الفهرس 
coverOnly 14 pages are availabe for public view
 |  | from | 151 |  |  |
| | | from | 151 | | |
Abstract
The present study was designed to investigate the relation between maternal mental health and the nutritional status of their children aged 6-24 months .
This is a case–control study conducted in the Centre for Social and Preventive Medicine (CSPM), in the period between July 2011 and October 2011. A number of 407 children aged between 6 and 24 months, together with their mothers were included in the study.
Assessment of the nutritional status of children was done by using the anthropometric measurements of the children (measuring weight, length/height).
The Self Reporting Questionnaire 20 (SRQ20) was then used to assess the mental health of mothers.
Mothers were interviewed using the semi-structured interviewing form to collect data about the various factors that might be contributing to the nutritional status of their children. These factors included maternal and child characteristics, child health and development, child feeding practices and mother-child interaction.
The study included 407 children: a total of 185(45.5%) children were found to be normal regarding their nutritional status and were considered to be the controls, while 222 (54.5%) were found to be undernourished. Undernourished children included: 86 (38.7%) children were underweight, 53 (23.9%) were stunted, and 83 (37.4%) children were underweight-stunted. .
Maternal mean age was significantly highest among mothers of stunted children (27.5 ± 5.1 years), whereas the lowest mean age was recorded among mothers of underweight children (25.4 ± 5.3 years).
Mean number of children was insignificantly different among the study groups (p>0.05). About 15.8% of undernourished children’s mothers reported having more than 3 children compared to 6.8% of well nourished controls’ mothers.
The majority of well nourished children’s mothers were found to have secondary and university education (56.2%), compared to the majority of undernourished children’s mothers who were non-educated (43.2%).
About 9.4% of mothers of stunted children were working mothers , this percent is significantly highest as compared to mothers of underweight and underweight-stunted (p<0.05).
The majority of studied mothers reported having enough income with the highest percent among mothers of underweight children (95.3%).
Anaemia was insignificantly higher among mothers of controls compared to those of cases (32.4% and 27.0% respectively). While hypertension and diabetes mellitus were higher among cases as compared to controls (7.2% and 7.2% respectively).
Mean age of controls (well nourished children) was significantly lower than that of the undernourished group (12.4± 5.0 months and 14.1 ± 5.6 months respectively, p<0.001).
Among the undernourished group the mean age ± SD was significantly higher among the stunted group (16.6 ± 5.0 months) followed by the underweight-stunted group (15.3 ± 5.7 months) and the youngest was the underweight group (11.3± 4.6 months).
No significant difference in sex distribution was observed between cases and controls (p>0.05).
Almost one third of the undernourished group (32.9%) had low birth weight as compared to a significantly lesser proportion of the normal control group (14.1% , p<0.001).
Almost all the children had their immunization completed.
Though statistically insignificant (p>0.05), yet slightly higher percents of mothers of malnourished children had a probable mental illness (56.3%). No significant association between maternal mental health and child nutritional status was detected among each group of cases with reference to the controls.
Maternal answers to the SRQ20 revealed that being easily frightened and unable to play a useful role in life were significantly higher among cases (57.2% and 5.4% respectively) when compared to controls (47.6% and 0.5% respectively, p<0.05).
History of diarrheal attack within the past 15 days was insignificantly higher among cases as compared to controls (54.5% and 45.4% respectively)(p>0.05). History of hospitalization was significantly higher among cases (15.3%) as compared to controls (7.6%), while it was highest among underweight-stunted group of children (21.7%) (p<0.05).
Mothers of normal and stunted children were significantly more satisfied with their children health (70.2% and 75.5% respectively), compared to mothers of underweight and underweight-stunted children (44.2% and 39.7% respectively, p<0.001).
The percent of currently breastfed children was higher than that of currently non-breastfed among all study groups. For non-breastfed children insufficient amount of breast milk was the main cause of stopping breastfeeding.
Dietary malpractices were significantly higher in the cases (64.5%), this pattern was more reported to be among underweight and underweight-stunted as compared to the stunted group (p< 0.05).
The majority of mothers of controls (90.8%) were found to be insignificantly more interactive with their children compared to mothers of cases.
Mothers of underweight children were most harsh with their children with percent of (64.0%). However, no significant difference was observed between the study groups (p> 0.05).
As regards to mothers’ response to child refusal to eat, no significant difference was detected among the study groups (p> 0.05).
It was found that lack of maternal education almost doubled the risk of children to develop underweight and underweight-stunting (OR=1.69 and 2.17 respectively, p<0.05).Working mothers had 4.71 times higher risk to have stunted child (p<0.05), while mothers satisfied with their income had 3.91 times higher risk to have underweight child (p<0.05).
Low birth weight significantly tripled the risk of children to develop underweight, stunting and underweight-stunting (OR=2.95, 2.89 and 3.11 respectively, p<0.05).
Children during their second year of life (age 12-24 months) had also significant high risk to develop stunting and underweight-stunting (OR=3.98 and 2.61 respectively, p<0.05).
Regarding maternal perception of child health, children whose mothers were unsatisfied about their health had significantly 2.86 and 3.45 times higher risk to develop underweight and underweight-stunting respectively, while non-breastfeeding almost doubled the risk of underweight (OR=1.89).