Association of maternal depression with dietary intake, growth, and development of preterm infants: a cohort study in Beijing, China

Abstract

This study aimed to explore the association of maternal depression with nutrient intake, growth, and development of preterm infants. A cohort study of 201 infants was conducted in Beijing. Based on the gestational age of an infant and status of the mother, the infants were divided into four groups: non-depression-fullterm (64), non-depression-preterm (70), depression-fullterm (36), and depression-preterm (31). Data on sociodemographic characteristics, nutritional intake, growth, and developmental status of children at 8 months (corrected ages) were collected using a quantitative questionnaire, a 24-Hour Dietary Recall, anthropometric measurements, and the Bayley-III scale. A multivariate analysis was used to evaluate the effects of maternal depression and preterm birth on infant growth and development. The energy, protein, and carbohydrate intake in the depression group was lower than the recommended amounts. The depression preterm groups indicated the lowest Z-scores for length and weight and the lowest Bayley-III scores. Preterm infants of depressed mothers are at high risks of poor growth and development delay.

Keywords

maternal depression / preterm / infant / nutrition / growth / development

Introduction

Mothers are highly vulnerable to depression in the first year after childbirth. Approximately 10%–20% of mothers suffer from depression during this period worldwide [¹,²]. In China, a meta-analysis results showed that the prevalence of postpartum depression range from 13.1%–16.3% [³]. Maternal depression has detrimental effects on child growth and development outcomes, including malnutrition [⁴], developmental delay [⁵], and behavioral and emotional problems [⁶]. Studies have shown that maternal depression is associated with disrupted and less positive mother-infant interactions [⁷]. Furthermore, depressed mothers provide less cognitive stimulation to infants, whereas infants exhibit less secure attachments to depressed than non-depressed mothers [⁷,⁸]. Depression characteristics may limit the ability of mothers to appropriately respond when feeding their children [⁹].

According to estimates by the World Health Organization (WHO), approximately 15 million premature babies (more than 1 in 10 babies) are born annually [¹⁰]. Preterm infants often display poor growth rates and development delays [¹¹]. Studies have also suggested that growth is “pre-programmed” to occur at certain times that if missed, may not be recoverable [¹²]. Under-nutrition and poor growth and development are clearly associated in preterm infants [¹³] who need increased nutrient intake to “catch up” with their growth in their first year [¹⁴]. Nutritional supplements [¹⁵] and feeding strategies [¹⁶] for preterm infants have been widely studied. Infant feeding practices not only involve the transfer of nutrients, but also represent a complex activity, as the neuro-motor, cognitive, social, and communicative capacities of infants develop during their first year [¹⁷].

Previous studies have indicated that maternal depression or preterm birth affects the health of children [⁴,⁶,¹¹]. Thus, the preterm infants of depressed mothers may be at high risk of experiencing serious feeding problems, malnutrition, and poor growth and development. However, whether a history of maternal depression is associated with prematurity and whether it affects dietary intake, growth, and development remain underexplored. This study sought to explore if maternal depression and preterm birth are associated with the nutrient intake, body growth, and development of premature infants of depressed mothers. This study aimed to explore whether preterm infants with depressed mothers are more vulnerable than either a fullterm birth with a depressed mother or a preterm birth alone.

Materials and methods

Participants and study design

A cohort study was used to investigate the association of maternal depression with the growth and development of preterm infants. The study was conducted at Haidian Maternal and Child Health Hospital and Peking University Third Hospital from December 2012 to November 2014. A total of 130 preterm infants (born at 30^0/7 to 36^6/7 weeks’ gestational age) comprised the exposed group, whereas the non-exposed group consisted of a total of 130 fullterm infants (born at 37^0/7 to 41^6/7 weeks’ gestational age). The depression status of mothers was measured within three days of delivery. Based on the maternal depression and delivery status, the infants were divided into four subgroups: non-depression-fullterm, non-depression-preterm, depression-fullterm, and depression-preterm. The study procedures were explained to each pregnant woman upon admission to the delivery room, and written informed consent was obtained from the guardians of all the infants involved in the present study.

