Skip to main content

Advertisement

SpringerLink
Log in

Infant Development and Pre- and Post-partum Depression in Rural South African HIV-Infected Women

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

HIV-exposed infants born to depressed women may be at risk for adverse developmental outcomes. Half of HIV-infected women in rural South Africa (SA) may suffer from pregnancy-related depression. This pilot study examined the impact of depression in HIV-infected women in rural SA on infant development. Mother-infant dyads (N = 69) were recruited in rural SA. Demographics, HIV disclosure, depression, male involvement, and alcohol use at baseline (18.35 ± 5.47 weeks gestation) were assessed. Male involvement, depression, infant HIV serostatus and development were assessed 12 months postnatally. Half of the women (age = 29 ± 5) reported depression prenatally and one-third reported depression postnatally. In multivariable logistic regression, not cohabiting with their male partner, nondisclosure of HIV status, and postnatal depression predicted cognitive delay; decreased prenatal male involvement predicted delayed gross motor development (ps < 0.05). Assessing pregnancy-related depression among HIV-infected women and infant development and increasing male involvement may reduce negative developmental outcomes among HIV-exposed or infected infants.

Resumen

Los bebés expuestos al VIH, provenientes de mujeres deprimidas, pueden estar a riesgo de resultados adversos en el desarrollo. La mitad de las mujeres infectadas con VIH, en Sudáfrica (SA) rural, pueden sufrir de depresión relacionada con el embarazo. Este estudio piloto examinó el impacto de la depresión en el desarrollo infantil entre mujeres infectadas con VIH en SA rural. Parejas (N = 69) de madre e infante fueron reclutadas en SA rural. Se evaluaron datos demográficos, revelación de estatus de VIH a su pareja masculina, depresión, participación masculina en el embarazo y consumo de alcohol al inicio del estudio (18,35 ± 5,47 semanas de gestación). La participación masculina, depresión, el estatus serológico de VIH y el desarrollo infantil se evaluaron 12 meses postnatalmente. La mitad de las mujeres (edad = 29 ± 5) presentaron depresión prenatal y un tercio depresión postparto. En regresión logística multivariable, no vivir con su pareja, no revelar su estatus de VIH, y depresión postnatal predijeron retraso cognitivo; la disminución de participación masculina durante el embarazo predijo el desarrollo motor grueso retardado (p < 0,05). Evaluar la depresión relacionada con el embarazo entre mujeres infectadas con VIH y el desarrollo infantil; así, como aumentar la participación de las parejas masculinas pudieran reducir los resultados adversos en el desarrollo de niños expuestos a, o infectados por, el VIH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Yonkers KA, Wisner KL, Stewart DE, Oberlander TF, Dell DL, Stotland N, et al. The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Gen Hosp Psychiatry. 2009;31(5):403–13.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Roehr B. American Psychiatric Association explains DSM-5. BMJ. 2013;346:f3591.

    Article  PubMed  Google Scholar 

  3. Natamba B, Achan J, Arbach A, Oyok T, Ghosh S, Mehta S, et al. Reliability and validity of the center for epidemiologic studies-depression scale in screening for depression among HIV-infected and-uninfected pregnant women attending antenatal services in northern Uganda: a cross-sectional study. BMC psychiatry. 2014;14(1):1.

    Article  Google Scholar 

  4. Stringer EM, Meltzer-Brody S, Kasaro M, Stuebe AM, Wiegand S, Paul R, et al. Depression, pregnancy, and HIV: the case to strengthen mental health services for pregnant and post-partum women in sub-Saharan Africa. Lancet Psychiatry. 2014;1(2):159–62.

    Article  PubMed  Google Scholar 

  5. Dow A, Dube Q, Pence BW, Van Rie A. Postpartum depression and HIV infection among women in Malawi. Jaids-J Acq Imm Def. 2014;65(3):359–65.

    Article  Google Scholar 

  6. Sawyer A, Ayers S, Smith H. Pre- and postnatal psychological wellbeing in Africa: a systematic review. J Affect Disorders. 2010;123(1–3):17–29.

