How is the study progressing?

We successfully recruited 909 mothers during pregnancy, 825 were eligible for postnatal follow-up. We followed up 742 families at least once from 8-12 weeks postpartum to 2 years of children’s age (BCHADS I), with the majority of families completing multiple follow-up assessments. We successfully gained further funding to continue following-up the same families into later childhood at age 5 and 7-9 years (BCHADS II).

We have completed the pregnancy phases of the study and the postnatal phases up to age 5 years, and we are running the 7-9 years phase, after successfully securing funding to do so. After each child was born we asked families to meet our researchers for data collection either at their home or at the NIMHANS Centre for Well Being, an urban community mental health centre or at the Anganwadi centres (community venue). They were invited to take part in the study on six occasions after birth up to 7-9 years (8-16 weeks, 6 months, 1 year, and 2, 5 and 7-9 years of child age). We also gathered information from a key alternative caregiver on five occasions (around 6 months, and at 1, 2, 5 and 7-9 years of age) where possible. Mothers and caregivers were asked to complete detailed interviews and questionnaires about their lives and the study child, and to let us observe and film them playing with the child. We assessed children’s behavioural, emotional and cognitive (mental) development and we collected samples of saliva for genetic and epigenetic analysis.

During COVID-19 we completed three additional waves of telephonic assessment when children in the cohort were between three and five years of age, to ensure we captured the impact of COVID-19 on child mental health. We asked mothers about how children and families have been impacted by the pandemic and how they have been coped.

At age 5 we were able to resume planned face to face assessments. We gathered information on quality of parenting through video-recorded observations, DNA for epigenetic analyses of key stress-response and immune-response related genes, and we assessed cognitive, emotional and behavioural development through the use of standardised tasks and tests. At age 7-9 we involve teachers and ask them questions about children behaviours and emotions when children are attending school.

Gathering information from multiple people is important to reflect the reality in India where family members other than mothers are involved in the daily care of children, more often than in Western cultures. So, in addition to mothers, we interview fathers, grandparents, aunts and uncles if they are actively involved in the care of the child according to the mother. Findings are also much stronger when based on reports from several people as children can behave differently with a different caregiver who, in turn, might take care of distinctive aspects of the family life. All these factors can affect children and it’s important to know how.

The BCHADS List of measures briefly summarises the research plan of the study from the first trimester of pregnancy up to age 7-9 (BCHADS I and BCHADS II).