Maternal Mental Health, Education Are Key Predictors of Pediatric Nutrition

Maternal common mental disorders (CMDs) and educational status were key predictors in outcomes regarding childhood nutrition, according to a study published in BMJ Paediatrics Open.¹ While paternal employment was another predictor, researchers used their findings to advocate for improved maternal mental health and child nutrition interventions.

“The overlapping of symptoms such as depression, anxiety, exhaustion, and somatic problems results in the categorization of mental diseases as CMDs,” wrote the authors of the study. “CMDs are notably widespread among women, particularly in low- and middle-income countries.”

According to Agenda Alliance, just under 1 in 5 women (19%) experience CMDs compared with 12% of all men. One key factor that could explain these gender discrepancies is the prevalence of physical and sexual abuse among women. Although 78% of women who have faced violence also experienced life-threatening trauma, another 53% of all women with CMDs have been victims of abuse.²

As current and previous researchers have explored, these poor CMD outcomes among women can be detrimental to the development of their children.

READ MORE: Infants Without Access to Maternal Care Exhibit High Mortality Risk

“Maternal depression has been associated with compromised child growth, a vital measure of general health and nutritional quality,” they continued.¹ “Insufficient growth during early childhood can result in enduring repercussions, such as impaired physical development, diminished cognitive capacities, decreased economic production, and heightened vulnerability to diseases.”

From the moment of conception through every child’s formative years, the actions and behaviors of the mother are crucial to childhood development—an observation that health care providers share almost across the ecosystem. However, according to the Maternal Mental Health Leadership Alliance, the first year postpartum may be the most critical in childhood development across infants’ physical, cognitive, social, and emotional health.³

More specifically, researchers have previously explored the link between mothers’ CMDs and childhood nutrition. A study published in Cureus confirmed this link in 2023, saying the mother’s nutritional and mental health during pregnancy are key factors in influencing childhood development. According to the study authors, these factors among mothers are key “building blocks” for their children’s development.⁴

Researchers of the current study, however, still believe more can be synthesized regarding the health care community’s understanding of this crucial mother-to-child nutritional link.

“Previous research frequently examines maternal depression and child malnutrition in isolation, neglecting their synergistic effects,” wrote the authors.¹ “This study examines the association between CMD—evaluated through the Self-Reporting Questionnaire-20 (SRQ-20)—and child nutritional outcomes, specifically stunting, wasting, and underweight, in children under 5 years old attending e-health clinics in rural Sindh, Pakistan.”

To better understand this pertinent association, researchers conducted a cross-sectional observational study of e-health clinic data from April to June 2025. Clinic visits consisted of mother-provider consultations at 1 of 63 e-health clinics in Pakistan. The study participants consisted of mother-child pairs where the children’s ages spanned 6 months to 5 years.

Their primary outcome was the nutritional indicators among children, defined as wasting, stunting, and underweight—which are also the World Health Organization’s sub-forms of malnutrition.⁵ With the primary independent variable being mothers’ CMDs, they used the SRQ-20 tool to determine these outcomes among mothers, with a score of at least 7 determining high risk of CMDs.

The final analysis included a total of 455 mother-child pairs.

“This study identified increased maternal CMDs (SRQ≥7) as a significant predictor for adverse nutritional outcomes in children under 5 years of age,” the authors continued.¹ “Elevated CMD scores were associated with increased odds of stunting and a marginal association with underweight status.”

Researchers found that 76.9% of participants had CMDs, further highlighting the prevalence of mental health issues among women and expecting mothers relative to other populations. Addressing the link with pediatric nutrition, mothers with CMDs made their children almost twice as likely to be stunted and over 1.5 times more likely to be underweight. There were minimally significant findings regarding CMDs’ link with wasting.

While these findings confirm much of what was already known, researchers also uncovered insights regarding social factors that impacted pediatric nutrition. They found that secondary-level maternal education was associated with protective effects for children’s nutrition. On the paternal side of things, small business ownership and unemployment were associated with either stunting and/or underweight.

“These findings confirm that addressing undernutrition requires more than just nutritional interventions,” they concluded.¹ “Holistic, cohesive strategies that enhance maternal mental health, advance female education, and bolster household economic stability are crucial for attaining sustainable enhancements in child health and development.”

READ MORE: Women’s Health Resource Center

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REFERENCES

1. Muzzamil M, Aga IZ, Karim M, et al. Association between maternal mental health and child nutritional status in rural Sindh: a cross-sectional study using an e-health clinical model. BMJ Paediatr Open. 2025;9(1):e003972-e003972. https://doi.org/10.1136/bmjpo-2025-003972

2. Women’s mental health facts. Agenda Alliance. Accessed December 3, 2025. https://www.agendaalliance.org/our-work/projects-and-campaigns/previous-work/womens-mental-health-facts/

3. Maternal mental health: impact on the child. Maternal Mental Health Leadership Alliance. August 20, 2025. Accessed December 3, 2025. https://www.mmhla.org/articles/maternal-mental-health-impact-on-the-child-fact-sheet

4. Naaz A, Muneshwar KN. How maternal nutritional and mental health affects child health during pregnancy: a narrative review. Cureus. 2023 Nov 13;15(11):e48763. doi: 10.7759/cureus.48763.

5. Malnutrition. WHO. March 1, 2024. Accessed December 3, 2025. https://www.who.int/news-room/fact-sheets/detail/malnutrition