King's College London, Child and Adolescent Psychiatry Department, Institute of Psychiatry, London, UK.
J Child Psychol Psychiatry. 2011 Jul;52(7):800-7. doi: 10.1111/j.1469-7610.2010.02341.x. Epub 2010 Nov 12.
Maternal eating disorders (ED) have been shown to increase the risk of feeding difficulties in the offspring. Very few studies, however, have investigated whether the effect of a maternal ED on childhood feeding is a direct effect or whether it can be ascribed to other child or maternal factors. We aimed to determine the role of maternal anxiety and depression in mediating the risk for feeding difficulties in infants of women with ED.
A prospective study comparing women with lifetime ED (441) and without any lifetime psychiatric disorder (10,461) and their infants from the Avon Longitudinal Study of Parents and Children (ALSPAC). We investigated the effect of: maternal anxiety and depression in late pregnancy (32 weeks) and the post-partum (8 weeks), child temperament and developmental status on infant feeding difficulties at 1 and 6 months. We also investigated the effect of active pregnancy ED symptoms. We tested 3 models and their fit to the data using structured equation modelling: a direct effect model, a fully mediational model and an integrated (partial meditational) model.
The integrated model including a direct effect of maternal lifetime ED on infant feeding and a mediational path via maternal distress (a latent variable combining anxiety and depression) fitted the data best. This also applied to maternal pregnancy ED symptoms. Feeding difficulties in turn increased maternal distress over time.
Lifetime ED and active pregnancy ED increase the risk for infant feeding difficulties and do so via maternal distress (i.e., depression and anxiety). This has important implications for prevention and early intervention in relation to infant feeding difficulties, as well as for future research in the field.
已有研究表明，母亲的饮食失调（ED）会增加后代喂养困难的风险。然而，很少有研究调查母亲 ED 是否对儿童喂养的影响是直接的，还是可以归因于其他儿童或母亲因素。我们旨在确定母亲焦虑和抑郁在介导 ED 女性后代喂养困难风险中的作用。
这是一项前瞻性研究，比较了患有终生 ED（441 名）和无任何终生精神障碍（10461 名）的妇女及其婴儿，该研究来自阿冯纵向父母与子女研究（ALSPAC）。我们调查了以下因素的影响：母亲在妊娠晚期（32 周）和产后（8 周）的焦虑和抑郁，以及儿童气质和发育状况对婴儿在 1 个月和 6 个月时的喂养困难的影响。我们还调查了妊娠期间 ED 症状的影响。我们使用结构方程模型测试了 3 种模型及其对数据的拟合程度：直接效应模型、完全中介模型和综合（部分中介）模型。
包括母亲终生 ED 对婴儿喂养的直接影响以及通过母亲痛苦（焦虑和抑郁的组合）的中介途径的综合模型最适合数据。这也适用于母亲妊娠 ED 症状。反过来，喂养困难随着时间的推移增加了母亲的痛苦。
终生 ED 和妊娠期间 ED 增加了婴儿喂养困难的风险，这是通过母亲的痛苦（即抑郁和焦虑）实现的。这对婴儿喂养困难的预防和早期干预以及该领域的未来研究具有重要意义。
