Punamäki Raija-Leena, Repokari Leena, Vilska Sirpa, Poikkeus Piia, Tiitinen Aila, Sinkkonen J, Tulppala Maija
Department of Psychology, University of Tampere, 33014 Tampere, Finland.
Infant Behav Dev. 2006 Apr;29(2):230-42. doi: 10.1016/j.infbeh.2005.12.001. Epub 2006 Jan 13.
Transition to parenthood involves considerable psychological, social and physiological changes. We examined how prenatal and perinatal mental health and medical conditions predict infant's developmental and health status at 12 months, and whether former infertility and assisted reproduction treatment (ART) affect the predictor model.
The participants were 520 mothers who filled in questionnaires at the second trimester of pregnancy (T1), and when the child was 2 months (T2) and 12 months old (T3). Depressive and anxiety symptoms indicate reduced levels of mental health, and medical factors involve problems in pregnancy (e.g., high blood pressure and bleeding) and birth complications (pain and loss of blood). Neonatal health refers to, e.g., birth-weight and neurological status. At 12 months mothers reported infants' verbal and motor development and general health status.
First, it was shown that generally maternal prenatal anxiety and medical problems in pregnancy together predicted infant's developmental problems at 12 months through poor neonatal health, and medical problems alone also through increased level of birth complications. Second, the predictor models differed according to the history of infertility. In the ART group prenatal depression and anxiety and medical problems together predicted infant's developmental problems through maternal post-partum depression, and medical problems also through birth complications, whereas in the spontaneous conception group psychological and medical paths were separated and did not carry on developmental and health problems into 12 months.
Maternal health care should consider both psychological and medical risk paths across the whole transition to parenthood, and be aware of specific mediating paths in the risk groups.
为人父母的转变涉及相当多的心理、社会和生理变化。我们研究了产前和围产期的心理健康及医疗状况如何预测婴儿12个月时的发育和健康状况，以及既往不孕和辅助生殖治疗（ART）是否会影响预测模型。
研究对象为520名母亲，她们在孕期中期（T1）、孩子2个月大时（T2）以及12个月大时（T3）填写问卷。抑郁和焦虑症状表明心理健康水平降低，医疗因素包括孕期问题（如高血压和出血）和分娩并发症（疼痛和失血）。新生儿健康状况包括出生体重和神经状态等。母亲们在孩子12个月时报告婴儿的语言和运动发育情况以及总体健康状况。
首先，研究表明，一般来说，母亲产前焦虑和孕期医疗问题共同通过新生儿健康状况不佳预测婴儿12个月时的发育问题，仅医疗问题也可通过分娩并发症增加来预测。其次，预测模型因不孕史而异。在ART组中，产前抑郁、焦虑和医疗问题共同通过母亲产后抑郁预测婴儿的发育问题，医疗问题也可通过分娩并发症来预测，而在自然受孕组中，心理和医疗途径相互分离，且不会将发育和健康问题延续到12个月时。
孕产妇保健应在整个为人父母的转变过程中考虑心理和医疗风险途径，并了解风险群体中的特定中介途径。