    Article  PubMed  Google Scholar 

  7. Peltzer K, Rodriguez VJ, Jones D. Prevalence of prenatal depression and associated factors among HIV-positive women in primary care in Mpumalanga province, South Africa. Sahara J-J Soc Asp H. 2016;13(1):60–7.

    Article  Google Scholar 

  8. O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psycho. 2013;9:379–407.

    Article  Google Scholar 

  9. Ammassari A, Antinori A, Aloisi MS, Trotta MP, Murri R, Bartoli L, et al. Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. Psychosomatics. 2004;45(5):394–402.

    Article  PubMed  Google Scholar 

  10. French AL, Gawel SH, Hershow R, Benning L, Hessol NA, Levine AM, et al. Trends in mortality and causes of death among women with HIV in the US: a ten-year study. J Acquir Immune Defic Syndr. 2009;51(4):399–406.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ickovics JR, Reed E, Magriples U, Westdahl C, Schindler Rising S, Kershaw TS. Effects of group prenatal care on psychosocial risk in pregnancy: results from a randomised controlled trial. Psychol Health. 2011;26(2):235–50.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kapetanovic S, Christensen S, Karim R, Lin F, Mack WJ, Operskalski E, et al. Correlates of perinatal depression in HIV-infected women. AIDS Patient Care STDS. 2009;23(2):101–8.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Nachega JB, Mutamba B, Basangwa D, Nguyen H, Dowdy DW, Mills EJ, et al. Severe mental illness at ART initiation is associated with worse retention in care among HIV-infected Ugandan adults. Trop Med Int Health. 2013;18(1):53–7.

    Article  PubMed  CAS  Google Scholar 

  14. Turner BJ, Hecht FM. Improving on a coin toss to predict patient adherence to medications. Ann Intern Med. 2001;134(10):1004–6.

    Article  PubMed  CAS  Google Scholar 

  15. Levine AB, Aaron EZ, Criniti SM. Screening for depression in pregnant women with HIV infection. J Reprod Med. 2008;53(5):352–6.

    PubMed  Google Scholar 

  16. Blaney NT, Fernandez MI, Ethier KA, Wilson TE, Walter E, Koenig LJ, et al. Psychosocial and behavioral correlates of depression among HIV-infected pregnant women. Aids Patient Care St. 2004;18(7):405–15.

    Article  Google Scholar 

  17. Bonacquisti A, Geller PA, Aaron E. Rates and predictors of prenatal depression in women living with and without HIV. Aids Care. 2014;26(1):100–6.

    Article  PubMed  Google Scholar 

  18. Casale M, Wild L, Cluver L, Kuo C. Social support as a protective factor for depression among women caring for children in HIV-endemic South Africa. J Behav Med. 2015;38(1):17–27.

    Article  PubMed  Google Scholar 

  19. Davies T, Schneider M, Nyatsanza M, Lund C. “The sun has set even though it is morning”: experiences and explanations of perinatal depression in an urban township, Cape Town. Transcult Psychiatry. 2016;53(3):286–312.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Van den Bergh BR, Mulder EJ, Mennes M, Glover V. Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms, A review. Neurosci Biobehav Rev. 2005;29(2):237–58.

    Article  PubMed  Google Scholar 

  21. Kingston D, McDonald S, Austin MP, Tough S. Association between prenatal and postnatal psychological distress and toddler cognitive development: a systematic review. PLoS ONE. 2015;. doi:10.1371/journal.pone.0126929.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Murray L, Fiori-Cowley A, Hooper R, Cooper P. The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome. Child Dev. 1996;67(5):2512–26.

    Article  PubMed  CAS  Google Scholar 

  23. Murray L, Kempton C, Woolgar M, Hooper R. Depressed mothers speech to their infants and its relation to infant gender and cognitive-development. J Child Psychol Psyc. 1993;34(7):1083–101.

    Article  CAS  Google Scholar 

  24. Field T. Prenatal depression effects on early development: a review. Infant Behav Dev. 2011;34(1):1–14.

    Article  PubMed  Google Scholar 

  25. Sinclair D, Murray L. Effects of postnatal depression on children’s adjustment to school—teacher’s reports. Brit J Psychiat. 1998;172:58–63.