Within three days of delivery, developmental pediatricians performed physical and neuro-motor examinations on the infants. The exclusion criteria for the study included medical complications in the perinatal period, intra-partum infection, hypoxic-ischemic encephalopathy, genetic metabolic diseases, any disability, cerebral palsy, and hearing impairment.

Baseline survey within three days of delivery was conducted using a standardized questionnaire. The socio-economic characteristics of mothers and households were collected, including the age, ethnicity, education, and income of mothers. The Edinburgh Postnatal Depression Scale (EPDS), a self-administered questionnaire that has been translated and validated for Chinese women, was used to screen postpartum depression [¹⁸]. Women were asked to complete the EPDS by themselves and neonatal information (e.g., sex, Apgar scores, gestational age at birth, delivery method, birthweight, and birth length) were collected from medical records.

At 8 months of age, after adjusting for expected delivery date for preterm infants, a follow-up face-to-face survey was administered wherein 201 pairs of mothers and infants were interviewed (59 participant pairs were missing). Two observers who were blinded to the birth and hospital information of participants assessed the neurodevelopment of the infants. The observers comprised of trained developmental pediatricians and medical students with a bachelor’s degree or above. Interobserver agreement between the two observers achieved a high level of 95%. The length of each infant was measured to the nearest 0.1 cm using the Length Meter with Model WB-B Horizontal Type (Wujin Weighing Apparatus Factory, Changzhou, China) for babies, and a scale (Bailida electronic scale HD-305; Wuxi Measurement Factory, Wuxi, China) was utilized to measure weight to the nearest 0.1 kg. The third edition of the Bayley Scales of Infant and Toddler Development (Bayley-III) (Pearson) was employed to evaluate the developmental status of the infants. Finally, a 24-Hour Dietary Recall (HDR) survey on food intake was used to collect information about the food consumption of infants. The study was approved by the Ethics Committee of Peking University’s Health Science Centre (No. IRB00001052-13001).

Measurements

Status of maternal depression

The 10-item Chinese version of the EPDS was used in the study with a psychometric performance comparable to the original scale [¹⁸]. For each item, mothers were invited to score their postpartum status over the past 7 days across different levels (i.e., 0–3). Thus, total scores ranged from 0 to 30. A cut-off score of 9 was used in the study to balance sensitivity and specificity, and a score over 9 was obtained as a positive indication of depression symptoms [¹⁹,²⁰].

Nutrient intake

The HDR survey was administered during a face-to-face interview with the caregiver who fed the infant in the previous day. All the researchers were trained in the process for administering a standardized dietary survey, the requirements and methods of the auxiliary measuring atlas, and the process for completing the HDR survey. All the food and liquids consumed by the infant in the last 24 h were recorded. The survey included questions on the number of meals, food names, and food textures, as well as the amount consumed by the infant in the previous day (i.e., in the last 24 h). The food included breast milk, infant formula milk, staple foods, vegetables, legumes, fruits, meat and fish, eggs, and dairy. An auxiliary food atlas measured food quantity. Records of the food consumption of the infants at 8 months were used to calculate their intake of energy and nutrients. Based on the 2004 China Food Composition [²¹], the energy and nutrients consumed were analyzed and converted into percentages of Recommended Nutrient Intakes (RNIs) or Adequate Intakes (AIs) for energy and nutrients based on age- and gender-normalized Dietary Reference Intake (DRIs). Adequate intake was defined as greater or equal to 100% DRI for each dietary element.

Anthropometric measurements

The body weight and length of each infant were measured twice, and mean values were used. Infants were weighed without shoes and with light indoor clothing; length of the infants was also measured without shoes and socks. The SAS macro recommended by WHO (http://www.who.int/childgrowth/software/en/) was utilized to calculate the Z-scores of the infants for weight and length at 8 months (corrected age).

Developmental assessments

The general development of infants at 8 months was assessed using the Bayley-III scale [²²], which consists of five major developmental domains: cognitive, language, motor, social-emotional, and adaptive behavior. The present study utilized cognitive and motor scales, in which each item was scored as 1 (passed) or 0 (not passed) for the cognitive (91 items) and motor (66 fine and 72 gross motor items) scales. The progression or regression of the tests for all scales adhered to the reversal and discontinue rules. Under the reversal rule, a participant must obtain “passed” scores for the first three consecutive items following an age-specific starting point in the examination to progress. If a participant receives a “not passed” score on any of the items, then the assessment score reverts to the previous age range until the rule is fulfilled. Under the discontinue rule, the examination is terminated when “not passed” scores are recorded for five consecutive items. Finally, the total composite scores for the Cognitive and Motor scales were calculated, and a higher domain score represented better development.

