Maternal Depressive Symptoms and Emergency Department Use Among Inner-city Children With Asthma | Asthma | JAMA Pediatrics | JAMA Network
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March 2001

Maternal Depressive Symptoms and Emergency Department Use Among Inner-city Children With Asthma

Author Affiliations

From the Departments of Medicine (Drs Bartlett, Kolodner, and Rand), Pediatrics (Dr Butz) and Pediatric Allergy and Immunology (Dr Eggleston), The Johns Hopkins University, Baltimore, Md; and College of Medicine, Howard University, Washington, DC (Dr Malveaux).

Arch Pediatr Adolesc Med. 2001;155(3):347-353. doi:10.1001/archpedi.155.3.347

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.