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Community health workers can improve child growth of antenatally-depressed, South African mothers: a cluster randomized controlled trial.

Tomlinson M, Rotheram-Borus MJ, Harwood J, le Roux IM, O'Connor M, Worthman C - BMC Psychiatry (2015)

Bottom Line: The infants of depressed pregnant women in the PIP group were similar in height (height-for-age Z scores) to the children of non-depressed mothers in both the PIP and the SC conditions, but significantly taller at 6 months of age than the infants of pregnant depressed mothers in the SC condition.The intervention did not moderate children's growth.Depressed SC mothers tended to have infants less than two standard deviations in height on the World Health Organization's norms at two weeks post-birth compared to infants of depressed PIP mothers and non-depressed mothers in both conditions.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, South Africa. markt@sun.ac.za.

ABSTRACT

Background: Maternal antenatal depression has long-term consequences for children's health. We examined if home visits by community health workers (CHW) can improve growth outcomes for children of mothers who are antenatally depressed.

Methods: A cluster randomized controlled trial of all pregnant, neighbourhood women in Cape Town, South Africa. Almost all pregnant women (98 %, N = 1238) were recruited and assessed during pregnancy, two weeks post-birth (92 %) and 6 months post-birth (88 %). Pregnant women were randomized to either: 1) Standard Care (SC), which provided routine antenatal care; or 2) an intervention, The Philani Intervention Program (PIP), which included SC and home visits by CHW trained as generalists (M = 11 visits). Child standardized weight, length, and weight by length over 6 months based on maternal antenatal depression and intervention condition.

Results: Depressed mood was similar across the PIP and SC conditions both antenatally (16.5 % rate) and at 6 months (16.7 %). The infants of depressed pregnant women in the PIP group were similar in height (height-for-age Z scores) to the children of non-depressed mothers in both the PIP and the SC conditions, but significantly taller at 6 months of age than the infants of pregnant depressed mothers in the SC condition. The intervention did not moderate children's growth. Depressed SC mothers tended to have infants less than two standard deviations in height on the World Health Organization's norms at two weeks post-birth compared to infants of depressed PIP mothers and non-depressed mothers in both conditions.

Conclusions: A generalist, CHW-delivered home visiting program improved infant growth, even when mothers' depression was not reduced. Focusing on maternal caretaking of infants, even when mothers are depressed, is critical in future interventions.

Trial registration: ClinicalTrials.gov registration # NCT00996528 . October 15, 2009.

No MeSH data available.


Related in: MedlinePlus

Trial profile
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Fig1: Trial profile

Mentions: In 2009, 26 township neighborhoods were matched on size (450–600 households), density, public utilities (water, electricity, toilets), distance of primary health care, and the number of alcohol bars. UCLA randomized matched pairs of neighborhoods to either the PIP or SC condition. The minimum number of pregnant women needed per neighbourhood to achieve 80 % power to detect a standardized effect size of 0.40 set the sample size; the original size was 1238. Participant flow through each phase of the study can be seen in Fig. 1.Fig. 1


Community health workers can improve child growth of antenatally-depressed, South African mothers: a cluster randomized controlled trial.

Tomlinson M, Rotheram-Borus MJ, Harwood J, le Roux IM, O'Connor M, Worthman C - BMC Psychiatry (2015)

Trial profile
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4581418&req=5

Fig1: Trial profile
Mentions: In 2009, 26 township neighborhoods were matched on size (450–600 households), density, public utilities (water, electricity, toilets), distance of primary health care, and the number of alcohol bars. UCLA randomized matched pairs of neighborhoods to either the PIP or SC condition. The minimum number of pregnant women needed per neighbourhood to achieve 80 % power to detect a standardized effect size of 0.40 set the sample size; the original size was 1238. Participant flow through each phase of the study can be seen in Fig. 1.Fig. 1

Bottom Line: The infants of depressed pregnant women in the PIP group were similar in height (height-for-age Z scores) to the children of non-depressed mothers in both the PIP and the SC conditions, but significantly taller at 6 months of age than the infants of pregnant depressed mothers in the SC condition.The intervention did not moderate children's growth.Depressed SC mothers tended to have infants less than two standard deviations in height on the World Health Organization's norms at two weeks post-birth compared to infants of depressed PIP mothers and non-depressed mothers in both conditions.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, South Africa. markt@sun.ac.za.

ABSTRACT

Background: Maternal antenatal depression has long-term consequences for children's health. We examined if home visits by community health workers (CHW) can improve growth outcomes for children of mothers who are antenatally depressed.

Methods: A cluster randomized controlled trial of all pregnant, neighbourhood women in Cape Town, South Africa. Almost all pregnant women (98 %, N = 1238) were recruited and assessed during pregnancy, two weeks post-birth (92 %) and 6 months post-birth (88 %). Pregnant women were randomized to either: 1) Standard Care (SC), which provided routine antenatal care; or 2) an intervention, The Philani Intervention Program (PIP), which included SC and home visits by CHW trained as generalists (M = 11 visits). Child standardized weight, length, and weight by length over 6 months based on maternal antenatal depression and intervention condition.

Results: Depressed mood was similar across the PIP and SC conditions both antenatally (16.5 % rate) and at 6 months (16.7 %). The infants of depressed pregnant women in the PIP group were similar in height (height-for-age Z scores) to the children of non-depressed mothers in both the PIP and the SC conditions, but significantly taller at 6 months of age than the infants of pregnant depressed mothers in the SC condition. The intervention did not moderate children's growth. Depressed SC mothers tended to have infants less than two standard deviations in height on the World Health Organization's norms at two weeks post-birth compared to infants of depressed PIP mothers and non-depressed mothers in both conditions.

Conclusions: A generalist, CHW-delivered home visiting program improved infant growth, even when mothers' depression was not reduced. Focusing on maternal caretaking of infants, even when mothers are depressed, is critical in future interventions.

Trial registration: ClinicalTrials.gov registration # NCT00996528 . October 15, 2009.

No MeSH data available.


Related in: MedlinePlus