Statistical analysis

Chi-square tests were used to compare differences among the four subgroups across categorical variables (i.e., infant gender, delivery method, and family income). A univariate analysis of variance (ANOVA) was conducted to compare differences in four groups across numerical variables (i.e., Apgar score, gestational age, birthweight, birth length, maternal age, maternal education, and EPDS score). The Bonferroni test was used to perform pairwise comparisons between group means. If significant differences were found for any of variables, then they were subsequently considered in a Multivariate Variate Analysis of Variance (MANOVA) that compared the differences of the consumed dietary nutrients, growth, and development of infants in four groups. A P-value<0.05 was considered statistically significant. Data were analyzed using SPSS 23.0 (SPSS Inc., Chicago, IL, USA).

Results

Demographic and anthropometric measurements

Table 1 shows the characteristics of the 201 infants (followed-up at 8 months of age) involved in this cohort study. Note that the study has an attrition rate of 22.7% (i.e., 59) infants. In relation to gender, gestational age, Apgar score, birth length, birthweight, proportion of preterm, age of mother, education, mental status, and income, the characteristics of the 201 infants are not significantly different from those of the 59 infants who did not participate during the follow-up.

Table 2 presents the demographic and anthropometric measurements of the participants. No statistically significant differences were observed between fullterm infants in the depression and non-depression groups (P>0.05) and preterm infants (P>0.05) in relation to gender, Apgar score, gestational age, birthweight, birth length, maternal age, maternal education, and family income. However, depressed mothers indicated significantly higher EPDS scores than non-depressed mothers in both fullterm and preterm groups. No significant differences were found in the four groups in relation to infant gender, maternal age, education, and family income, except in relation to delivery method (P = 0.03). Thus, the variable of delivery method was controlled for in subsequent multivariate analyses.

Twenty-four hour diet recall

The intake of most nutrients (e.g., energy, protein, fat, vitamin A, thiamine, riboflavin, niacin, vitamin C, vitamin E, calcium, phosphorus, potassium, sodium, iron, zinc, selenium, copper, and retinol) in the non-depression-preterm group was higher than that in the other three groups. In relation to the fullterm infants, the energy, protein, and fat intake in the depression group were lower than that in the non-depression group (P<0.05). The intake of other nutrients (e.g., carbohydrate, thiamin, riboflavin, niacin, vitamin C, vitamin E, calcium, phosphorus, potassium, magnesium, iron, zinc, and selenium) in the depression group for fullterm infants were lower than that in the non-depression group, although no statistical difference among the groups (P>0.05) was found. The intake of energy, protein, carbohydrate, and most other nutrients were lower among preterm infants with depressed mothers than those without depressed mothers (P<0.05; Table 3).

Furthermore, the mean dietary consumption of energy, protein, and carbohydrate in the depression group was lower than 100% of the RNI in fullterm and preterm infants (Table 4). In the non-depression-preterm group, the mean intake of energy, protein, and carbohydrate were adequate and higher than 100% of the RNI.

Impact on growth and development

The Z-scores for weight and length, as well as the Bayley-III composite scores for the cognitive and motor scales were lower among preterm infants in the depression group than those in the fullterm group (P<0.05; Table 5). The Z-scores for weight and the Bayley-III composite scores for the cognitive and motor scales of preterm infants in the depression group were lower than those in the non-depression group (P<0.05). The Z-scores for length of preterm infants in the depression group were lower than those in the non-depression group although no statistical differences between groups was observed (P>0.05) and no significant differences existed between the non-depression preterm and fullterm groups (P>0.05).