    Article  PubMed  CAS  Google Scholar 

  26. O’Hara MW. Postpartum depression: what we know. J Clin Psychol. 2009;65(12):1258–69.

    Article  PubMed  Google Scholar 

  27. Goodman S, Brand S, Hammen C. Maternal depression and infant mental health. Handbook of depression and its treatment. 2nd ed. New York: Guilford; 2008. p. 249–76.

    Google Scholar 

  28. Dobrova-Krol NA, van IJzendoorn MH, Bakermans-Kranenburg MJ, Juffer F. Effects of perinatal HIV infection and early institutional rearing on physical and cognitive development of children in Ukraine. Child Dev. 2010;81(1):237–51.

    Article  PubMed  Google Scholar 

  29. Le Doare K, Bland R, Newell ML. Neurodevelopment in children born to HIV-infected mothers by infection and treatment status. Pediatrics. 2012;130(5):E1326–44.

    Article  PubMed  Google Scholar 

  30. Whitehead N, Potterton J, Coovadia A. The neurodevelopment of HIV-infected infants on HAART compared to HIV-exposed but uninfected infants. Aids Care. 2014;26(4):497–504.

    Article  PubMed  Google Scholar 

  31. O’Connor TG, Heron J, Glover V, Team AS. Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Psy. 2002;41(12):1470–7.

    Article  Google Scholar 

  32. Buss C, Davis EP, Hobel CJ, Sandman CA. Maternal pregnancy-specific anxiety is associated with child executive function at 6–9 years age. Stress. 2011;14(6):665–76.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  33. van den Berg S, Shapiro DA, Bickerstaffe D, Cavanagh K. Computerized cognitive-behaviour therapy for anxiety and depression: a practical solution to the shortage of trained therapists. J Psychiatr Ment Health Nurs. 2004;11(5):508–13.

    Article  PubMed  Google Scholar 

  34. Mellins CA, Kang E, Leu CS, Havens JF, Chesney MA. Longitudinal study of mental health and psychosocial predictors of medical treatment adherence in mothers living with HIV disease. AIDS Patient Care STDS. 2003;17(8):407–16.

    Article  PubMed  Google Scholar 

  35. Talge NM, Neal C, Glover V, Early Stress TR, Prevention Science Network F Neonatal Experience on C, et al. Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J Child Psychol Psychiatry. 2007;48(3–4):245–61.

    Article  PubMed  Google Scholar 

  36. Emerson E, Einfeld S. Emotional and behavioural difficulties in young children with and without developmental delay: a bi-national perspective. J Child Psychol Psychiatry. 2010;51(5):583–93.

    Article  PubMed  Google Scholar 

  37. Feldman M, Hancock C, Rielly N, Minnes P, Cairns C. Behavior problems in young children with or at risk for developmental delay. J Child Fam Stud. 2000;9(2):247–61.

    Article  Google Scholar 

  38. Sheeber L, Davis B, Hops H. Gender-specific vulnerability to depression in children of depressed mothers. Children of depressed parents: Mechanisms of risk and implications for treatment. 2002:253–74.

  39. Goodman SH, Rouse MH, Connell AM, Broth MR, Hall CM, Heyward D. Maternal depression and child psychopathology: a meta-analytic review. Clin Child Fam Psychol Rev. 2011;14(1):1–27.

    Article  PubMed  Google Scholar 

  40. Hauser-Cram P, Woodman AC. Trajectories of internalizing and externalizing behavior problems in children with developmental disabilities. J Abnorm Child Psychol. 2016;44(4):811–21.

    Article  PubMed  Google Scholar 

  41. Lowe K, Allen D, Jones E, Brophy S, Moore K, James W. Challenging behaviours: prevalence and topographies. J Intellect Disabil Res. 2007;51(Pt 8):625–36.

    Article  PubMed  CAS  Google Scholar 

  42. Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800–19.

    Article  PubMed  Google Scholar 

  43. Hartley C, Pretorius K, Mohamed A, Laughton B, Madhi S, Cotton MF, et al. Maternal postpartum depression and infant social withdrawal among human immunodeficiency virus (HIV) positive mother-infant dyads. Psychol Health Med. 2010;15(3):278–87.

