McManus B M, Poehlmann J
Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, WI 53726, USA.
Child Care Health Dev. 2012 May;38(3):425-34. doi: 10.1111/j.1365-2214.2011.01253.x. Epub 2011 Jun 8.
Among families of infants born preterm, the association between post-natal depression and children's cognitive function is not well understood, but thought to be compromised. The purpose of this study is to investigate maternal depressive symptoms and perceived social support as predictors of children's cognitive function trajectories.
This is a longitudinal study of a sample of infants born preterm (less than 37 weeks) in Wisconsin. This study includes 130 infants who were hospitalized in one of three Wisconsin neonatal intensive care units in 2002-2005 and followed until 36 months of age. Maternal depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Social support was measured using the Maternal Support Scale. Children's cognitive function was measured using the Bayley Scales of Infant Development, 2nd Edition, and the Stanford-Binet Intelligence Scale, 5th Edition.
Children's cognitive function trajectories declined initially and then increased. Being female (coefficient = 5.14, SE = 1.89) and non-poor (coefficient = 11.26, SE = 5.78), and having a mother who has a graduate degree (coefficient = 7.67, SE = 3.37) was associated with higher levels of cognition initially. Being white was associated with a more optimal cognitive trajectory. Although depression did not predict children's cognitive trajectories, the presence of clinically elevated depressive symptoms at 9 months post term was associated with lower cognitive functioning at 16 months when mothers reported low social support.
Post-natal depressive symptoms appear to have a meaningful, dynamic influence on the cognitive outcomes of children born preterm, above and beyond family socio-demographic risk when the presence and timing of perceived social support are considered. Interventions to ameliorate developmental risk associated with preterm birth should include repeated assessments of maternal social support and post-natal depression and be targeted towards socially disadvantaged families.
在早产婴儿家庭中，产后抑郁与儿童认知功能之间的关联尚未完全明确，但普遍认为二者存在一定影响。本研究旨在探讨母亲的抑郁症状及感知到的社会支持作为儿童认知功能轨迹预测因素的情况。
这是一项针对威斯康星州早产（小于37周）婴儿样本的纵向研究。该研究纳入了2002年至2005年在威斯康星州三个新生儿重症监护病房之一住院的130名婴儿，并随访至36个月龄。使用流行病学研究中心抑郁量表测量母亲的抑郁症状。使用母亲支持量表测量社会支持。使用贝利婴儿发展量表第二版和斯坦福-比奈智力量表第五版测量儿童的认知功能。
儿童的认知功能轨迹最初下降，随后上升。女性（系数 = 5.14，标准误 = 1.89）、非贫困家庭（系数 = 11.26，标准误 = 5.78）以及母亲拥有研究生学位（系数 = 7.67，标准误 = 3.37）与最初较高水平的认知能力相关。白人儿童的认知轨迹更为理想。虽然抑郁并不能预测儿童的认知轨迹，但当母亲报告社会支持较低时，足月后9个月临床抑郁症状升高与16个月时较低的认知功能相关。
当考虑到感知到的社会支持的存在和时机时，产后抑郁症状似乎对早产儿童的认知结果有显著的动态影响，这种影响超出了家庭社会人口统计学风险因素。改善与早产相关的发育风险的干预措施应包括对母亲社会支持和产后抑郁的反复评估，并针对社会弱势群体家庭。
