Department of Psychological Sciences, Birkbeck, University of London, United Kingdom.
Depress Anxiety. 2011 Aug;28(8):696-702. doi: 10.1002/da.20856. Epub 2011 Jul 18.
The adverse effect of both pre- and post-natal maternal anxiety and depression on the development of offspring is shown by a large body of research. No published studies, however, have simultaneously: (i) controlled for co-occurring prenatal risks that may influence maternal prenatal anxiety and depression; (ii) compared the relative contributions of prenatal and postnatal maternal anxiety and depression on child functioning; and (iii) assessed a full range of child psychopathology and functioning to determine the relative effects of prenatal and postnatal anxiety and depression in the mother.
Using 3,298 mother-offspring pairs, the authors examined these factors in a single-path analytic model. Measurements of maternal anxiety and depression were collected at two time points: 32 weeks prenatal and 1.5 years postnatal. Other prenatal risks were assessed between 8 and 32 weeks of gestation. Child outcomes included (a) ordered-categorical measures of DSM-IV externalizing and internalizing disorders, and (b) an assessment of verbal IQ.
In both the prenatal and postnatal periods, maternal depression had a wider impact on different types of child maladjustment than maternal anxiety, which appeared more specific to internalizing difficulties in the child. Of note, prenatal risks were prospectively associated with child externalizing difficulties and verbal IQ, beyond the effects of prenatal and postnatal maternal anxiety and depression.
The present results suggest that addressing both maternal anxiety and depression, in the prenatal and postnatal periods-as well as associated risk factors-may be the most effective approach to prevent adverse outcomes in the offspring.
大量研究表明，母亲在产前和产后的焦虑和抑郁都会对后代的发育产生不良影响。然而，目前尚无研究同时：（i）控制可能影响母亲产前焦虑和抑郁的并存产前风险；（ii）比较产前和产后母亲焦虑和抑郁对儿童功能的相对影响；以及（iii）评估儿童心理病理学和功能的全貌，以确定母亲产前和产后焦虑和抑郁的相对影响。
作者使用了 3298 对母婴对，在单路径分析模型中检查了这些因素。在两个时间点收集了母亲焦虑和抑郁的测量值：产前 32 周和产后 1.5 年。在妊娠 8 周至 32 周之间评估了其他产前风险。儿童结局包括：（a）DSM-IV 外化和内化障碍的有序分类测量，以及（b）言语智商评估。
在产前和产后期间，母亲抑郁对儿童不同类型的适应不良的影响比母亲焦虑更为广泛，而母亲焦虑似乎更特定于儿童的内化困难。值得注意的是，产前风险与儿童外化困难和言语智商呈前瞻性相关，超出了产前和产后母亲焦虑和抑郁的影响。
本研究结果表明，解决产前和产后的母亲焦虑和抑郁问题以及相关的风险因素，可能是预防后代不良结局的最有效方法。