    Article  PubMed  CAS  Google Scholar 

  44. Avan B, Richter LM, Ramchandani PG, Norris SA, Stein A. Maternal postnatal depression and children’s growth and behaviour during the early years of life: exploring the interaction between physical and mental health. Arch Dis Child. 2010;95(9):690–5.

    Article  PubMed  Google Scholar 

  45. Tomlinson M, Cooper P, Murray L. The mother-infant relationship and infant attachment in a south African peri-urban settlement. Child Dev. 2005;76(5):1044–54.

    Article  PubMed  Google Scholar 

  46. Hadley C, Tegegn A, Tessema F, Asefa M, Galea S. Parental symptoms of common mental disorders and children’s social, motor, and language development in sub-Saharan Africa. Ann Hum Biol. 2008;35(3):259–75.

    Article  PubMed  Google Scholar 

  47. Jones D, Peltzer K, Weiss SM, Sifunda S, Dwane N, Ramlagan S, et al. Implementing comprehensive prevention of mother-to-child transmission and HIV prevention for South African couples: study protocol for a randomized controlled trial. Trials. 2014;15:417.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Kershaw TS, Magriples U, Westdahl C, Rising SS, Ickovics J. Pregnancy as a window of opportunity for HIV prevention: effects of an HIV intervention delivered within prenatal care. Am J Public Health. 2009;99(11):2079–86.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Metzger DS, Koblin B, Turner C, Navaline H, Valenti F, Holte S, et al. Randomized controlled trial of audio computer-assisted self-interviewing: utility and acceptability in longitudinal studies. HIVNET Vaccine Preparedness Study Protocol Team. Am J Epidemiol. 2000;152(2):99–106.

    Article  PubMed  CAS  Google Scholar 

  50. Bayley N, Reuner G. Bayley scales of infant and toddler development: Bayley-III: Harcourt Assessment. Tex: Psych. Corporation San Antonio; 2006.

    Google Scholar 

  51. Rademeyer V, Jacklin L. A study to evaluate the performance of black South African urban infants on the Bayley Scales of Infant Development III. S. Afr. J Child Health. 2013;7(2):54–9.

    Article  Google Scholar 

  52. Ferguson G, Jelsma J. The prevalence of motor delay among HIV infected children living in Cape Town, South Africa. Int J Rehabil Res. 2009;32(2):108–14.

    Article  PubMed  Google Scholar 

  53. Marlow N. Measuring neurodevelopmental outcome in neonatal trials: a continuing and increasing challenge. Arch Dis Child Fetal Neonatal Ed. 2013;98:F554–8.

    Article  PubMed  Google Scholar 

  54. Hutchings J, Potterton J. Developmental delay in HIV-exposed infants in Harare, Zimbabwe. Vulnerable Children Youth Stud. 2014;9(1):43–55.

    Article  Google Scholar 

  55. Van Rie A, Mupuala A, Dow A. Impact of the HIV/AIDS epidemic on the neurodevelopment of preschool-aged children in Kinshasa, Democratic Republic of the Congo. Pediatrics. 2008;122(1):e123–8.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression—development of the 10-Item Edinburgh postnatal depression scale. Brit J Psychiat. 1987;150:782–6.

    Article  PubMed  CAS  Google Scholar 

  57. Lawrie TA, Hofmeyr GJ, de Jager M, Berk M. Validation of the Edinburgh postnatal depression scale on a cohort of South African women. S Afr Med J. 1998;88(10):1340–4.

    PubMed  CAS  Google Scholar 

  58. Byamugisha R, Tumwine JK, Semiyaga N, Tylleskar T. Determinants of male involvement in the prevention of mother-to-child transmission of HIV programme in Eastern Uganda: a cross-sectional survey. Reprod Health. 2010;7.

  59. Koutra K, Chatzi L, Bagkeris M, Vassilaki M, Bitsios P, Kogevinas M. Antenatal and postnatal maternal mental health as determinants of infant neurodevelopment at 18 months of age in a mother-child cohort (Rhea Study) in Crete, Greece. Soc Psych Psych Epid. 2013;48(8):1335–45.

