Maternal depression and anxiety disorders and child mental health outcomes

Problems relating to Maternal Depression and Anxiety Disorders (MDAD) are common and are known to affect child health and development. In the UK, the cost of these problems has been estimated at £8.1 billion for each birth cohort of children, and 72 percent of this cost is related to the direct impact on the children.

The overarching aim of our proposed research is to provide robust empirical evidence that helps understand how depression and anxiety disorders are transmitted from one generation to the next, and to help design interventions aimed at reducing the negative consequences of poor maternal mental health for children.

To achieve this aim, we will address the following research questions:
1) Are the negative effects of MDAD on children exclusively explained by genetic transmission and family background characteristics? Or are these negative effects also explained by changes in the child’s home environment?
2) Do school policies and health practices have a role in mitigating and reducing the negative effect of maternal depression on children?

We will develop and use state-of-the-art estimation methods in combination with a novel administrative dataset covering general practices and hospitals to study the mental health of mothers and their children at different stages of the children’s lives up to adolescence.

We will focus on mothers who gave birth between the ages of 13 and 49 and on children born between 1st January 2000 and 31st July 2020. Child and maternal depression will be measured by identifying all relevant records for depression/anxiety recorded in GP and HES records, using BNF, Read and ICD-10 codes.

We follow the mother (when possible) from up to 2 years before the birth of the child to account for previous maternal mental health. We will follow children until the latest data available.

Furthermore, for the first time, we will link children with their siblings. Such sibling linkage has not yet been performed in the UK. It will allow us to use objective measures of health, as well as sibling difference methods to analyse the effect of mothers’ mental health on child mental health, while controlling for unobserved variables that are shared by siblings such as genetic endowment, maternal education, or maternal preferences.
We will follow mothers across the life stages of her child up to 2020 and identify contacts with GPs for depression and anxiety disorders (physician visits and filled prescriptions).

The children will be followed from when they were born until 2020 and we focus on their mental health, injuries (fractures, poisoning, i.e. external causes), vaccinations, drugs prescriptions, asthma, nurse visits, GPs visits, number of A&E visits, number of referrals and number of hospital admissions.

We will include several control variables in our estimation, namely birth delivery method, parity, gestation weeks, birth weight, sex of baby, ethnicity, quintile of Townsend Deprivation Index, and general practice code.

We are using data covering primary care from EMIS and data covering secondary care from HES.

Dr Catia Nicodemo, University of Oxford

Dr Joaquim Vidiella-Martin, University of Oxford

Prof Julia Hippisley-Cox, University of Oxford

Prof Cheti Nicoletti, University of York