Discussion

In our study, the dietary intake of energy, protein, and carbohydrates in the depression group were lower than the recommended intake amounts. Furthermore, the preterm infants of depressed mothers do not have sufficient nutrient intake for “catch-up growth” and reported poorer growth and development than infants of fullterm groups, and more importantly, lower than preterm infants of non-depressed mothers. The study results are consistent with previous studies; infants of mothers with depression have poor growth [⁴,²³], which may be attributed to the low maternal responses of depressed mothers to the needs of infants [²⁴]. For example, mothers with elevated depression symptoms demonstrated less responsive feeding practices than mothers with lower levels of depression symptoms [²⁵]. In addition, mothers with more depression symptoms are less interactive and show less encouragement to engage infants in feeding [²⁶]. Other studies [²⁴,²⁷] have suggested that depressed mothers display negative maternal feeding behaviors over the first year of an infant’s life.

Preterm infants often have nutrient deficits and display poor growth [¹³]. Moreover, they need high nutrition intake for “catch-up growth” in their first year [¹⁴,²⁸]. Our study demonstrated that preterm infants of mothers without depression have the highest nutrient intake of the four groups, which may be attributed to the careful feeding practices [²⁹,³⁰] of mothers without depression. Mothers without depression are usually aware of the functional immaturity of the gastrointestinal system [³⁰] and show adequate sensitivity and involvement in the nutritional management of their preterm infants [²⁹]. Furthermore, our results showed that preterm infants with depressed mothers have insufficient nutrient intake for “catch-up growth,” which may be due to the poor feeding competency of mothers with depression. Consequently, preterm infants of depressed mothers displayed poorer growth than those of non-depressed mothers. A previous study [³¹] showed that interventions among mothers experiencing depressive symptom may improve their responsiveness to child feeding.

Our study indicated that preterm infants of depressed mothers performed more poorly on cognitive development tests than infants in the other three groups. These findings are consistent with previous studies that have suggested that preterm infants of depressed mothers are an at-risk population. For example, previous studies [⁸,³²] have shown that depressed mothers provide less cognitive stimulation and less interaction to their infants than non-depressed mothers. Aktar et al. [³³] suggested that maternal depression might affect the attention to emotion-object associations of infants in social learning contexts. Perra et al. [³⁴] found an association between maternal postnatal depression and later cognitive development. Furthermore, early maternal depression and environmental risk factors directly affect the cognitive and social functioning of children later in life [⁶,³⁵].

In the present study, maternal depression and preterm births were found to be associated with delayed motor development. A previous study [³⁶] reported that delayed gross motor development was associated with small body sizes throughout infancy (i.e., poor “catch-up growth”) and that nutrition is the material basis for infant growth and development. Our study indicated that maternal depression and preterm births were associated with infant nutrition. Depressed mothers with poor feeding practices may not provide sufficient nutrition for the “catch-up growth” of preterm infants and consequently, preterm infants experience delayed motor development. In addition, nutrient intake deficiencies can lead to brain and metabolic abnormalities [³⁷] that may affect motor function. Depressed mothers display less positive interactions and provide less motor stimulation to their infants [⁷,⁸], which may delay motor development.

Deficient postnatal “catch-up growth” was associated with poor neurologic outcome for preterm infants [¹²,³⁸,³⁹], and gross motor development information was associated with child cognitive performance [⁴⁰]. Pina-Camacho et al. [⁴¹] conducted a path analysis and indicated that maternal depression and unhealthy nutrition in early life periods are both interrelated and independent risk factors for abnormal child emotional–behavioral development. Thus, supporting individuals with maternal depression and nutrition interventions may be important to preterm infants.

This study has a number of strengths compared with previous studies. First, this study is first to examine the dual effects of maternal depression and preterm birth on the growth and development of infants. Previous studies have only considered the effects of maternal depression [⁴,²³] or preterm birth [¹¹,⁴²] alone on the growth and development of infants. Our study discovered that preterm infants with depressed mothers have poorer nutrition intake, growth, and development, and they were more vulnerable than those with either fullterm birth with depressed mothers or preterm birth alone. The finding is important as it will inform future intervention practices to focus on the more vulnerable group of preterm born infants with depressed mothers. Second, this is the first study to investigate the nutrient intake of infants with depressed mothers using HDR. This approach provided novel insights into the effects of maternal depression and preterm birth on the growth and development of infants.

