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. 2024 Jan 24;10(1):18.
doi: 10.1186/s40795-024-00826-0.

Impact of maternal depression on malnutrition treatment outcomes in older children with sickle cell anemia

Claire Ritter  1 , Shehu U Abdullahi  2 , Safiya Gambo  3 , Hassan Adam Murtala  3 , Halima Kabir  2 , Khadija A Shamsu  2 , Garba Gwarzo  2 , Yasmin Banaei  4 , Sari A Acra  5 , Virginia A Stallings  6 , Mark Rodeghier  7 , Michael R DeBaun  8   9 , Lauren J Klein  10   11
Affiliations

Impact of maternal depression on malnutrition treatment outcomes in older children with sickle cell anemia

Claire Ritter et al. BMC Nutr. .

Abstract

Background: Malnutrition and sickle cell anemia (SCA) result in high childhood mortality rates. Although maternal depression is an established risk factor for malnutrition in younger children, little is known about its impact on treatment response in children with malnutrition. We aimed to determine the relationship, if any, between maternal depression scores and malnutrition treatment outcomes in older children with SCA.

Methods: We conducted a planned ancillary study to our randomized controlled feasibility trial for managing severe acute malnutrition in children aged 5-12 with SCA in northern Nigeria (NCT03634488). Mothers of participants completed a depression screen using the Patient Health Questionnaire (PHQ-9).We used a multivariable linear regression model to describe the relationship between the baseline maternal PHQ-9 score and the trial participant's final body mass index (BMI) z-score.

Results: Out of 108 mother-child dyads, 101 with maternal baseline PHQ-9 scores were eligible for inclusion in this analysis. At baseline, 25.7% of mothers (26 of 101) screened positive for at least mild depression (PHQ-9 score of 5 or above). The baseline maternal PHQ-9 score was negatively associated with the child's BMI z-score after 12 weeks of malnutrition treatment (β=-0.045, p = 0.041).

Conclusions: Maternal depressive symptoms has an impact on malnutrition treatment outcomes. Treatment of malnutrition in older children with sickle cell anemia should include screening for maternal depression and, if indicated, appropriate maternal referral for depression evaluation and treatment.

Trial registration: The trial was registered at clinicaltrials.gov (#NCT03634488) on January 30, 2018, https://clinicaltrials.gov/study/NCT03634488 .

Keywords: Body mass index; Malnutrition; Maternal depression; Maternal health; Patient health questionnaire; Sickle cell anemia.

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Conflict of interest statement

Dr. DeBaun and his institution sponsor two externally funded research investigator-initiated projects. Clinical studies will have funds provided by Global Blood Therapeutics (GBT). GBT was not a co-sponsor of either study. Dr. DeBaun did not receive any compensation for the conduct of these two investigator-initiated observational studies. Dr. DeBaun is a member of the GBT advisory board for a proposed randomized controlled trial for which he receives compensation. Dr. DeBaun is on the steering committee for a Novartis-sponsored phase II trial to prevent priapism in men. Dr. DeBaun was a medical advisor in developing the CTX001 Early Economic Model and provided medical input as part of an expert reference group for the Vertex/CRIPR CTX001 Early Economic Model in 2020. Dr. DeBaun consulted for the Formal Pharmaceutical company about sickle cell disease in 2021 and 2022. The authors have no other relevant affiliation or financial involvement with any entity or organization with a financial interest in or conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Fig. 1
Fig. 1
Correlation of the maternal baseline PHQ-9 score and the child’s change in BMI z-score
Fig. 2
Fig. 2
Child’s predicted final BMI z-score with 95% confidence intervals based on maternal baseline PHQ-9 score
See this image and copyright information in PMC

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