Researchers studied 500 mothers in Pakistan to understand why some babies don’t survive infancy. They found that mothers living in cities had higher rates of depression, anxiety, and stress compared to rural mothers, and these mental health struggles were connected to worse outcomes for babies. Interestingly, mothers who exercised regularly and ate healthy foods had better mental health and lower rates of infant death. The study suggests that helping mothers feel better mentally and supporting healthy habits could save babies’ lives, especially in urban areas where stress levels are higher.

The Quick Take

  • What they studied: Whether a mother’s mental health (depression, anxiety, stress), exercise habits, diet, and where she lives affect whether her baby survives infancy
  • Who participated: 500 mothers in Pakistan—250 living in cities and 250 living in rural areas. The study looked at their age, when they got married, how much money they made, and whether they could see a doctor
  • Key finding: City mothers had much higher depression, anxiety, and stress than rural mothers. Surprisingly, babies in rural areas had better survival rates. Mothers who exercised and ate well had less depression and anxiety, and their babies were more likely to survive
  • What it means for you: If you’re a mother or planning to become one, taking care of your mental health through exercise and good nutrition may help protect your baby’s health. This is especially important if you live in a city where stress levels tend to be higher. Talk to your doctor about mental health support if you’re struggling

The Research Details

Researchers asked 500 mothers in Pakistan to answer questions about their lives, health, and habits. Half lived in cities and half lived in rural areas. The mothers filled out questionnaires that measured their depression, anxiety, and stress levels, as well as how much they exercised and what they ate. The researchers then looked at whether babies born to these mothers survived their first five years of life. This type of study is called ‘cross-sectional’ because researchers collected all the information at one point in time, like taking a snapshot rather than following people over months or years.

This research approach helps identify connections between different factors and baby survival. By comparing city and rural mothers, researchers could see how location affects stress and health. By measuring exercise and diet, they could understand whether lifestyle choices matter. This information helps doctors and public health workers know where to focus their efforts to save babies’ lives.

The study used validated tools (DASS-21) that are recognized worldwide for measuring depression, anxiety, and stress accurately. The researchers collected information from a decent-sized group (500 mothers), which makes the findings more reliable than studying just a few people. However, because this was a snapshot study rather than following mothers over time, we can’t be completely sure that exercise and diet directly cause better outcomes—they might just be connected. The study was done in one region of Pakistan, so results might be different in other countries or cultures

What the Results Show

The most striking finding was that city mothers experienced much higher levels of mental health struggles compared to rural mothers. Urban mothers had depression scores of 6.59 compared to 1.63 for rural mothers, anxiety scores of 7.68 versus 2.18, and stress scores of 9.65 versus 2.32. These differences were very large and statistically significant, meaning they’re unlikely to be due to chance. Surprisingly, despite these mental health challenges, rural mothers actually had lower infant mortality rates than urban mothers. This suggests that factors beyond just mental health—like access to healthcare, sanitation, or nutrition—may play important roles. Mothers who exercised regularly had better mental health scores, with active mothers scoring 23.46 on physical activity measures compared to 21.79 for less active mothers. Similarly, mothers with healthier diets scored 16.01 on diet quality compared to 14.85 for those with poorer diets.

The study found that mothers who married very young (early marriage) had significantly higher anxiety and stress levels. This suggests that becoming a mother at a young age adds extra emotional burden. The research also highlighted the importance of healthcare access—mothers who could see a doctor regularly and had professional help during childbirth had better outcomes for their babies. Socioeconomic status (how much money a family has) was connected to these outcomes, with wealthier families generally having better access to healthcare and lower infant mortality

Previous research has shown that maternal depression and stress can affect baby health, but this study adds important information by comparing rural and urban areas. Most earlier studies focused on wealthy countries, so this research from Pakistan helps us understand how these connections work in different parts of the world. The finding that exercise and diet help reduce depression and anxiety matches what other studies have shown. However, the surprising finding that rural areas had lower infant mortality despite higher poverty levels suggests that other protective factors in rural communities (like stronger family support or different healthcare practices) may be important

This study took a snapshot at one point in time, so we can’t be sure whether depression causes poor baby outcomes or if poor outcomes cause depression. The study only included mothers from one region in Pakistan, so results might be different in other countries or even other parts of Pakistan. The researchers used purposive sampling (choosing specific people rather than random selection), which could introduce bias. We don’t know if mothers who answered the survey were different from those who didn’t. The study didn’t measure all possible factors that affect baby survival, like access to clean water, nutrition during pregnancy, or infections

The Bottom Line

Moderate confidence: Mothers should prioritize regular physical activity and healthy eating as part of their mental health care. Strong confidence: Mothers experiencing depression, anxiety, or stress should seek professional help from a doctor or counselor. Moderate confidence: Young mothers and those living in cities should receive extra mental health support and healthcare access. Strong confidence: All mothers should have access to professional healthcare during pregnancy and childbirth

This research is most relevant to mothers living in cities or developing countries where mental health support may be limited. Young mothers and those with limited access to healthcare should especially pay attention. Healthcare workers, public health officials, and government policymakers should use this information to improve maternal mental health services. Expectant mothers and those planning pregnancy should consider these findings when preparing for motherhood. This research is less directly applicable to mothers in wealthy countries with strong healthcare systems, though the mental health connections may still be relevant

Mental health improvements from exercise and diet typically appear within 4-8 weeks of consistent effort. Baby health benefits would likely take longer to measure—potentially months to years. If you’re struggling with depression or anxiety, you may feel better within 2-4 weeks of starting treatment with professional help. Don’t expect overnight changes; building healthy habits is a gradual process

Want to Apply This Research?

  • Track three things weekly: (1) minutes of physical activity, (2) number of servings of fruits and vegetables eaten daily, and (3) mood rating on a scale of 1-10. Look for patterns—do you feel better on days you exercise or eat well?
  • Set a goal to add 30 minutes of moderate activity (like brisk walking) three times per week, and aim to eat at least one fruit or vegetable with each meal. Use the app to log these activities and celebrate small wins
  • Review your weekly trends in the app to see if your mood improves as you increase activity and healthy eating. If you’re struggling with depression, anxiety, or stress, use the app to track when you reach out for professional help and how you feel afterward. Share your progress with your doctor at regular check-ups

This research suggests associations between maternal mental health, lifestyle factors, and infant outcomes, but cannot prove direct cause-and-effect relationships. If you are pregnant, planning pregnancy, or experiencing depression, anxiety, or stress, please consult with your healthcare provider or mental health professional for personalized medical advice. This information is not a substitute for professional medical care. The findings are based on a study in Pakistan and may not apply to all populations or healthcare settings. Always work with qualified healthcare providers to develop a plan that’s right for your individual situation and health needs.