Maternal depressive symptoms and emergency department use among inner-city children with asthma

Susan J. Bartlett, Kenneth Kolodner, Arlene Manns Butz, Peyton Eggleston, Floyd J. Malveaux, Cynthia S Rand

Research output: Contribution to journalArticle

Abstract

Context: Inner-city minority children with asthma use emergency departments (ED) frequently. Objective: To examine whether maternal depressive symptoms are associated with ED use. Design, Setting, and Patients: Baseline and 6-month surveys were administered to mothers of children with asthma in inner-city Baltimore, Md, and Washington, DC. Main Outcome Measures: Use of the ED at 6-month follow-up was examined. Independent variables included asthma morbidity, age, depressive symptoms, and other psychosocial data. Results: Among mothers, nearly half reported significant levels of depressive symptoms. There were no demographic or asthma-related differences between the children of mothers with high and low depressive symptoms. However, in bivariate analyses, mothers with high depressive symptoms were 40% (prevalence ratio [PR], 1.4; 95% confidence interval [CI], 1.0-3.6; P=.04) more likely to report taking their child to the ED. Mothers aged 30 to 35 years were more than twice as likely (PR, 2.2; 95% CI, 1.9-9.3; P=.001) to report ED use, as were children with high morbidity (PR, 1.9; 95% CI, 1.4-7.1; P=.006). Child age and family income were not predictive of ED use. After controlling for asthma symptoms and mother's age, mothers with depressive symptoms were still 30% more likely to report ED use. Conclusions: Depression is common among inner-city mothers of children with asthma. Beyond asthma morbidity, maternal age and depressive symptoms are strong predictors of reports of ED visits. Identifying and addressing poor psychological adjustment in mothers may reduce unnecessary ED visits and optimize asthma management among inner-city children.

Original languageEnglish (US)
Pages (from-to)347-353
Number of pages7
JournalArchives of Pediatrics and Adolescent Medicine
Volume155
Issue number3
StatePublished - 2001

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Hospital Emergency Service
Asthma
Mothers
Depression
Confidence Intervals
Morbidity
Baltimore
Maternal Age
Demography
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Maternal depressive symptoms and emergency department use among inner-city children with asthma. / Bartlett, Susan J.; Kolodner, Kenneth; Butz, Arlene Manns; Eggleston, Peyton; Malveaux, Floyd J.; Rand, Cynthia S.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 155, No. 3, 2001, p. 347-353.

Research output: Contribution to journalArticle

Bartlett, Susan J. ; Kolodner, Kenneth ; Butz, Arlene Manns ; Eggleston, Peyton ; Malveaux, Floyd J. ; Rand, Cynthia S. / Maternal depressive symptoms and emergency department use among inner-city children with asthma. In: Archives of Pediatrics and Adolescent Medicine. 2001 ; Vol. 155, No. 3. pp. 347-353.
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abstract = "Context: Inner-city minority children with asthma use emergency departments (ED) frequently. Objective: To examine whether maternal depressive symptoms are associated with ED use. Design, Setting, and Patients: Baseline and 6-month surveys were administered to mothers of children with asthma in inner-city Baltimore, Md, and Washington, DC. Main Outcome Measures: Use of the ED at 6-month follow-up was examined. Independent variables included asthma morbidity, age, depressive symptoms, and other psychosocial data. Results: Among mothers, nearly half reported significant levels of depressive symptoms. There were no demographic or asthma-related differences between the children of mothers with high and low depressive symptoms. However, in bivariate analyses, mothers with high depressive symptoms were 40{\%} (prevalence ratio [PR], 1.4; 95{\%} confidence interval [CI], 1.0-3.6; P=.04) more likely to report taking their child to the ED. Mothers aged 30 to 35 years were more than twice as likely (PR, 2.2; 95{\%} CI, 1.9-9.3; P=.001) to report ED use, as were children with high morbidity (PR, 1.9; 95{\%} CI, 1.4-7.1; P=.006). Child age and family income were not predictive of ED use. After controlling for asthma symptoms and mother's age, mothers with depressive symptoms were still 30{\%} more likely to report ED use. Conclusions: Depression is common among inner-city mothers of children with asthma. Beyond asthma morbidity, maternal age and depressive symptoms are strong predictors of reports of ED visits. Identifying and addressing poor psychological adjustment in mothers may reduce unnecessary ED visits and optimize asthma management among inner-city children.",
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