Maternal depressive symptoms and their association with child maltreatment behaviors in middle-childhood: evidence from rural Bangladesh.

Child maltreatment is a major global public health concern, yet its burden remains underreported in low- and middle-income countries due to social stigma and cultural normalization. Maternal depression and child maltreatment frequently co-occur and share common risk factors, including domestic violence, inflammatory dysregulation, socioeconomic adversity, and inadequate social support. However, empirical evidence on this association is very limited in Bangladesh. This study aimed to examine the relationship between maternal depressive symptoms and child maltreatment behaviors in middle childhood, alongside child biological markers and relevant socioeconomic characteristics. Participants included mothers and their children aged 9-11 years from a rural subdistrict of Bangladesh, using data from a follow-up survey. Child maltreatment was assessed using selected items from an adapted ICAST-P tool, while maternal depressive symptoms were measured with the WHO SRQ-20. We also measured children's haemoglobin, soluble transferrin receptor (sTfR), ferritin, and C-reactive protein (CRP) levels. Multi-variable logistic regression models were applied to identify associated factors. The prevalence of scolding and physical punishment was 61.7% and 33.5%, respectively. Maternal depressive symptoms were reported by 43.7% of participants. Among these mothers, scolding was adopted by 72.1% and physical punishment by 39%. While haemoglobin, sTfR, and CRP were comparable between groups, ferritin levels were significantly higher among children of depressed mothers [mean (standard deviation): 39.6 (32.3) vs 32.8 (27.9); p < 0.05]. Maternal depressive symptoms were associated with higher odds of scolding (adjusted odds ratio (aOR) 2.52; 95% confidence interval (CI): 1.56-4.05; p < 0.001) but not with physical punishment (aOR 1.55; 95% CI 0.98-2.46; p = 0.059) after adjusting for covariates. While maternal depressive symptoms were associated with higher ferritin levels in children, neither scolding nor physical punishment represented an indirect pathway linking this association (p > 0.05). Integrating positive parenting interventions and maternal mental health screening into child protection schemes may help reduce child maltreatment risks in this resource-constrained setting.