205178 Early maternal depression in relation to parenting and child outcomes amond adolescent and adult mothers

Wednesday, November 11, 2009: 8:30 AM

Robin Gaines Lanzi, PhD, MPH , Center on Health and Education, Georgetown University, Washington DC, DC
Jennifer Burke Lefever, PhD , Department of Psychology, University of Notre Dame, South Bend, IN
Kristi Carter Guest, PhD , Civitan International Research Center, University of Alabama at Birmingham, Birmingham, AL
Loral Patchen, CNM , Teen Alliance for Prepared Parenting, Washington Hospital Center, Washington DC, DC
  
Research has shown that about 1 out of every 10 people in the United States suffer from depression, with women being affected at about twice the rate as men (NIMH, 2008). We explore (1) rates of positive depression screens and their fluctuations; (2) whether depression screens fluctuate by age; and (3) how depression screens are related to individual characteristics and child outcomes. Three groups of first-time mothers were recruited prenatally: adolescents (n=396), low-education adults (less than HS diploma; n=169), and hi-education adults (at least 2 years of formal education; n=117). 65% of the sample is African-American, 19% is White/Non-Hispanic, and 15% is Hispanic. Findings: (1) greater prevalence of moderate-to-severe depression during the prenatal assessment among all groups, with high-education adult mothers significantly less likely to be moderately-to-severely depressed than teen and low-education adult moms at the prenatal, 6-month, and 24-month assessments. Mothers were separated into 3 groups based on clinical depression ratings at the prenatal, 6-month, 12-month, and 24-month visits: those who were never depressed, those who were mildly depressed at least once, and those who were moderately-to-severely depressed at least once. Never depressed mothers were significantly older, and had lower prenatal neglectful behaviors, greater levels of prenatal support from their mothers and their babies' fathers; showed significantly more warmth and responsiveness towards their toddlers than mothers who were moderately-to-severely depressed and had significantly higher HOME scores. Children of mothers who were never depressed had significantly lower ITSEA Externalizing and Dysregulation T-scores. Public health implications and recommendations will be presented.

Learning Objectives:
Discuss the prevalence of positive depression screens and their fluctuations among adolescent and adult mothers; how depression screens fluctuate by age; and how depression screens are related to individual characteristics and child outcomes.

Keywords: Adult and Child Mental Health, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: CURRENT POSITION Director, Division of Midwifery, Department of Obstetrics and Gynecology Associate Fellowship Director, Fellowship in Pediatric and Adolescent Gynecology Executive Director, Center for Adolescent Women & TAPP Program Member, Washington Hospital Center OB/GYN Faculty, 1999 – Present Washington Hospital Center PROFILE Ms. Patchen brings more than 15 years of experience in public health practice, supervision and program management in under-served communities. She has strong research and evaluation skills which enables her to measure the impact of public health interventions and to ensure evidence-based practice. Her bilingual capability in English and Spanish and direct community experience allows her to develop trusting relationships with at-risk populations by learning their values and building upon their strengths. Her holistic approach to clinical care and reproductive health is an important and vital component of her management style, research interests and clinical practice. Ms. Patchen is responsible for overall program implementation, management, and service delivery of the Center for Adolescent Women and TAPP Program. Over one third of all pregnant adolescents in DC enroll in program services annually; at present, total active enrollment exceeds 500 clients, including teen mothers, fathers and their children. Under her leadership, the Center adopted a youth development approach to service delivery; added two community-based sites; initiated services for young fathers; expanded its funding base by more than 50%; increased program retention rates by 40%; and decreased clinical no-show rates by 30%. Subsequent pregnancy rates among adolescents served by Center programs decreased more than 30% between November 2003 and July 2006, as measured by a three year longitudinal assessment of program outcomes. Ms. Patchen also is the founding director of the Division of Midwifery in the department of obstetrics and gynecology. The Division of Midwifery brings comprehensive care to women in the area of reproductive and sexual health. Ms. Patchen is responsible for overall development and direction of midwifery services. She also provides obstetric and gynecologic health services, co-managing high risk patients with physicians as appropriate (e.g., patients with complicating medical conditions such as HIV infection, gestational diabetics, and chronic hypertension). Her current research interests and programming initiatives include culturally relevant parenting supports for teen mothers and fathers; strategies to prevent primary acquisition of sexually transmitted infections and reduction of re-infection rates among those who test positive; therapeutic supports for youth with trauma history and depression; health services for youth detained in the juvenile justice system; and successful re-integration of truant youth into the school system.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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