Cheng Shunyue, Kondo Naoji, Aoki Yutaka, Kitamura Yumi, Takeda Yasuhisa, Yamagata Zentaro
Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.
Early Hum Dev. 2007 Oct;83(10):683-91. doi: 10.1016/j.earlhumdev.2007.01.008. Epub 2007 Feb 21.
The aim of this study was to assess the effectiveness of early home-based intervention as a community health service and evaluate the influence of both early maternal depression and mother-infant relationships on child behavioral problems at age 2 in a longitudinal setting.
A randomized controlled trial was conducted in this study. A total of 95 mother-infant pairs were assigned randomly to intervention (48) or control (47) groups. The intervention group received monthly specific home visits between the infant ages of 5 and 9 months while the control group received only routine center-based services. Maternal depression and the mother-infant relationship were assessed by medical checkups at the ages of 4 and 10 months. Child behavioral problems were assessed at age 2.
The intervention had no significant impact on child behavioral problems. However, for mothers who had a disturbed relationship with their infants, the rate of improvement in the quality of the relationship was higher in the intervention group. Disturbed mother-infant relationships at 10 months and early maternal depression significantly increased the risk of high scores on the Child Behavior Checklist (CBCL).
These findings indicate that intervention is most likely to have a positive impact on the quality of mother-infant relationships in cases where the relationship is disturbed and that a disturbed mother-infant relationship and maternal depression during infancy are relevant to the future mental health of the child. To prevent difficulties in child functioning, more prolonged interventions focusing on disturbed mother-infant relationships may be required.
本研究旨在评估早期家庭干预作为一种社区卫生服务的有效性，并在纵向研究中评估早期母亲抑郁和母婴关系对2岁儿童行为问题的影响。
本研究进行了一项随机对照试验。总共95对母婴被随机分配到干预组（48对）或对照组（47对）。干预组在婴儿5至9个月大时每月进行一次特定的家访，而对照组仅接受常规的基于中心的服务。在4个月和10个月大时通过医学检查评估母亲抑郁和母婴关系。在2岁时评估儿童行为问题。
干预对儿童行为问题没有显著影响。然而，对于与婴儿关系失调的母亲，干预组中关系质量的改善率更高。10个月时母婴关系失调和早期母亲抑郁显著增加了儿童行为量表（CBCL）高分的风险。
这些发现表明，在母婴关系失调的情况下，干预最有可能对母婴关系质量产生积极影响，并且婴儿期母婴关系失调和母亲抑郁与儿童未来的心理健康有关。为了预防儿童功能出现困难，可能需要针对失调的母婴关系进行更长期的干预。
