Joanna Maselko, ScD 

The contribution of grandmother involvement to child growth and development: an observational study in rural Pakistan

BMJ Global Health (2020), 5(8)

Chung, E., Hagaman, A., LeMasters, K., Andrabi, N., Baranov, V., Bates, L., Gallis, J., O'Donnell, K., Rahman, A., Sikander, S., Turner, E., Maselko, J.

Early childhood interventions primarily focus on the mother-child relationship, but grandmothers are often critical in childcare in low-resource settings. Prior research is mixed on how grandmother involvement influences child outcomes and there is paucity of research on grandmother caregiving in low-income and middle-income countries. In this study, conducted in rural Pakistan, 68% of children lived with a grandmother. This study uncovered relationships between grandmother involvement for infants at 3-months old with infant weight at 12-months and 24-months, such that weight was positively associated with grandmother involvement at 12-months and negatively associated at 24-months. Furthermore, high 12-month grandmother involvement was associated with improved 12-month cognitive, fine motor skills, and 24-month socioemotional development. 

​

Association of maternal depression and home adversities with infant hypothalamic-pituitary-adrenal (HPA) axis biomarkers in rural Pakistan

Journal of Affective Disorders (2020), 276

Hagaman, A., Baranov, V., Chung, E., LeMasters, K., Andrabi, N., Bates, L., Rahman, A., Sikander, S., Turner, E., Maselko, J.

Each year, almost 35% of children are exposed to maternal depression and more grow up in persistent poverty, increasing the risk for stress-related disease and other socio-developmental deficits later in life. These impacts are likely related to chronic stress via the hypothalamic-pituitary-adrenal (HPA) axis. However, there is little evidence relating early windows of child HPA axis activity to multiple exposures. This study did not yield associations between infant cortisol and maternal depression or home adversities. Contrastingly, infants exposed to maternal depression during pregnancy and those with mothers who experienced multiple types of IPV within one year of post-partum had lower dehydroepiandrosterone (DHEA) levels. Furthermore, higher socioeconomic-status had a significant positive association with infant DHEA levels and depression severity and chronicity at one year postpartum had near significant associations with infant DHEA. 

​

​

Maternal depression in rural Pakistan: the protective associations with cultural postpartum practices

BMC Public Health (2020), 20(68)

LeMasters, K., Andrabi, N., Zalla, L., Hagaman, A., Chung, E., Gallis, J., Turner, E., Bhalotra, S., Sikander, S., Maselko, J.

Traditional postpartum practices are intended to provide care to mothers, but there is mixed evidence concerning their impact on postpartum depression (PPD). It remains unknown if there is a unique impact of postpartum practices on PPD separately from other types of social support, or if practices differentially affect those with existing prenatal depression. In Pakistan, chilla (چله) is a traditional postpartum practice in which women receive relief from household work, additional familial support, and supplemental food for up to 40 days postpartum. This study found that chilla was inversely associated with both major depressive episodes and depression symptom severity at 6 months postpartum above and beyond social support. 

​

Maternal Depression, Women's Empowerment, and Parental Investment: Evidence from a Randomized Control Trial

American Economic Review (2020), 110(3)

Baranov, V., Bhalotra, S., Biroli, P., Maselko, J.

This paper investigates the medium-term impacts of treating maternal depression on women's mental health, financial empowerment, and parenting decisions. In order to investigate hypothesized associations, this study leverages variation induced by a cluster-randomized controlled trial that provided psychotherapy to 903 prenatally depressed mothers in rural Pakistan. It was one of the world's largest psychotherapy interventions, and it dramatically reduced postpartum depression. Seven years after psychotherapy concluded, impacts on women's mental health had persisted, with a 17 percent reduction in depression rates. The intervention also improved women's financial empowerment and increased both time- and money-intensive parental investments by between 0.2 and 0.3 standard deviations.

​