    Article  Google Scholar 

  60. Barker ED, Jaffee SR, Uher R, Maughan B. The Contribution of prenatal and postnatal maternal anxiety and depression to child mal adjustment. Depress Anxiety. 2011;28(8):696–702.

    Article  PubMed  Google Scholar 

  61. Korhonen M, Luoma I, Salmelin R, Tamminen T. A longitudinal study of maternal prenatal, postnatal and concurrent depressive symptoms and adolescent well-being. J Affect Disorders. 2012;136(3):680–92.

    Article  PubMed  Google Scholar 

  62. Peltzer, K., Mlambo, M., Matseke, M. G., Shikwane, E., Louw, J., & Kekana, Q. (2011). Report on PMTCT comprehensive community intervention package including male involvement, infant follow-up, peer support, partner violence and infant feeding in Nkangala District, Mpumalanga province.

  63. Olley BO, Seedat S, Nei DG, Stein DJ. Predictors of major depression in recently diagnosed patients with HIV/AIDS in South Africa. AIDS Patient Care STDS. 2004;18(8):481–7.

    Article  PubMed  CAS  Google Scholar 

  64. Sarkadi A, Kristiansson R, Oberklaid F, Bremberg S. Fathers’ involvement and children’s developmental outcomes: a systematic review of longitudinal studies. Acta Paediatr. 2008;97(2):153–8.

    Article  PubMed  Google Scholar 

  65. Rhodes KV, Lauderdale DS, He T, Howes DS, Levinson W. “Between me and the computer”: increased detection of intimate partner violence using a computer questionnaire. Ann Emerg Med. 2002;40(5):476–84.

    Article  PubMed  Google Scholar 

  66. Lewis AJ, Austin E, Knapp R, Vaiano T, Galbally M. Perinatal maternal mental health, fetal programming and child development. Healthcare (Basel). 2015;3(4):1212–27.

    Article  Google Scholar 

  67. Aluisio AR, Bosire R, Bourke B, Gatuguta A, Kiarie JN, Nduati R, et al. Male partner participation in antenatal clinic services is associated with improved HIV-free survival among infants in Nairobi, Kenya: a Prospective Cohort Study. Jaids-J Acq Imm Def. 2016;73(2):169–76.

    Article  Google Scholar 

  68. Crozier SR, Robinson SM, Borland SE, Godfrey KM, Cooper C, Inskip HM, et al. Do women change their health behaviours in pregnancy? Findings from the Southampton Women’s Survey. Paediatr Perinat Epidemiol. 2009;23(5):446–53.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This study was funded by a collaborative NIH/PEPFAR grant, R01HD078187-S. Activities were conducted with the support of the University of Miami Miller School of Medicine Center for AIDS Research, funded by an NIH grant, P30AI073961.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Avenue, Dominion Tower 404A, Miami, FL, 33136, USA

    Violeta J. Rodriguez, Ryan Cook, Stephen M. Weiss, Doyle Patton, Maria Lopez & Deborah L. Jones

  2. Department of Psychology, University of Georgia, Athens, GA, USA

    Violeta J. Rodriguez

  3. HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa

    Gladys Matseke & Karl Peltzer

  4. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA

    Ryan Cook

  5. Department of Psychology, Florida Atlantic University, Boca Raton, FL, USA

    Seanna Bellinger

  6. Department of Psychology, Florida International University, Miami, FL, USA

    Seanna Bellinger

  7. Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

    Maria L. Alcaide

  8. Department of Research & Innovation, University of Limpopo, Sovenga, South Africa

    Karl Peltzer

Authors
  1. Violeta J. Rodriguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gladys Matseke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ryan Cook
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seanna Bellinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stephen M. Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria L. Alcaide
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Karl Peltzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Doyle Patton
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Maria Lopez
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Deborah L. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Deborah L. Jones.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodriguez, V.J., Matseke, G., Cook, R. et al. Infant Development and Pre- and Post-partum Depression in Rural South African HIV-Infected Women. AIDS Behav 22, 1766–1774 (2018). https://doi.org/10.1007/s10461-017-1925-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-017-1925-0

Keywords

Palabras Clave

Search

Navigation