Maternal perinatal depression is not independently associated with child body mass index in the Generation R Study: methods and missing data matter

Abstract

Objectives: To advance the understanding of the relationship between maternal perinatal depression and child overweight, we used appropriate methodology to account for missing data; incorporated three exposure time points; and included adequate covariate adjustment in a large, sociodemographically diverse sample.

Study design and setting: We used data from 6,782 mother-child pairs in a prospective population-based study. Maternal depression was assessed with the Brief Symptom Inventory at midpregnancy and 2 and 6 months postpartum. Child height and weight were measured at 36 months of age and converted to body mass index (BMI) z-scores. We compared the complete-case and multiple imputation (MI) analyses.

Results: Fully adjusted complete-case models showed a positive association between depression at 2 months postpartum and child BMI z-score (β=0.19 [95% confidence interval (CI)=0.03, 0.36]; n=1,732), and no association between prenatal depression or 6-month postpartum depression and child BMI. Using MI (n=6,782), there was no association between perinatal depression and child BMI at any time point.

Conclusions: Our study adds evidence that postpartum depression is not associated with child growth across the population in high-income countries. Our results highlight the importance of appropriate handling of missing data, adequate covariate control, and the value of studying the conditions that have produced conflicting evidence regarding perinatal depression and child weight.