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Maternal depression increases infant risk of diarrhoeal illness: –a cohort study
  1. A Rahman1,
  2. J Bunn2,
  3. H Lovel3,*,
  4. F Creed4
  1. 1Human Development Research Foundation, Islamabad, Pakistan
  2. 2Department of Tropical Child Health, Liverpool School of Tropical Child health, Liverpool, UK
  3. 3WHO Collaborating Centre for Primary Care, University of Manchester, Manchester, UK
  4. 4School of Psychiatry and Behavioural Sciences, University of Manchester, Manchester, UK
  1. Correspondence to:
    Dr A Rahman
    Division of Psychiatry, School of Psychiatry and Behavioural Sciences, University of Manchester, Rawnsley Building, Oxford Road, Manchester M13 9WL, UK; atif.rahman{at}


Aims: To examine the associations between postnatal depression in mothers and diarrhoeal illness in their infants in the first year of life in a low-income country.

Methods: Using a prospective cohort design, 265 infants (n = 130 of mothers having a depressive episode according to the International Classification of Diseases, 10th revision, at 3 months postnatal and n = 135 of psychologically well mothers) living in rural Rawalpindi, Pakistan, were followed up for 1 year. Frequency of diarrhoeal episodes was measured fortnightly by health workers using a standard questionnaire.

Results: Infants of depressed mothers had significantly more diarrhoeal episodes per year than those of controls (mean 5.5 v 4.0; 95% confidence interval (CI) 0.9 to 2.0). The relative risk of having ⩾5 diarrhoeal episodes per year in infants of depressed mothers was 2.3 (95% CI 1.6 to 3.1). The association remained significant after adjustment for other risk factors by multivariate analysis.

Conclusions: Maternal depression is associated with infant diarrhoeal morbidity in a low-income community setting. It is independent of the effects of known factors such as undernutrition, socioeconomic status and parental education. Preventive child health programmes targeting mothers must consider their mental health.

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  • Published Online First 6 September 2006

  • * Current address: East of England Public Health Group, Department of Health, Cambridge CB2 2DF, UK.

  • Funding:This study was funded by a grant from the Wellcome Trust, UK (060177/Z/00/Z).

  • Competing interests: None.

  • This work is dedicated to the memory of Richard Harrington, Professor, Department of Child and Adolescent Psychiatry, University of Manchester, Manchester, UK, who supervised this work from 2000 until his untimely death in May 2004.

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