This study also has some limitations. First, the attrition of approximately 22.7% of the infants in the follow-up time of 8 months may have minimally influenced the results. However, note that the remaining 201 infants did not differ significantly from the 59 infants who failed to participate in the follow-up part of the study in terms of their demographics and anthropometric measurements. Second, the depression status of mothers was measured within three days of delivery and its predictive value to infant development may be overestimated. Although previous studies have found the positive correlation between the EPDS scores at 2 to 3 days and 4 to 6 weeks postpartum (r= 0.59, P<0.0001) [⁴³], the EPDS scores at only 3 days postpartum may not fully represent the mental status of the mother in later postpartum. Maternal mental status may be associated with many other factors such as mode of delivery [⁴⁴,⁴⁵], newborn sex [⁴⁶], and family status [⁴⁷]. Thus, the depression status of mothers may be confounded by these factors leading to misclassification in our study. Future studies should measure maternal depression at different postnatal periods to provide predictive value of the mental status of the mother at 2 to 3 days postpartum. Third, as we did not obtain sufficient samples of mothers with severe depression symptoms (EPDS≥13), the association between depression symptoms and outcomes may be underestimated. Thus, future studies with sufficient participants with severe depression symptoms are necessary. Finally, the disruption of mother-infant interactions and stimulation of infants were not considered as independent variables and were excluded in the multivariable models.

For implications and future research, the cognitive and motor development of infants are based on their physical growth. Furthermore, the “catch-up growth” during infancy is directly related to improved neurodevelopment [³⁹]. A previous study [⁴⁰] found that gross motor development is associated with cognitive performance. In addition, disrupted interactions between depressed mothers and infants may affect the motor development of infants. Consequently, adequate nutritional support and healthy mother–infant interactions may contribute to the “catch-up growth” of preterm infants and their motor and cognitive development. The preterm infants of depressed mothers require special attention to ensure their “catch-up growth” and improve their development as soon as possible. Thus, mothers with maternal depression and nutrition intervention should be supported. In conclusion, preterm infants with depressed mothers are more vulnerable than either fullterm birth with a depressed mother or preterm birth alone. The preterm infants of depressed mothers are at high risk of poor nutrition intake, poor growth, and developmental delay, and thus, they require special attention. Intervention approaches should seek to support mothers with maternal depression, improve mother–infant interactions, and consider the necessity of nutrition interventions.

References

[1] Weobong B, Ten Asbroek AH, Soremekun S, Danso S, Owusu-Agyei S, Prince M, Kirkwood BR. Determinants of postnatal depression in rural Ghana: findings from the don population based cohort study. Depress Anxiety 2015; 32(2): 108–119

[2] O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol 2013; 9(2): 379–407

[3] Qian Y, Yan X. Prevalence of postpartum depression in China: a systematic analysis. Chin J Prac Nurs (Zhongguo Shi Yong Hu Li Za Zhi) 2013; 29(12):1–3 (in Chinese)

[4] Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R. Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry 2004; 61(9): 946–952

[5] Hipwell AE, Goossens FA, Melhuish EC, Kumar R. Severe maternal psychopathology and infant-mother attachment. Dev Psychopathol 2000; 12(2): 157–175

[6] Lewinsohn PM, Olino TM, Klein DN. Psychosocial impairment in offspring of depressed parents. Psychol Med 2005; 35(10): 1493–1503

[7] El-Behadli AF, Sharp C, Hughes SO, Obasi EM, Nicklas TA. Maternal depression, stress and feeding styles: towards a framework for theory and research in child obesity. Br J Nutr 2015;113Suppl:S55–71

[8] Singer LT, Fulton S, Davillier M, Koshy D, Salvator A, Baley JE. Effects of infant risk status and maternal psychological distress on maternal-infant interactions during the first year of life. J Dev Behav Pediatr 2003; 24(4): 233–241

[9] Rahman A, Harrington R, Bunn J. Can maternal depression increase infant risk of illness and growth impairment in developing countries? Child Care Health Dev 2002; 28(1): 51–56

[10] World Health Organization. Almost one million children die each year due to complications of preterm birth. Many survivors may face a lifetime of disability, including learning disabilities and visual and hearing problems. 2014

[11] Wendell-Smith C. Estimation of fetal weight by ultrasound. Aust N Z J Obstet Gynaecol 2000; 40(3): 361–362

