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      Mothers’ health-related quality of life: Its relationship with children’s health-related quality of life and behavior in low-income families


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          Objective: To examine the association between mothers’ health-related quality of life (HRQOL) and their children’s HRQOL and behavior in low-income families.

          Methods: Mothers of 278 children aged 6–12 years from low-income families were invited to complete the Child Health Questionnaire Parent Form 50 (CHQ-PF50) and the Strength and Difficulties Questionnaire (SDQ) for their children as well as the 12-item Short-Form Health Survey version 2 (SF-12v2) and the Patient Health Questionnaire-2 (PHQ-2). Multiple linear regressions with mother–child pairs as the unit of analysis were performed to examine the associations between maternal and child variables with adjustment of mother- and child-level confounders.

          Results: Compared with the general population, low-income mothers had a lower mean SF-12v2 mental component summary score and their children also had lower mean CHQ-PF50 physical and psychosocial summary scores and SDQ total difficulties score. Children of mothers with SF-12v2 scores below the population mean of 50 had significantly worse CHQ-PF50 scores and higher SDQ total difficulties scores. The mother’s PHQ-2 depression status had no association with the child’s CHQ-PF50 scores.

          Conclusion: Our findings suggest that more attention should be paid to reducing the negative impact of health problems on mothers’ daily roles in childcare in low-income families.

          Most cited references46

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          Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at age 18 years.

          Some small studies suggest that maternal postnatal depression is a risk factor for offspring adolescent depression. However, to our knowledge, no large cohort studies have addressed this issue. Furthermore, only 1 small study has examined the association between antenatal depression and later offspring depression. Understanding these associations is important to inform prevention. To investigate the hypothesis that there are independent associations between antenatal and postnatal depression with offspring depression and that the risk pathways are different, such that the risk is moderated by disadvantage (low maternal education) with postnatal depression but not with antenatal depression. Prospective investigation of associations between symptoms of antenatal and postnatal parental depression with offspring depression at age 18 years in a UK community-based birth cohort (Avon Longitudinal Study of Parents and Children) with data from more than 4500 parents and their adolescent offspring. Diagnosis of offspring aged 18 years with major depression using the International Classification of Diseases, 10th Revision. Antenatal depression was an independent risk factor. Offspring were 1.28 times (95% CI, 1.08-1.51; P = .003) more likely to have depression at age 18 years for each standard deviation increase in maternal depression score antenatally, independent of later maternal depression. Postnatal depression was also a risk factor for mothers with low education, with offspring 1.26 times (95% CI, 1.06-1.50; P = .01) more likely to have depression for each standard deviation increase in postnatal depression score. However, for more educated mothers, there was little association (odds ratio, 1.09; 95% CI, 0.88-1.36; P = .42). Analyses found that maternal education moderated the effects of postnatal but not antenatal depression. Paternal depression antenatally was not associated with offspring depression, while postnatally, paternal depression showed a similar pattern to maternal depression. The findings suggest that treating maternal depression antenatally could prevent offspring depression during adulthood and that prioritizing less advantaged mothers postnatally may be most effective.
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            Chronicity, severity, and timing of maternal depressive symptoms: relationships with child outcomes at age 5.

            The relationships between severity, chronicity, and timing of maternal depressive symptoms and child outcomes were examined in a cohort of 4,953 children. Mothers provided self-reports of depressive symptoms during pregnancy, immediately postpartum, and when the child was 6 months old and 5 years old. At the age 5 follow-up, mothers reported on children's behavior and children completed a receptive vocabulary test. Results suggest that both the severity and the chronicity of maternal depressive symptoms are related to more behavior problems and lower vocabulary scores in children. The interaction of severity and chronicity of maternal depressive symptoms was significantly related to higher levels of child behavior problems. Timing of maternal symptoms was not significantly related to child vocabulary scores, but more recent reports of maternal depressive symptoms were associated with higher rates of child behavior problems.
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              Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study.

              The objective of this study was to investigate the impact of two different socioeconomic status (SES) measures on child and adolescent self reported health related quality of life (HRQoL). The European KIDSCREEN project aims at simultaneous developing, testing, and implementing a generic HRQoL instrument. The pilot version of the questionnaire was applied in school surveys to students from 8 to 18 years of age, as well as to their parents, together with such determinants of health status as two SES indicators, the parental educational status and the number of material goods in the family (FAS, family affluence scale). Students from seven European countries: 754 children (39.8%; mean: 9.8 years), and 1142 adolescents (60.2 %; mean: 14.1 years), as well as their respective parents. In children, a higher parental educational status was found to have a significant positive impact on the KIDSCREEN dimensions: physical wellbeing, psychological wellbeing, moods and emotions, bullying and perceived financial resources. Increased risk of low HRQoL was detected for adolescents in connection with their physical wellbeing. Family wealth plays a part for children's physical wellbeing, parent relations and home life, and perceived financial resources. For adolescents, family wealth furthermore predicts HRQoL on all KIDSCREEN dimensions. There is evidence to suggest that exposure to low parental educational status may result in a decreased HRQoL in childhood, whereas reduced access to material (and thereby social) resources may lead to a lower HRQoL especially in adolescence.

                Author and article information

                Family Medicine and Community Health
                Compuscript (Ireland )
                December 2016
                December 2016
                : 4
                : 4
                : 4-12
                [1] 1Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, China
                [2] 2Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
                Author notes
                CORRESPONDING AUTHOR: Cindy Lo Kuen Lam, MD Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F., Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, China, E-mail: clklam@ 123456hku.hk
                Copyright © 2016 Family Medicine and Community Health

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

                : 25 July 2016
                : 18 September 2016
                Original Research

                General medicine,Medicine,Geriatric medicine,Occupational & Environmental medicine,Internal medicine,Health & Social care
                child health,Health-related quality of life,child behavior,low income


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