Drewett Robert, Blair Peter, Emmett Pauline, Emond Alan
Department of Psychology, University of Durham, UK.
J Child Psychol Psychiatry. 2004 Feb;45(2):359-66. doi: 10.1111/j.1469-7610.2004.00226.x.
To examine the relationship between failure to thrive in preterm and term infants and postnatal depression in their mothers.
In a whole population birth cohort of 12,391 infants (excluding those born after term or with major congenital abnormalities) failure to thrive over the first nine months was identified using a conditional weight gain criterion which identified the slowest-gaining 5%. Depression symptoms were recorded using the Edinburgh Postnatal Depression Scale (EPDS) at 18 and 32 weeks of pregnancy and at 8 weeks and 8 months after delivery.
After the birth, high depression scores were significantly more common in the mothers of infants born preterm, and controlling for depression scores in pregnancy did not eliminate this association after the birth. Failure to thrive was identified in 4.5% of the children born at term (531/11718) and in 8.3% of those born preterm (56/673). The difference was highly significant (chi2 = 20.25 with 1 df, p < .0001). Using a conventional cut-off on the EPDS (score > 12) to identify mothers as 'depressed', the prevalence of failure to thrive in the term infants of mothers depressed at 8 weeks postpartum was 5.0%; in the remainder of the population (controls) it was 4.3%. In mothers depressed at 8 months the prevalence was 4.3% in both groups. The prevalence of failure to thrive in the preterm infants of mothers depressed at 8 weeks was 8.8% (7.0% in controls) and in those depressed at 8 months it was 12.3% (6.7% in controls). None of these differences in prevalence was statistically significant, and significant differences did not emerge from further analyses using more stringent criteria for depression.
Preterm births are specifically associated with high maternal depression scores in the postpartum period, and with a higher prevalence of failure to thrive. High depression scores in the postpartum period are not themselves associated with a higher prevalence of failure to thrive, however, either in infants born at term or in those born preterm.
研究早产和足月儿生长发育迟缓与其母亲产后抑郁之间的关系。
在一个包含12391名婴儿的全人群出生队列中（不包括过期产或患有重大先天性异常的婴儿），采用条件性体重增加标准确定前九个月生长发育迟缓的情况，该标准识别出体重增加最慢的5%的婴儿。在怀孕18周和32周以及分娩后8周和8个月时，使用爱丁堡产后抑郁量表（EPDS）记录抑郁症状。
出生后，早产婴儿母亲的高抑郁评分明显更为常见，并且在控制孕期抑郁评分后，出生后的这种关联并未消除。足月儿中有4.5%（531/11718）被确定为生长发育迟缓，早产儿中有8.3%（56/673）被确定为生长发育迟缓。差异非常显著（卡方检验，自由度为1，卡方值 = 20.25，p < 0.0001）。使用EPDS的常规临界值（评分 > 12）将母亲确定为“抑郁”，产后8周抑郁母亲的足月儿生长发育迟缓患病率为5.0%；在其余人群（对照组）中为4.3%。在产后8个月抑郁的母亲中，两组的患病率均为4.3%。产后8周抑郁母亲的早产儿生长发育迟缓患病率为8.8%（对照组为7.0%），产后8个月抑郁母亲的早产儿生长发育迟缓患病率为12.3%（对照组为6.7%）。这些患病率差异均无统计学意义，并且在使用更严格的抑郁标准进行进一步分析时也未出现显著差异。
早产与产后母亲的高抑郁评分以及更高的生长发育迟缓患病率特别相关。然而，无论是足月儿还是早产儿，产后的高抑郁评分本身与更高的生长发育迟缓患病率并无关联。