[12] Ehrenkranz RA, Dusick AM, Vohr BR, Wright LL, Wrage LA, Poole WK. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics 2006; 117(4): 1253–1261

[13] O’Connor DL, Khan S, Weishuhn K, Vaughan J, Jefferies A, Campbell DM, Asztalos E, Feldman M, Rovet J, Westall C, Whyte H; Postdischarge Feeding Study Group. Growth and nutrient intakes of human milk-fed preterm infants provided with extra energy and nutrients after hospital discharge. Pediatrics 2008; 121(4): 766–776

[14] Cooke RJ. Catch-up growth: implications for the preterm and term infant. Eur J Clin Nutr 2010; 64 Suppl1:S8–S10

[15] Morgan C, Herwitker S, Badhawi I, Hart A, Tan M, Mayes K, Newland P, Turner MA. SCAMP: standardised, concentrated, additional macronutrients, parenteral nutrition in very preterm infants: a phase IV randomised, controlled exploratory study of macronutrient intake, growth and other aspects of neonatal care. BMC Pediatr 2011; 11(7): 53

[16] Lee SH, Nurmatov UB, Nwaru BI, Mukherjee M, Grant L, Pagliari C. Effectiveness of mHealth interventions for maternal, newborn and child health in low- and middle-income countries: systematic review and meta-analysis. J Glob Health 2016; 6(1): 010401

[17] Sroufe LA. Emotional Development: The Organization of Emotional Life in the Early Years (Cambridge Studies in Social and Educational Development). New York: Cambridge University Press, 1996

[18] Lee DT, Yip SK, Chiu HF, Leung TY, Chan KP, Chau IO, Leung HC, Chung TK. Detecting postnatal depression in Chinese women. Validation of the Chinese version of the Edinburgh Postnatal Depression Scale. Br J Psychiatry 1998; 172(5): 433–437

[19] Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150(6): 782–786

[20] Spitzer RL, Endicott J, Robins E. Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 1978; 35(6): 773–782

[21] Yuexin Y, Guangya W, Xingchang P. China Food Composition 2004. Beijing: Peking University Medical Press, 2004

[22] Kathleen V, Jamie Z, Ron D, Willis JO. Bayley Scales of Infant and Toddler Development. Third Edition. John Wiley & Sons, Inc., 2014

[23] Anoop S, Saravanan B, Joseph A, Cherian A, Jacob KS. Maternal depression and low maternal intelligence as risk factors for malnutrition in children: a community based case-control study from South India. Arch Dis Child 2004; 89(4): 325–329

[24] Pridham K, Brown R, Clark R, Limbo RK, Schroeder M, Henriques J, Bohne E. Effect of guided participation on feeding competencies of mothers and their premature infants. Res Nurs Health 2005; 28(3): 252–267

[25] Goulding AN, Rosenblum KL, Miller AL, Peterson KE, Chen YP, Kaciroti N, Lumeng JC. Associations between maternal depressive symptoms and child feeding practices in a cross-sectional study of low-income mothers and their young children. Int J Behav Nutr Phys Act 2014; 11(1): 75

[26] Singer LT, Davillier M, Preuss L, Szekely L, Hawkins S, Yamashita T, Baley J. Feeding interactions in infants with very low birth weight and bronchopulmonary dysplasia. J Dev Behav Pediatr 1996; 17(2): 69–76

[27] Pridham K, Lin CY, Brown R. Mothers’ evaluation of their caregiving for premature and full-term infants through the first year: contributing factors. Res Nurs Health 2001; 24(3): 157–169

[28] Embleton ND. Optimal protein and energy intakes in preterm infants. Early Hum Dev 2007; 83(12): 831–837

[29] Agostini F, Neri E, Dellabartola S, Biasini A, Monti F. Early interactive behaviours in preterm infants and their mothers: influences of maternal depressive symptomatology and neonatal birth weight. Infant Behav Dev 2014; 37(1): 86–93

[30] Premji SS. Ontogeny of the gastrointestinal system and its impact on feeding the preterm infant. Neonatal Netw 1998; 17(2): 17–24 9592497

[31] Mallan KM, Daniels LA, Wilson JL, Jansen E, Nicholson JM. Association between maternal depressive symptoms in the early post-natal period and responsiveness in feeding at child age 2 years. Matern Child Nutr 2015; 11(4): 926–935

