Department of Health Systems, Management and Policy, Colorado School of Public Health, Aurora, CO, United States. beth
Infant Behav Dev. 2012 Jun;35(3):489-98. doi: 10.1016/j.infbeh.2012.04.005. Epub 2012 Jun 19.
Preterm infants are at risk for cognitive difficulties due to infant neurological immaturity and family social disadvantage, and this may be exacerbated by maternal depressive symptoms. This longitudinal study of infants born preterm (<35 weeks) or low birth weight (<2500 g) (n = 137) tests if maternal depressive symptoms at 4 months is associated with preterm children's cognitive function at 16 months. Additionally, we test if this association is mediated by the quality of parent-child interaction at 9 months, and if these associations differ by levels of maternal social support. Children's cognitive function was measured using the Bayley Scales of Infant Development, 2nd edition. Maternal depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Perceived social support was measured using the Maternal Support scale. The quality of parent-child interaction was measured using the Parent-Child Early Relational Assessment. Linear regression and structural equation modeling were used to test the research questions. Postnatal depression at 4 months is associated with lower cognitive function (mean difference = -5.22, 95% CI: [-10.19, -0.25]) at 16 months controlling for a host of socioeconomic characteristics. For mothers with fewer depressive symptoms, bolstering effects of maternal supports on children's cognitive function were evident. We find no evidence for effect mediation by quality of parent-child interaction. Early exposure to maternal depressive symptoms appears to have a negative influence on preterm children's later cognitive function. These findings suggest important policy and programmatic implications for early detection and intervention for families of preterm infants.
早产儿由于婴儿神经系统不成熟和家庭社会劣势而面临认知困难的风险，而母亲的抑郁症状可能会使这种情况更加恶化。本项针对早产儿（<35 周）或低出生体重儿（<2500 克）（n = 137）的纵向研究检验了母亲在 4 个月时的抑郁症状是否与早产儿在 16 个月时的认知功能有关。此外，我们还检验了这种关联是否通过 9 个月时亲子互动的质量来介导，以及这些关联是否因母亲社会支持的水平而异。使用贝利婴幼儿发展量表第二版评估儿童的认知功能。使用流行病学研究中心抑郁量表评估母亲的抑郁症状。使用母亲支持量表评估感知到的社会支持。使用亲子早期关系评估量表测量亲子互动的质量。使用线性回归和结构方程模型来检验研究问题。在控制了一系列社会经济特征后，4 个月时的产后抑郁与 16 个月时的认知功能较低（平均差异=-5.22，95%置信区间：[-10.19，-0.25]）相关。对于抑郁症状较少的母亲，母亲支持对孩子认知功能的促进作用明显。我们没有发现亲子互动质量作为中介因素的证据。早期暴露于母亲的抑郁症状似乎对早产儿的后期认知功能有负面影响。这些发现为早产儿家庭的早期检测和干预提供了重要的政策和计划意义。
