Maternal mood and anxiety disorders and child school readiness: a Manitoba population-based study

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Comaskey, Brenda
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Title: Maternal Mood and Anxiety Disorders and Child School Readiness: A Manitoba Population-Based Study Objective: This study examined the relationship between several features of maternal Mood/Anxiety – timing, recurrence/persistence and severity – and child development on five key areas of school readiness at kindergarten, controlling for health, demographic and socio-economic factors. Methods: Using administrative data to further understand these relationships at a population level and over time, 18,331mother-child pairs were linked using a unique identifier. Maternal Mood/Anxiety was defined using the number of physician visits for mood and anxiety disorders and the number of prescriptions filled for antidepressants or sedatives/hypnotics. The outcome measures were child scores on five domains of the Early Development Instrument, a population-level tool for determining readiness for school at an aggregate level. Structural equation modeling was used to examine the relationship between maternal Mood/Anxiety and child outcomes for individual time periods, Mood/Anxiety recurrence/persistence and Mood/Anxiety severity. Infant health at birth, the family/socio-economic environment, child age and child gender were also entered into the models. Stratified analysis was undertaken to determine whether SES moderates the relationship between Mood/Anxiety and child outcomes. Results: Maternal Mood/Anxiety had a modest significant negative association with EDI scores, particularly for social, emotional and physical development. Prenatal and recurrent Mood/Anxiety were associated with lower scores on all five outcome domains. The influence of maternal Mood/Anxiety was mediated by the family environment, which had a strong, significant association with the outcomes, particularly for language and cognitive development. Infant health at birth was significantly associated with child outcomes, particularly for physical health. Socio-economic status (SES) was a moderator of the relationship between Mood/Anxiety and child outcomes. Conclusion: Using administrative data to define maternal mood and anxiety disorders is a sensitive measure to detect differences in five key areas of child development, particularly for social, emotional and physical outcomes. Family-related variables had a much stronger relationship with child outcomes than mood and anxiety disorders. Findings from this study can be used to design, implement and evaluate high quality clinical, program and policy interventions to support mothers and families and the healthy development of their children.
maternal depression, maternal anxiety, school readiness, early development instrument, structural equation modeling, epidemiology, Manitoba, administrative data, child development