Maternal postpartum depression and infant social withdrawal among human immunodeficiency virus (HIV) positive mother–infant dyads

Abstract

Maternal postpartum depression poses significant risks for mother–child interaction and long-term infant outcomes. Human immunodeficiency virus (HIV) status has also been implicated in the development of postpartum depression, but the association between maternal depression and infant social behavior in the context of HIV infection has not been fully investigated. First, we examined the relationship between maternal postpartum depression and infant social withdrawal at 10–12 months of age in HIV-infected mothers and infants. Second, we ascertained whether infant social withdrawal could be significantly predicted by maternal postpartum depression. The sample consisted of 83 HIV-infected mother–infant dyads. Mothers were assessed for postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS), and infant social withdrawal behavior was rated using the Modified Alarm Distress Baby Scale (m-ADBB). 42.2% of the mothers scored above the cut-off point for depression on the EPDS, and a third of infants (31%) were socially withdrawn. Notably, maternal depression did not predict infant social withdrawal as measured by the m-ADBB. Infant social withdrawal was also not significantly associated with failure to thrive or gender. These preliminary findings need further investigation with respect to the impact on long-term neurodevelopmental and behavioral outcomes.

Keywords:

• postpartum depression
• infant social withdrawal
• HIV status
• m-ADBB
• EPNDS

Acknowledgements

Support for this study was provided by the Medical Research Council of South Africa. The CIPRA study was funded through the US National Institute of Allergy and Infectious Diseases (NIAID) through the Comprehensive International Program of Research on AIDS (CIPRA) network, Grant U19 AI53217. The content of this publication does not necessarily reflect the views or policies of NIAID, nor does mention of trade names, commercial projects, or organizations imply endorsement by the US Government. Miss Lungiswa Rosy Khethelo was instrumental in the interviewing of participants. Professor Martin Kidd (Centre for Statistical Services, Stellenbosch University) assisted with statistical analyses. Staff at KID-CRU, Tygerberg Children's Hospital played an active role in undertaking this work. We thank Dr Avy Violari from the Perinatal HIV Research Unit in Soweto, and co-principal investigator of the CHER study, for permission to conduct the study.