Mekonnen Habtamu, Medhin Girmay, Tomlinson Mark, Alem Atalay, Prince Martin, Hanlon Charlotte
Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
BMJ Open. 2018 Jan 21;8(1):e018916. doi: 10.1136/bmjopen-2017-018916.
To examine the association between exposure to maternal common mental disorders (CMD) in preschool and early school age children and subsequent child educational outcomes.
A population-based cohort study.
The study was undertaken in the Butajira health and demographic surveillance site (HDSS), a predominantly rural area of south central Ethiopia.
Inclusion criteria are women aged between 15 and 49 years, able to speak Amharic, in the third trimester of pregnancy and resident of the HDSS. 1065 women were recruited between July 2005 and February 2006 and followed up. When the average age of children was 6.5 years old, the cohort was expanded to include an additional 1345 mothers and children who had been born in the 12 months preceding and following the recruitment of the original cohort, identified from the HDSS records. Data from a total of 2090 mother-child dyads were included in the current analysis.
Maternal CMD was measured when the children were 6-7 (6/7) and 7-8 (7/8) years old using the Self-reporting Questionnaire, validated for the setting. Educational outcomes (dropout) of the children at aged 7/8 years (end of 2013/2014 academic year) were obtained from maternal report. At age 8/9 years (end of 2014/2015 academic year), educational outcomes (academic achievement, absenteeism and dropout) of the children were obtained from school records.
After adjusting for potential confounders, exposure to maternal CMD at 7/8 years was associated significantly with school dropout (OR 1.07; 95% CI 1.00 to 1.13, P=0.043) and absenteeism (incidence rate ratio 1.01; 95% CI 1.00 to 1.02 P=0.026) at the end of 2014/2015 academic year. There was no association between maternal CMD and child academic achievement.
Future studies are needed to evaluate whether interventions to improve maternal mental health can reduce child school absenteeism and dropout.
研究学龄前和学龄早期儿童接触母亲常见精神障碍（CMD）与儿童后续教育成果之间的关联。
一项基于人群的队列研究。
该研究在布塔吉拉健康与人口监测点（HDSS）开展，位于埃塞俄比亚中南部一个主要为农村的地区。
纳入标准为年龄在15至49岁之间、会说阿姆哈拉语、处于妊娠晚期且居住在HDSS的女性。2005年7月至2006年2月招募了1065名女性并进行随访。当儿童平均年龄为6.5岁时，该队列扩大，纳入另外1345名母亲和儿童，这些母亲和儿童是在最初队列招募前后12个月内出生的，从HDSS记录中识别出来。本分析纳入了总共2090对母婴的数据。
当儿童6至7岁（6/7岁）和7至8岁（7/8岁）时，使用经过该研究环境验证的自填问卷测量母亲的CMD。儿童7/8岁（2013/2014学年末）的教育成果（辍学情况）通过母亲报告获得。在8/9岁（2014/2015学年末），儿童的教育成果（学业成绩、缺勤率和辍学情况）通过学校记录获得。
在对潜在混杂因素进行调整后，7/8岁时接触母亲CMD与2014/2015学年末的辍学（比值比1.07；95%置信区间1.00至1.13，P = 0.043）和缺勤率（发病率比1.01；95%置信区间1.00至1.02，P = 0.026）显著相关。母亲CMD与儿童学业成绩之间无关联。
需要进一步研究评估改善母亲心理健康的干预措施是否能减少儿童缺勤和辍学情况。
