Health Care Utilisation in the First Year of Life Among Infants of Mothers With Perinatal Depression or Anxiety

• Published in: Paediatric and perinatal epidemiology Vol. 27; no. 1; pp. 81 - 88
• Main Authors: Farr, Sherry L., Dietz, Patricia M., Rizzo, Joanne H., Vesco, Kimberly K., Callaghan, William M., Bruce, F. Carol, Bulkley, Joanna E., Hornbrook, Mark C., Berg, Cynthia J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-2013; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Anxiety; Anxiety - psychology; Anxiety Disorders - psychology; Babies; Delivery of Health Care - utilization; Depression; Depression, Postpartum - psychology; emergency medical services; Female; Health care; Health services utilization; Humans; immunisations; Infant; Infant Care - utilization; Infants; Mental depression; Mental disorders; Mental health care; Middle Aged; Oregon; postpartum; Postpartum depression; Postpartum Period - psychology; Pregnancy; Prenatal experience; Regression Analysis; Risk Factors; Socioeconomic Factors; Washington; Young Adult; Oregon; Washington
• ISSN: 0269-5022; 1365-3016
• DOI: 10.1111/ppe.12012

Background:  Limited information is available on associations between maternal depression and anxiety and infant health care utilisation.
Methods:  We analysed data from 24 263 infants born between 1998 and 2007 who themselves and their mothers were continuously enrolled for the infant's first year in Kaiser Permanente Northwest. We used maternal depression and anxiety diagnoses during pregnancy and postpartum to categorise infants into two depression and anxiety groups and examined effect modification by timing of diagnosis (pregnancy only, postpartum only, pregnancy and postpartum). Using generalised estimating equations in multivariable log‐linear regression, we estimated adjusted risk ratios (RR) between maternal depression and anxiety and well baby visits (<5 and ≥5), up to date immunisations (yes/no), sick/emergency visits (<6 and ≥6) and infant hospitalisation (any/none).
Results:  Infants of mothers with perinatal depression or anxiety were as likely to attend well baby visits and receive immunisations as their counterparts (RR = 1.0 for all). Compared with no depression or anxiety, infants of mothers with prenatal and postpartum depression or anxiety, or postpartum depression or anxiety only were 1.1 to 1.2 times more likely to have ≥6 sick/emergency visits. Infants of mothers with postpartum depression only had marginally increased risk of hospitalisation (RR = 1.2 [95% confidence interval 1.0, 1.4]); 70% of diagnoses occurred after the infant's hospitalisation.
Conclusions:  An understanding of the temporality of the associations between maternal depression and anxiety and infant acute care is needed and will guide strategies to decrease maternal mental illness and improve infant care for this population.