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Maternal mental health and childhood injury: evidence from the UK Millennium Cohort Study
  1. Steven Hope1,
  2. Jessica Deighton2,
  3. Nadia Micali1,
  4. Catherine Law1
  1. 1 UCL Great Ormond Street Institute of Child Health, London, UK
  2. 2 UCL and Anna Freud National Centre for Children and Families, London, UK
  1. Correspondence to Dr Steven Hope, Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK; s.hope{at}ucl.ac.uk

Abstract

Objective We assessed whether maternal mental health problems increased rates for child injury during the preschool years and mid-childhood, and the extent to which associations could be accounted for by a range of potential explanatory factors.

Design We analysed the UK Millennium Cohort Study, a nationally representative sample with data collected throughout childhood. Multinomial regression was used to investigate whether two measures of maternal mental health (diagnosed depression/anxiety and psychological distress) were associated with subsequent childhood injury. Models adjusted for sociodemographics, parenting and child externalising behaviours.

Main outcome measure Maternal report of unintentional injuries (none, 1, 2+) recorded at three data collection periods (3–5 years; 5–7 years; 7–11 years).

Results The analytic sample comprised n=9240 families who participated 3–11 years with complete data on exposures and outcomes (multiply imputing missing covariates). Exposure to maternal mental health problems was associated with increased rates of subsequent childhood injuries. Associations attenuated after adjustment for potential explanatory factors, although they remained elevated. For example, high maternal distress was associated with injuries 3–5 years (adjusted relative risk ratio (aRRR): 1 injury=1.18, 95% CI 0.86 to 1.61; 2+ injuries=2.22, 95% CI 1.22 to 4.02); injuries 5–7 years (aRRR: 1 injury=1.31, 95% CI 0.97 to 1.76; 2+ injuries=1.84, 95% CI 1.09 to 3.09); and injuries 7–11 years (aRRR: 1 injury=1.03, 95% CI 0.81 to 1.31; 2+ injuries=1.33, 95% CI 0.97 to 1.81).

Conclusions Children exposed to mothers with mental health problems had higher rates of childhood injury than those not exposed. If further investigation of this association suggests causality then it will be important to test measures that address mothers’ mental health issues with a view to reducing injuries among their children.

  • epidemiology
  • unintentional childhood injury
  • cohort study

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Footnotes

  • Contributors SH contributed to the study conceptualisation and design, devised and carried out the analyses, interpreted the results, drafted the initial manuscript, and reviewed and revised the manuscript. JD and NM contributed to the study conceptualisation and design, interpreted the results, and reviewed and revised the manuscript. CL initiated the study, contributed to the study conceptualisation and design, interpreted the results, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding This study was funded by Policy Research Unit in the Health of Children, Young People and Families (0090001).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval MCS1: South West Multi-Centre REC; MCS2, MCS3: London Multi-Centre REC; MCS4, MCS5: Northern and Yorkshire Multi-Centre REC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All MCS data used in this analysis are available from UK Data Service, University of Essex and University of Manchester: http://doi.org/10.5255/UKDA-SN-4683-4; http://doi.org/10.5255/UKDA-SN-5350-4; http://doi.org/10.5255/UKDA-SN-5795-4; http://doi.org/10.5255/UKDA-SN-6411-7; http://doi.org/10.5255/UKDA-SN-7464-3; http://doi.org/10.5255/UKDA-SN-7238-1; http://doi.org/10.5255/UKDA-SN-7464-3.