המכון הלאומי לחקר שרותי הבריאות ומדיניות הבריאות (ע”ר)

The Israel National Institute For Health Policy Research

Immigration and the psychosocial wellbeing of mothers in Israel: Prevalence, determinants, utilization of health services, and implications on child development.

Researchers: Ronit Calderon-Margalit1, Lubotzky-Gete Shakked1
  1. Hebrew University-Hadassah
Background: Mental disorders are the most common complications that women experience after delivery. Migration is associated with stress and has been found to be a risk factor for developmental delays in infants. Few studies have looked into the associations between postpartum depression (PPD), immigration and child development.
Objectives: To estimate whether immigration and psychological distress after birth are associated with infant development.
Method: I- A historical-cohort-study in the setting of the Mother and Child Health Clinics. II- prospective- cohort: Women were interviewed in-hospital, 6-8 weeks and 12 months postpartum, using questionnaires to assess their well-being, mental state (EPDS, GAD-7) and child's development (ASQ-3 at age 12 months).
Findings: PPD was associated with delays in language skills, (e.g., production of voices OR=1.86), personal-social skills (e.g., pointing to selected objects OR=1.48), fine-motor skills (pinching OR=1.47), and gross-motor skills (ground crawling OR=1.35).
Migrants’ children were less likely to meet developmental milestones compared with native-Israelis. Delays among offspring of immigrants were observed mostly in language skills in producing 2-3 words (OR = 1.39 and OR = 1.22, Ethiopia and FSU, respectively), in personal-social skills (pointing selected objects - OR=2.29 and OR=1.51, respectively, and social smile OR=1.98 and OR=1.50, respectively) and in fine-motor skills, including building a cube tower (1.66 and 1.28, respectively).
In the prospective cohort study, PPD was only associated with poor personal-social skills at age 1 year (β=-0.44). However, maternal anxiety was associated with delayed development in communication skills (β =-0.54), personal-social skills (β =-0.89), solving problems skills (β =-0.57) and fine-motor skills (β =-0.42, 95% CI: -0.84, -0.01).
Conclusions: Mental disorders postpartum and immigration from Ethiopia are strong predictors of developmental delays in infants. Anxiety may be associated more strongly with delays than PPD.
Recommendations: Supporting women with psychological distress and migrants, especially from Ethiopia, may improve their wellbeing and mitigate developmental disparities.
Research number: R/167/2016
Research end date: 06/2020
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