***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aims : To examine the associations between  postnatal depression in mothers and diarrhoeal illness in their infants in the first year of life in a low-income country . Methods : Using a prospect i ve cohort design , 265 infants ( n = 130 of mothers having a depressive episode according to the International Classification of Diseases , 10th revision , at 3 months postnatal and n = 135 of psychologically well mothers ) living in rural Rawalpindi , Pakistan , were followed up for 1 year . Frequency of diarrhoeal episodes was measured fortnightly by health workers using a st and ard question naire . Results : Infants of depressed mothers had significantly more diarrhoeal episodes per year than those of controls ( mean 5.5 v 4.0 ; 95 % confidence interval ( CI ) 0.9 to 2.0 ) . The relative risk of having ⩾5 diarrhoeal episodes per year in infants of depressed mothers was 2.3 ( 95 % CI 1.6 to 3.1 ) . The association remained significant after adjustment for other risk factors by multivariate analysis . Conclusions : Maternal depression is associated with infant diarrhoeal morbidity in a low-income community setting . It is independent of the effects of known factors such as undernutrition , socioeconomic status and parental education . Preventive child health programmes targeting mothers must consider their mental health Combined psychosocial and nutrition interventions improve the development of infants . However , there is a paucity of studies examining the effectiveness of such interventions in humanitarian setting s. This article examines the impact of combining a group-based psychosocial intervention with an existing emergency feeding program for internally displaced mothers in Northern Ug and a. The intervention consisted of mother and baby group sessions and home visits for mothers attending 3 emergency feeding centers . Psychosocial outcomes were compared with a contrast group of mothers who received nutritional support alone . The outcomes investigated were infant stimulation and maternal mood . After controlling for the effects of interview site and baseline scores , mothers in the intervention group ( n = 70 ) showed greater involvement with their babies , more availability of play material s , and less sadness and worry at follow-up in comparison to the contrast group ( n = 77 ) . The intervention was acceptable to the mothers and easily taught . A proportion of the mothers chose to continue the intervention spontaneously with other mothers in their neighbourhoods . Further research needs to be done to vali date these preliminary findings and explore the longer term impact on child growth and intellectual development as well as maternal mood BACKGROUND Programmes that promote early psychological development of children in the developed world have been found to be beneficial . However , such programmes are rare in underprivileged parts of the developing world . We adapted one such parent-based programme ( Learning Through Play ) for a rural Pakistani population and aim ed to study if : ( 1 ) it was acceptable to community health workers ; ( 2 ) the programme led to an improvement , after a period of 6 months , in mothers ' knowledge and attitudes about early infant development ; ( 3 ) it led to a reduction in the levels of maternal mental distress in the post-natal period . METHODS Using a cluster r and omized design with villages as unit of r and omization , 163 mothers from 24 villages in a rural sub-district of Rawalpindi , Pakistan , received the ' Learning Through Play ' programme , whereas 146 mothers from 24 villages acted as controls . Twenty-four community health workers were trained to carry out the programme . Assessment s were conducted using a specially developed 15-item Infant Development Question naire and the 20-item Self-Reporting Question naire ( SRQ ) . RESULTS Over 80 % of the community health workers trained found the programme to be relevant and were able to integrate it into their routine work . There was a significant increase in mothers ' knowledge and positive attitudes about infant development in the intervention group , compared with the control group . Women in the intervention group answered correctly 4.3 ( 95 % CI 3.7 - 14.9 , P < 0.001 ) more questions than the control group . There was no difference in levels of mental distress measured by the SRQ . CONCLUSIONS The ' Learning Through Play ' programme was successfully integrated into the existing health system and accepted by community health workers . The programme succeeded in improving the knowledge and attitudes of mothers