母亲抑郁症状出现的时间与儿童认知发展：一项纵向研究。
The timing of maternal depressive symptoms and child cognitive development: a longitudinal study.
机构信息
Academic Unit, School of Social & Community Medicine, University of Bristol, Bristol, UK.
出版信息
J Child Psychol Psychiatry. 2012 Jun;53(6):632-40. doi: 10.1111/j.1469-7610.2011.02513.x. Epub 2011 Dec 23.
BACKGROUND
Maternal depression is known to be associated with impairments in child cognitive development, although the effect of timing of exposure to maternal depression is unclear.
METHODS
Data collected for the Avon Longitudinal Study of Parents and Children, a longitudinal study beginning in pregnancy, included self-report measures of maternal depression the Edinburgh Postnatal Depression Scale, completed on 6 occasions up to 3 years of age, and IQ of the index child (WISC) measured at aged 8 years. We used these data to assign women to 8 groups according to whether depression occurred in the antenatal, postnatal, preschool period, any combination of these times, or not at all. We compared a model comprising all patterns of depression (saturated model) with models nested within this to test whether there is a relationship between depression and child cognitive development and, if so, whether there is a sensitive period. We then investigated the relationship with child IQ for each model, following adjustment for confounders.
RESULTS
Six thousand seven hundred and thirty-five of 13,615 children from singleton births (49.5%, of eligible core sample) attended a research clinic at 8 years and completed a WISC with a score ≥ 70. A total of 5,029 mothers of these children had completed mood assessments over the 3 time periods. In unadjusted analyses, all three sensitive period models were as good as the saturated model, as was an accumulation model. Of the sensitive period models, only that for antenatal exposure was a consistently better fit than the accumulation model. After multiple imputation for missing data (to n = 6,735), there was no effect of postnatal depression on child IQ independent of depression at other times [-0.19 IQ points, 95% confidence interval (CI) -1.5 to 1.1 points]. There was an effect of antenatal depression (-3.19 IQ points, 95% CI: -4.33 to -2.06) which attenuated following adjustment (-0.64 IQ points, 95% CI: -1.68 to 0.40).
CONCLUSIONS
The postnatal period is not a sensitive one for the effect of maternal depression on child cognitive development.
背景
已知母亲抑郁与儿童认知发展受损有关，尽管暴露于母亲抑郁的时间影响尚不清楚。
方法
为阿冯纵向研究父母和孩子收集的数据，这是一项从怀孕开始的纵向研究，包括母亲抑郁的自我报告测量，即爱丁堡产后抑郁量表，在 3 岁之前完成了 6 次，以及指数儿童的智商（WISC）在 8 岁时测量。我们使用这些数据根据抑郁发生在产前、产后、学龄前、这些时间的任意组合或根本不发生，将女性分配到 8 个组。我们比较了包含所有抑郁模式的模型（饱和模型）和嵌套在其中的模型，以测试抑郁与儿童认知发展之间是否存在关系，如果存在，是否存在敏感时期。然后，我们在调整了混杂因素后，针对每个模型调查了与儿童智商的关系。
结果
在 13615 名单胎出生的儿童中，有 6735 名（核心样本中合格儿童的 49.5%）参加了 8 岁的研究诊所，并完成了 WISC，得分≥70。共有 5029 名儿童的母亲在这 3 个时期内完成了情绪评估。在未调整的分析中，所有三个敏感时期模型都与饱和模型一样好，积累模型也是如此。在敏感时期模型中，只有产前暴露模型始终比积累模型更好地拟合。在对缺失数据（n=6735）进行多次插补后，产后抑郁对儿童智商的影响与其他时间的抑郁无关[0.19 个智商点，95%置信区间（CI）-1.5 至 1.1 点]。产前抑郁有影响（-3.19 个智商点，95%CI：-4.33 至-2.06），调整后减弱[-0.64 个智商点，95%CI：-1.68 至 0.40]。
结论
产后时期不是母亲抑郁对儿童认知发展影响的敏感时期。
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