[32] Feldman R, Weller A, Leckman JF, Kuint J, Eidelman AI. The nature of the mother’s tie to her infant: maternal bonding under conditions of proximity, separation, and potential loss. J Child Psychol Psychiatry 1999; 40(6): 929–939

[33] Aktar E, Mandell DJ, de Vente W, Majdandžić M, Raijmakers MEJ, Bögels SM. Infants’ temperament and mothers’ and fathers’ depression predict infants’ attention to objects paired with emotional faces. J Abnorm Child Psychol 2016; 44(5): 975–990

[34] Perra O, Phillips R, Fyfield R, Waters C, Hay DF. Does mothers’ postnatal depression influence the development of imitation? J Child Psychol Psychiatry 2015; 56(11): 1231–1238

[35] Weissman MM, Wickramaratne P, Gameroff MJ, Warner V, Pilowsky D, Kohad RG, Verdeli H, Skipper J, Talati A. Offspring of depressed parents: 30 years later. Am J Psychiatry 2016; 173(10): 1024–1032

[36] Silventoinen K, Pitkäniemi J, Latvala A, Kaprio J, Yokoyama Y. Association between physical and motor development in childhood: a longitudinal study of Japanese twins. Twin Res Hum Genet 2014; 17(3): 192–198

[37] Simopoulos AP. Dietary omega-3 fatty acid deficiency and high fructose intake in the development of metabolic syndrome, brain metabolic abnormalities, and non-alcoholic fatty liver disease. Nutrients 2013; 5(8): 2901–2923

[38] Guellec I, Lapillonne A, Marret S, Picaud JC, Mitanchez D, Charkaluk ML, Fresson J, Arnaud C, Flamand C, Cambonie G, Kaminski M, Roze JC, Ancel PY. Effect of intra- and extrauterine growth on long-term neurologic outcomes of very preterm infants. J Pediatr 2016; 175:93–9 e1

[39] Latal-Hajnal B, von Siebenthal K, Kovari H, Bucher HU, Largo RH. Postnatal growth in VLBW infants: significant association with neurodevelopmental outcome. J Pediatr 2003; 143(2): 163–170

[40] Piek JP, Dawson L, Smith LM, Gasson N. The role of early fine and gross motor development on later motor and cognitive ability. Hum Mov Sci 2008; 27(5): 668–681

[41] Pina-Camacho L, Jensen SK, Gaysina D, Barker ED. Maternal depression symptoms, unhealthy diet and child emotional-behavioural dysregulation. Psychol Med 2015; 45(9): 1851–1860

[42] Ehrenkranz RA, Younes N, Lemons JA, Fanaroff AA, Donovan EF, Wright LL, Katsikiotis V, Tyson JE, Oh W, Shankaran S, Bauer CR, Korones SB, Stoll BJ, Stevenson DK, Papile LA. Longitudinal growth of hospitalized very low birth weight infants. Pediatrics 1999; 104(2 2 Pt 1): 280–289

[43] Teissèdre F, Chabrol H. Detecting women at risk for postnatal depression using the Edinburgh Postnatal Depression Scale at 2 to 3 days postpartum. Can J Psychiatry 2004; 49(1): 51–54

[44] Hiltunen P, Raudaskoski T, Ebeling H, Moilanen I. Does pain relief during delivery decrease the risk of postnatal depression? Acta Obstet Gynecol Scand 2004; 83(3): 257–261

[45] Patel RR, Murphy DJ, Peters TJ. Operative delivery and postnatal depression: a cohort study. BMJ 2005; 330(7496): 879–881

[46] de Tychey C, Briançon S, Lighezzolo J, Spitz E, Kabuth B, de Luigi V, Messembourg C, Girvan F, Rosati A, Thockler A, Vincent S. Quality of life, postnatal depression and baby gender. J Clin Nurs 2008; 17(3): 312–322

[47] Pan XF, Zhi-Ming LU, Xiao J. Prospective study on occurrence of postnatal depression and its psychosocial risk factors. Matern Child Health Care China (Zhongguo Fu You Bao Jian) 2004;19(9)：28–30 (in Chinese)

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