about infant development PURPOSE This study aim ed to study the effectiveness of an emotional self-management training program to antenatal women in the prevention of postnatal depression . DESIGN AND METHODS The sample comprised 240 women who were at 32 weeks antenatal . They were r and omly assigned into the intervention group and the control group . FINDINGS On completion of the program , the intervention group reported significantly lower mean Patient Health Question naire-9 and Edinburgh Postnatal Depression Scale scores than the control group . Fewer participants from the intervention group were diagnosed as having postnatal depression using the Structured Clinical Interview for DSM-IV . PRACTICE IMPLICATION S An antenatal emotional self-management training that may lower the risk of developing postnatal depression among Chinese women is recommended BACKGROUND The risk for emotional and behavioral problems is known to be high among children of depressed mothers , but little is known about the impact of prenatal and postnatal depression on the physical health of infants . OBJECTIVE To determine whether maternal depression is a risk factor for malnutrition and illness in infants living in a low-income country . DESIGN Prospect i ve cohort study . SETTING Rural community in Rawalpindi , Pakistan . PARTICIPANTS Six hundred thirty-two physically healthy women were assessed in their third trimester of pregnancy to obtain at birth a cohort of 160 infants of depressed mothers and 160 infants of psychologically well mothers . MAIN OUTCOME MEASURES All infants were weighed and measured at birth and at 2 , 6 , and 12 months of age , and they were monitored for episodes of diarrhea and acute respiratory infections . The mothers ' mental states were reassessed at 2 , 6 , and 12 months . Data were collected on potential confounders of infant outcomes , such as birth weight and socioeconomic status . RESULTS Infants of prenatally depressed mothers showed significantly more growth retardation than controls at all time points . The relative risks for being underweight ( weight-for-age z score of less than -2 ) were 4.0 ( 95 % confidence interval [ CI ] , 2.1 to 7.7 ) at 6 months of age and 2.6 ( 95 % CI , 1.7 to 4.1 ) at 12 months of age , and the relative risks for stunting ( length-for-age z score of less than -2 ) were 4.4 ( 95 % CI , 1.7 to 11.4 ) at 6 months of age and 2.5 ( 95 % CI , 1.6 to 4.0 ) at 12 months of age . The relative risk for 5 or more diarrheal episodes per year was 2.4 ( 95 % CI , 1.7 to 3.3 ) . Chronic depression carried a greater risk for poor outcome than episodic depression . The associations remained significant after adjustment for confounders by multivariate analyses . CONCLUSIONS Maternal depression in the prenatal and postnatal periods predicts poorer growth and higher risk of diarrhea in a community sample of infants . As depression can be identified relatively easily , it could be an important marker for a high-risk infant group . Early treatment of prenatal and postnatal depression could benefit not only the mother 's mental health but also the infant 's physical health and development Objective To assess the efficacy of an intervention design ed to improve the mother-infant relationship and security of infant attachment in a South African peri-urban settlement with marked adverse socioeconomic circumstances . Design R and omised controlled trial . Setting Khayelitsha , a peri-urban settlement in South Africa . Participants 449 pregnant women . Interventions The intervention was delivered from late pregnancy and for six months postpartum . Women were visited in their homes by previously untrained lay community workers who provided support and guidance in parenting . The purpose of the intervention was to promote sensitive and responsive parenting and secure infant attachment to the mother . Women in the control group received no therapeutic input from the research team . Main outcome measures Primary outcomes : quality of mother-infant interactions at six and 12 months postpartum ; infant attachment security at 18 months . Secondary outcome : maternal depression at six and 12 months . Results The intervention was associated with significant benefit to the mother-infant relationship . At both six and 12 months , compared with control mothers , mothers in the intervention group were significantly more sensitive ( 6 months : mean difference=0.77 ( SD 0.37 ) , t=2.10 , P<0.05 , d=0.24 ; 12 months : mean difference=0.42 ( 0.18 ) , t=−2.04 , P<0.05 , d=0.26 ) and less intrusive ( 6 months : mean difference=0.68 ( 0.36 ) , t=2.28 , P<0.05 , d=0.26 ; 12 months : mean difference=−1.76 ( 0.86 ) , t=2.28 , P<0.05 , d=0.24 ) in their interactions with their infants . The intervention was also associated with a higher rate of secure infant attachments at 18 months ( 116/156 ( 74 % ) v 102/162 ( 63 % ) ; Wald=4.74 , odds ratio=1.70 , P<0.05 ) . Although the prevalence of maternal depressive disorder was not significantly reduced , the intervention had a benefit in terms of maternal depressed mood at six months ( z=2.05 , P=0.04 ) on the Edinburgh postnatal depression scale ) . Conclusions The intervention , delivered by local lay women , had a significant positive impact on the quality of the mother-infant relationship and on security of infant attachment , factors known to predict favourable child development . If these effects persist , and if they are replicated , this intervention holds considerable promise for use in the developing world . Trial registration Current Controlled Trials IS RCT N25664149 BACKGROUND The optimum way to improve the recognition and treatment of postnatal depression in developing countries is uncertain . We compared the effectiveness of a multicomponent intervention with usual care to treat postnatal depression in low-income mothers in primary -care clinics in Santiago , Chile . METHODS 230 mothers with major depression attending postnatal clinics were r and omly allocated to either a multicomponent intervention ( n=114 ) or usual care ( n=116 ) . The multicomponent intervention involved a psychoeducational group , treatment adherence support , and pharmacotherapy if needed . Usual care included all services normally available in the clinics , including antidepressant drugs , brief psychotherapeutic interventions , medical consultations , or external referral for specialty treatment . The primary outcome measure was the Edinburgh postnatal depression scale ( EPDS ) score at 3 and 6 months after r and omisation . Analysis was by intention to treat . This study is registered with Clinical Trials.gov , number NCT00518830 . FINDINGS 208 ( 90 % ) of women r and omly assigned to treatment groups completed assessment s. The crude mean EPDS score was lower for the multicomponent intervention group than for the usual care group at 3 months ( 8.5 [ 95 % CI 7.2 - 9.7 ] vs 12.8 [ 11.3 - 14.1 ] ) . Although these differences between groups decreased by 6 months , EPDS score remained better in multicomponent intervention group than in usual care group ( 10.9 [ 9.6 - 12.2 ] vs 12.5 [ 11.1 - 13.8 ] ) . The adjusted difference in mean EPDS between the two groups at 3 months was -4.5 ( 95 % CI -6.3 to -2.7 ; p<0.0001 ) . The decrease in the number of women taking antidepressants after 3 months was greater in the intervention group than in the usual care group ( multicomponent intervention from 60/101 [ 59 % ; 95 % CI 49 - 69 % ] to 38/106 [ 36 % ; 27 - 46 % ] ; usual care from 18/108 [ 17 % ; 10 - 25 % ] to 11/102 [ 11 % ; 6 - 19 % ] ) . INTERPRETATION Our findings suggest that low-income mothers with depression and who have newly born children could be effectively helped , even in low-income setting s , through multicomponent interventions . Further refinements to this intervention are needed to ensure treatment compliance after the acute phase BACKGROUND Community mobilisation through participatory women 's groups might improve birth outcomes in poor rural communities . We therefore assessed this approach in a largely tribal and rural population in three districts in eastern India . METHODS From 36 clusters in Jharkh and and Orissa , with an estimated population of 228 186 , we assigned 18 clusters to intervention or control using stratified r and omisation . Women were eligible to participate if they were aged 15 - 49 years , residing in the project area , and had given birth during the study . In intervention clusters , a facilitator convened 13 groups every month to support participatory action and learning for women , and facilitated the development and implementation of strategies to address maternal and newborn health problems . The primary outcomes were reductions in neonatal mortality rate ( NMR ) and maternal depression scores . Analysis was by intention to treat . This trial is registered as an International St and ard R and omised Controlled Trial , number IS RCT 
    Output:
    
Where assessed , benefits to the child included improved mother-infant interaction , better cognitive development and growth , reduced diarrhoeal episodes and increased immunization rates .
CONCLUSION In LAMI countries , the burden of CPMDs can be reduced through mental health interventions delivered by supervised non-specialists .