NAME - Riya Rajendra Raut

TITLE- Role of Maternal Postpartum Depression in Child's Health and Development

AFFILIATION- Jawaharlal Nehru Medical College

Wardha, Maharashtra

ABSTRACT-

Depression is a widely discussed topic in the past few years but is still not taken into serious
account by many sections of the society , particularly the developing countries of Asia. There
are ample amounts of sectors of life that can lead to depression . Repeated episodes of
depression can result in chronic stress in later stages of life.Postpartum depression is one of
them which will be discussed here. It is not talked about much but can have serious
repercussions affecting the mother and child both.
It is a non- psychotic mental illness seen in the first year of postpartum.
It is one of the serious public health issues that we face and is more prominent in the
developing countries than the developed western countries. In comparison to other mental
health issues, it is much neglected. Even the information available postpartum depression is
limited.Thus , becoming a topic which requires intense research to improve the present
scenario. (1) (5)

There are various demands that the mother has to meet after delivery, making it a vulnerable
period in a mother's life. There are even physical demands to meet.

Symptoms experienced by the mother in postpartum depression- feeling lonely, weakness,

lack of love and care for the infant, under confidence, less interest in daily life, anxiety,
anger, guilt.
Such mothers end up thinking that they are not good mothers and fear that the society may
consider them as incompetent mothers. (1) (2)

Postpartum depression not only affects the mother but also the child. The effect could be in
terms of physical,social, emotional, or psychological disabilities. Even the mother child
relationship is hampered as the mother (being herself disturbed both mentally and
physically) is not able to spend quality time with the child . The connection that the infants
have with their primary caregivers is hampered here. Mothers in this scenario are less
sensitive and responsive to their kids when the daily interactions are taken into account. (3)

Negative impact of postpartum depression on the infant-

If the breast feeding practices of the infant are poor , it can lead to degraded physical health
and malnutrition.As the degree of interaction is less between the mother and the child , the
child faces disturbed social, emotional, and cognitive development. (4)

Some health problems that may have relation to postpartum depression are Asthma,
Disturbed sleep cycle, brain abnormalities, diarrhoea, and a few more.
The child is also exposed to ADHD( attention deficit hyperactivity disorder)
Cases of obesity are also seen where the kids are assumed to develop weight( thus
overweight) (3)
The child also faces problems in communicating, various gross motor domains of life and
also the personal social domains.
Child with a mother who has depression undergoes a lot because infancy is the period when
children are in need of their primary caregivers and due to developmental plasticity , high
degree of support in social interactions. Postpartum depression can also affect the child
even before he or she is born ie. in the foetal/embryonic stage. It can lead to preterm
delivery also.

Thus in postpartum depression both the mother and the child have to suffer. Sometimes their
surroundings also.

KEYWORDS- maternal depression, affect, child development, bonding between mother and
infant, anxiety, perinatal depression.

MANUSCRIPT-

BACKGROUND -The social and emotional development of kids has vivid importance in
shaping their respective mental health and other disorders related to it which they may face
throughout their lives. Thus, the government considers it as a priority in policies concerning
social, health and educational development. Many researches up to the date focus mainly on
the post- conception factors that may affect the infant but along with it antenatal and
perinatal periods also have a role in affecting the infant physically or mentally.
Another fact of interest is that over years there has been a change in the preconception
period. It is delayed drastically .Before the industrial revolution , the first child was born to a
mother in her teenage years. This later changed to 20s and now in early 30s.This does
affect the parenting capacities making the mother or the child more prone to conditions like
anxiety, depression, obesity and a few common related disorders. But an advantage of it is
that the parents would be financially ,educationally and emotionally mature enough to look
after the kids . Thus , providing for all their needs.Role of fathers in child health and
development still has a knowledge gap. Usually when we talk of health development
concerning infants we don't pay much attention to the psychosocial problems that the parent
may be or may have faced. This could include mental disorders, disturebed relationships
within the family and difficulties in the educational part(low iq etc).Not much is known about
the risk factors within the environment affecting infants but it does have an effect
unknowingly. Main concern has always been to reduce the infant mortality rate but this
aspect affecting the quality of life has been neglected.
Researches suggest that exposures we have in our early life can affect /have a role in any
kind of non communicable disorders.
Fearful / traumatic life experiences of the mother can affect the mental state of the infant in
a negative way. Some studies have been conducted in the past to confirm the same. It has
been observed that the mothers who had some kinds of bad experiences in the past , had
kids with some or the other kind of psychiatric disorder.(though the degree varies and is not
always true).Even dysfunction in their (mother) own household can affect the offsprings. It is
said that there is intergenerational transfer of bad childhood events to the offspring and thus
affecting its psychopathology.
Now let us see if there is any role assisted reproductive technology in our topic. Many
couples receive assisted reproductive technology treatment across the globe. Japan
accounts the most though ( 5-8% of births in past years are by assisted reproductive
technology ). ART patients often experience a burden whether it is physical or psychological.
The older ladies suffer less as compared to the young ones. The psychology of the patients
receiving art treatment is seen to be disturbed from the start due to the social stigma
attached. In many countries the birth rate has gone down but the kids born through art
techniques have gone up .This is mainly due to late conception (ie delayed childbearing).
Mothers facing postpartum depression are less likely to breastfeed their kids than the normal
mothers. Postpartum depression is strongly associated with breastfeeding cessation.

RATIONALE-My rationale for choosing this topic is to focus on how even the little things can
affect their mental health. Especially when it comes to mothers , their experiences, their
health and stability as a whole. childhood experiences of the mother can also have an
impact on the mother .

