with better cognitive (MD 0.26; CI 0.10-0.42; z = 3.15; p < 0.01), motor (MD 0.17; CI 0.02-0.33; z = 2.22; p = 0.03), and overall (MD 0.19; CI 0.03-0.35; z = 2.35; p = 0.02) development scores. Depressive symptoms were associated with greater risk of wasting, while social support was associated with better infant development scores. Strategies to improve mental health and social support for mothers living with HIV during the antenatal period may benefit infant growth and development.

Authors & Co-authors:  Saleh Arvin A Perumal Nandita N Muhihi Alfa A Duggan Christopher P CP Ulenga Nzovu N Al-Beity Fadhlun M Alwy FMA Aboud Said S Fawzi Wafaie W WW Manji Karim P KP Sudfeld Christopher R CR

Study Outcome 

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Statistics
Citations :  Smith Fawzi MC, Andrews KG, Fink G, Danaei G, McCoy DC, Sudfeld CR, et al. Lifetime economic impact of the burden of childhood stunting attributable to maternal psychosocial risk factors in 137 low/middle-income countries. BMJ Glob Heal. 2019;4(1):e001144.
Authors :  10
Identifiers
Doi : 10.1007/s10461-023-04073-5
SSN : 1573-3254
Study Population
Female,Women,Mothers
Mesh Terms
Other Terms
Depression;Development;Growth;Infant;Support
Study Design
Cohort Study
Study Approach
Country of Study
Tanzania
Publication Country
United States