Institute of Collective Health, Federal University of Bahia, Bahia, Brazil.
Soc Psychiatry Psychiatr Epidemiol. 2011 Jul;46(7):543-8. doi: 10.1007/s00127-010-0220-4. Epub 2010 Apr 18.
Despite improvements in the nutritional status of Brazilian children, child malnutrition remains a public health issue. The objective of the present study was to analyse the effect of maternal common mental disorders (MCMD) on child malnutrition in a large Brazilian urban centre with low rates of child malnutrition. Furthermore, we explored the hypothesis that a reduction in the quality of maternal caregiving mediates the relationship between maternal mental health problems and child nutrition.
A case-control study including 294 children aged between 0 and 5 years, with 147 cases and 147 age- and sex-matched controls, was conducted in the city of Salvador, northeastern Brazil. Mothers completed the Self-Report Questionnaire (SRQ-20), the family's socio-economic status was evaluated and the Home Observation for Measurement of the Environment (HOME) Inventory was applied. Children were diagnosed as moderately or severely malnourished when the weight-for-height z-score was below -2 SD. Conditional logistic regression was used in the analysis, and the final model was created using the backward technique.
MCMD doubled the risk of moderate or severe malnutrition in children (OR = 2.04; 95% CI: 1.10-3.78). Maternal caregiving can be an important factor mediating the relationship between maternal mental health and child malnutrition.
MCMD must be taken into account in programmes for the treatment and prevention of malnutrition, especially in areas of low malnutrition prevalence.
尽管巴西儿童的营养状况有所改善,但儿童营养不良仍是一个公共卫生问题。本研究旨在分析在一个营养不良率较低的巴西大城市中心,母亲常见精神障碍(MCMD)对儿童营养不良的影响。此外,我们还探讨了这样一种假设,即降低母婴照护质量可以调节母亲心理健康问题与儿童营养之间的关系。
这是一项病例对照研究,共纳入了 294 名 0-5 岁儿童,其中 147 例为病例,147 例为年龄和性别匹配的对照。母亲完成了自我报告问卷(SRQ-20),评估了家庭的社会经济地位,并应用了家庭观察测量环境(HOME)量表。当身高体重指数低于-2 个标准差时,儿童被诊断为中度或重度营养不良。采用条件逻辑回归进行分析,最终模型采用后向技术构建。
MCMD 使儿童中度或重度营养不良的风险增加了一倍(OR=2.04;95%CI:1.10-3.78)。母婴照护可以是调节母亲心理健康与儿童营养不良之间关系的一个重要因素。
在治疗和预防营养不良的方案中,必须考虑 MCMD,特别是在营养不良发生率较低的地区。