Research and Evaluation Division, BRAC, and School of Public Health, Brac University, 75 Mohakhali, Dhaka 1212, Bangladesh.
J Affect Disord. 2013 Apr 5;146(2):254-61. doi: 10.1016/j.jad.2012.09.013. Epub 2012 Oct 11.
Evidence linking maternal depressive symptoms with infant's growth and development in low-income countries is inadequate and conflicting. This study investigated the independent effect of maternal perinatal depressive symptoms on infant's growth and motor development in rural Bangladesh.
A cohort of 720 pregnant women was followed from the third trimester of pregnancy to 6-8 months postpartum. For growth and developmental outcomes, 652 infants at 2-3 months and 6-8 months were assessed. Explanatory variables comprised maternal depressive symptoms, socioeconomic status, and infant's health and temperament. Outcome measures included infant's underweight, stunting and motor development. Multiple linear regression analyses identified predictors of infant growth and development.
Maternal postpartum depressive symptoms independently predicted infant's underweight and impaired motor development, and antepartum depressive symptoms predicted infant's stunting. Infant's unadaptable temperament was inversely associated with infant's weight-for-age and motor development, and fussy and unpredictable temperament with height-for-age and motor development.
Repeated measures design might threaten the internal validity of the results 8.3% of the participant does not participate in the measurements at different times. As the study was conducted in two sub-districts of rural Bangladesh, it does not represent the urban scenario and cannot be generalized even for other rural areas of the country.
This study provides evidence that maternal ante- and postpartum depressive symptoms predict infant's growth and motor development in rural Bangladesh. It is recommended to integrate psychosocial components in maternal and child health interventions in order to counsel mothers with depressive symptoms.
在低收入国家,有关产妇抑郁症状与婴儿生长发育之间关系的证据不足且相互矛盾。本研究旨在探讨孟加拉国农村地区产妇围产期抑郁症状对婴儿生长和运动发育的独立影响。
对 720 名孕妇进行了队列研究,从妊娠晚期随访至产后 6-8 个月。在 2-3 个月和 6-8 个月时,对 652 名婴儿进行了生长和发育评估。解释变量包括产妇抑郁症状、社会经济状况以及婴儿的健康和气质。结局指标包括婴儿体重不足、发育迟缓以及运动发育情况。采用多元线性回归分析确定婴儿生长和发育的预测因素。
产妇产后抑郁症状可独立预测婴儿体重不足和运动发育受损,而产前抑郁症状可预测婴儿发育迟缓。婴儿适应性差的气质与婴儿的体重与年龄比和运动发育呈负相关,而烦躁和不可预测的气质与身高与年龄比和运动发育呈负相关。
重复测量设计可能会威胁到结果的内部有效性,有 8.3%的参与者在不同时间不参与测量。由于该研究是在孟加拉国的两个农村分区进行的,因此不能代表城市情况,即使在该国其他农村地区也不能推广。
本研究提供了证据表明,孟加拉国农村地区产妇产前和产后抑郁症状可预测婴儿的生长和运动发育。建议在母婴健康干预中纳入社会心理因素,以对有抑郁症状的母亲进行咨询。