Association between maternal depression and parenting practices: A longitudinal study with children from low-income families

Resumo

Background
Maternal depressive symptoms (MDS) are common in low-income Brazilian settings, yet longitudinal evidence on their links to parenting is limited. We examined whether MDS measured in infancy and early school age are associated with parenting practices at child school entry (∼5.5 years).
Methods
We used longitudinal data from the Impact Evaluation of Brazil's Happy Child Program (PCF), implemented in municipalities across four Brazilian macro-regions. The cohort included 3242 families at baseline (T0, 2018) and 1014 mother–child dyads with complete data at the fourth follow-up (T4, 2024). MDS was assessed at T0 and T4 using the Edinburgh Postnatal Depression Scale (EPDS). Parenting practices were assessed at T4 using the Parenting and Family Adjustment Scales (PAFAS). Associations were estimated using multivariable linear regression with municipality-level cluster-robust standard errors, adjusted for child sex and maternal sociodemographic characteristics. Sensitivity analyses used mixed-effects models (municipality random intercept) with BH-FDR adjustment and continuous EPDS scores.
Results
Maternal depression point prevalence was 26.5% at baseline (T0) and 31.5% at child school entry (T4). Maternal depression at both T0 and T4 was associated with higher (worse) overall PAFAS scores and higher scores for coercive practices, parental consistency, and parent–child relationship at T4. Associations for positive encouragement were smaller, with weaker evidence at T0 and clearer associations at T4. Findings were robust across sensitivity analyses.
Conclusions
Maternal depressive symptoms in infancy and at child school entry are associated with less favorable parenting practices at early school age in low-income families. Integrating depression care with parenting supports may improve child development in resource-constrained settings.