EXTENSION - There are furthermore more things to be discussed under/related to this point
of my research.
According to the hypothesis based on evolution , male infants are more vulnerable to poor
conditions from the mother's side as compared to the females.Postpartum depression is a
mental health condition which is much prevalent and results in many harmful outcomes in
the social community. Thus it is crucial to take appropriate actions. the recognition and
analysis must be quick and accurate of the factors contributing to it. Postpartum depression
is also called a mood disorder which shows up in women after childbirth. It acts as an
obstacle to their respective mental health. it consists of many dimensions which could be
social, economics, personal, familial, mental,etc. The traditional methods of identifying the
ones suffering from postpartum depression is through surveys and clinical responses. But
they are subjected to errors as not everyone would know if they are really going through
something, they may not want to talk about it and also stigma from society has a role.
Postpartum depression is said to interfere with the effective bond between the infant and the
mother, important for the overall development of the child. Reported cases of the same is
said to have increased steeply in the covid-19 period. This could be due to increased levels
of stress and less support. Thus bonding impairments arise.It is seen that the parenting
functioning is very much affected by the level of depressive symptoms.
Another interesting fact about postpartum depression is that it may not be serious in many
cases and may resolve on its own as a result of adaptation.According to WHO, women are
more prone to suffer depression after childbirth than any other stressful event in their life.
It is usually manifested in the time span of 4 weeks of delivery.
DSM-5 (Diagnostic and statistical manual of mental disorders)has also talked about it.
Peripartum depression is said to be an episode of major depression disorder.But
researchers have been confused about the same for several years, thus it remained
questioned for long.There are also some cases where it can occur upto one year after
delivery.
Over the years it has been confirmed that postpartum depression is no different from non-
postpartum depression , the only difference lies in severity. Postpartum depression is mildly
severe. Simply women are at a higher risk of developing depression after pregnancy, thus it
is also conceptualised as an adjustment disorder. But the term ‘Postpartum Depression’
must be preserved to reduce any kind of stigma attached to women and enhance self help
behaviour.The symptoms under PPD are broad ranged.
Considering the number of babies born in the world annually, ie. 135 million , the
rate of prevalence for postpartum depression is 14-18%,according to these statistics
20 million women across the world are at risk and need accurate diagnosis of their
condition. But there exist several issues when it comes to the diagnosis of
postpartum depression, the diagnosis may mislead resulting in wrong diagnosis and
wrong / no treatment ultimately worsening the condition.To encounter this
knowledge gap , a multidisciplinary Pan-European network of researchers and
professionals came together within the COST Action “Research Innovation and
Sustainable Pan-European Network in Peripartum Depression Disorder'' . Their goal
was to understand postpartum depression. This COST Action has over 150
researchers coming from more than 30 countries across the world, gathered in order
to contribute to the research , they aim to spread social awareness surrounding
postpartum depression and to foster efforts made in research towards the process of
standardisation of criteria used for diagnoses , screening of useful tools and
cost-effectiveness evaluation of prevention and treatment programs. As outlined
before, one of the main concerns of the Action was to clearly clarify inconsistent
findings concerning diagnosis. Other aimed involved in this are as follows,-
to synthesize current literature on issues regarding PPD diagnosis in different
aspects, including diagnostic criteria, development and course , risk and prognostic
factors , culture-related diagnostic issues, suicide risk, and comorbidity. This
narrative review provides a state-of-the-art overview of postpartum depression with
the purpose of better understanding whether postpartum depression is better
conceptualised as a part of the major depression disorder.
Postpartum depression is an illness about which not many women talk about or even
recognize.IT is also not considered well for mothers to complain about mental setbacks of
taking care of their kids. Thus along with self check of postpartum depression a check from
others point of view is also necessary.
Every 1 out of 5 pregnant women face mental issues after delivery and this is also a reason
for maternal deaths.
Thus, favourable postpartum care to the needy is essential for women to get over the stress.
There also exist some studies that talk about the role of catastrophic disasters on the current
topic under discussion.
According to many articles and researches , males are less likely to report an incidence of
anxiety or depression than females due to stereotypes and stigma .Similarly , yet abstract to
believe, approximately 10% fathers also face postnatal instances of depression. But they are
not really screened or examined for such cases as much as the mothers are. Thus talking
about the barriers expectant fathers face to seek for help is of concern. Whenever we talk
about postpartum depression we refer to the mother and its effect on the child but never the
fathers. Though the affect might not be that serious but it does affect their mental peace.
Men tend to adhere to the masculine norms which include competition, self reliance, and
violence.
Thus they act as barriers to themselves due to beliefs that are negative.
CONCLUSION-

CITATIONS-
1. Prevalence of Postpartum Depression in a Tertiary Health Care - PMC [Internet]. [cited
2023 Dec 13]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580319/
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Breastfeeding on Child Development, Anxiety, and Postpartum Depression. Int J Environ
Res Public Health. 2020 Apr 15;17(8):2725.
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Paulo’s Western Region Cohort Study. Rev Assoc Medica Bras 1992. 2016
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4. Abdollahi F, Rezai Abhari F, Zarghami M. Post-Partum Depression Effect on Child Health
and Development. Acta Med Iran. 2017 Feb;55(2):109–14.
5. Azad R, Fahmi R, Shrestha S, Joshi H, Hasan M, Khan ANS, et al. Prevalence and risk
factors of postpartum depression within one year after birth in urban slums of Dhaka,
Bangladesh. PloS One. 2019;14(5):e0215735.