Attendance of routine childcare visits in primary care for children of mothers with depression: a nationwide population-based cohort study

Bente Kjær Lyngsøe; Claus Høstrup Vestergaard; Dorte Rytter; Mogens Vestergaard; Trine Munk-Olsen; Bodil Hammer Bech

doi:10.3399/bjgp18X694565

Attendance of routine childcare visits in primary care for children of mothers with depression: a nationwide population-based cohort study

Br J Gen Pract. 2018 Feb;68(667):e97-e104. doi: 10.3399/bjgp18X694565. Epub 2018 Jan 15.

Authors

Bente Kjær Lyngsøe¹, Claus Høstrup Vestergaard¹, Dorte Rytter², Mogens Vestergaard³, Trine Munk-Olsen⁴, Bodil Hammer Bech⁵

Affiliations

¹ Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
² Department of Public Health, Aarhus University, Aarhus, Denmark.
³ Research Unit for General Practice, and Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
⁴ National Centre for Register-Based Research, Aarhus School of Business and Social Science, Aarhus University, Aarhus, Denmark.
⁵ Research Unit for General Practice, and Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.

Abstract

Background: Depression is a common and potentially debilitating illness worldwide. Attendance to routine childcare appointments is a key point of interest in the effort to improve the health and care for families facing depression.

Aim: To evaluate the association between maternal depression and offspring non-attendance to the Danish childcare and vaccination programme (CCP) for children from 0-5 years of age. The CCP consists of seven separate visits and several vaccinations. To investigate if exposure to recent and previous depression may affect attendance differently.

Design and setting: Population-based cohort study using Danish nationwide registers.

Method: Participants were all live-born children (n = 853 315) in Denmark in the period from 1 January 2000 until 31 August 2013, and their mothers. The outcome of interest was non-attendance of each one of the seven scheduled childcare visits and two vaccination entities in the CCP. Exposure was maternal (both previous and recent) depression. All information was obtained from Danish national registries.

Results: The risk of not attending CCP was higher for children of mothers with depression. For children of mothers with previous depression, the relative risk (RR) was 1.01 (95% confidence interval [CI] = 0.98 to 1.03) at the 5-week childcare visit, and 1.12 (95% CI = 1.09 to 1.14) at the 5-year childcare visit. For children of mothers with recent depression, the RR was 1.07 (95% CI = 1.03 to 1.13) at the 5-week visit, and 1.15 (95% CI = 1.13 to 1.17) at the 5-year visit. Furthermore, the risk of missing at least four of the seven childcare visits was higher for children of females with maternal depression (RR = 1.16, 95% CI = 1.13 to 1.19).

Conclusion: Maternal depression seems to compromise CCP attendance. These findings suggest a need for careful clinical attention to these vulnerable families, even years after a diagnosis of depression.

Keywords: Denmark; child care; delivery of health care; depression; general practice; maternal.

MeSH terms

Adult
Child Health*
Child of Impaired Parents / statistics & numerical data*
Child, Preschool
Cohort Studies
Denmark / epidemiology
Depression / epidemiology*
Female
Humans
Infant
Infant, Newborn
Male
Mothers / psychology
Mothers / statistics & numerical data*
Office Visits / statistics & numerical data*
Patient Acceptance of Health Care / psychology
Patient Acceptance of Health Care / statistics & numerical data
Patient Compliance / psychology
Patient Compliance / statistics & numerical data
Primary Health Care*
Registries
Review Literature as Topic
Vaccination / statistics & numerical data*