Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Paediatr Perinat Epidemiol. 2013 Jan;27(1):81-8. doi: 10.1111/ppe.12012.
Limited information is available on associations between maternal depression and anxiety and infant health care utilisation.
We analysed data from 24 263 infants born between 1998 and 2007 who themselves and their mothers were continuously enrolled for the infant's first year in Kaiser Permanente Northwest. We used maternal depression and anxiety diagnoses during pregnancy and postpartum to categorise infants into two depression and anxiety groups and examined effect modification by timing of diagnosis (pregnancy only, postpartum only, pregnancy and postpartum). Using generalised estimating equations in multivariable log-linear regression, we estimated adjusted risk ratios (RR) between maternal depression and anxiety and well baby visits (<5 and ≥ 5), up to date immunisations (yes/no), sick/emergency visits (<6 and ≥ 6) and infant hospitalisation (any/none).
Infants of mothers with perinatal depression or anxiety were as likely to attend well baby visits and receive immunisations as their counterparts (RR = 1.0 for all). Compared with no depression or anxiety, infants of mothers with prenatal and postpartum depression or anxiety, or postpartum depression or anxiety only were 1.1 to 1.2 times more likely to have ≥ 6 sick/emergency visits. Infants of mothers with postpartum depression only had marginally increased risk of hospitalisation (RR = 1.2 [95% confidence interval 1.0, 1.4]); 70% of diagnoses occurred after the infant's hospitalisation.
An understanding of the temporality of the associations between maternal depression and anxiety and infant acute care is needed and will guide strategies to decrease maternal mental illness and improve infant care for this population.
关于产妇抑郁和焦虑与婴儿保健利用之间的关联，现有信息有限。
我们分析了 1998 年至 2007 年间在 Kaiser Permanente Northwest 连续入组婴儿及其母亲的 24263 名婴儿的数据。我们使用妊娠和产后期间的母亲抑郁和焦虑诊断将婴儿分为两组抑郁和焦虑组，并检查诊断时间（仅妊娠、仅产后、妊娠和产后）的效应修饰。使用广义估计方程进行多变量对数线性回归，我们在调整风险比（RR）时考虑了母亲抑郁和焦虑与健康婴儿就诊（<5 次和≥5 次）、按时免疫接种（是/否）、生病/急诊就诊（<6 次和≥6 次）和婴儿住院（任何/无）之间的关系。
患有围产期抑郁或焦虑的婴儿与他们的同龄人一样可能会进行健康婴儿就诊并接受免疫接种（RR=1.0）。与无抑郁或焦虑相比，患有产前和产后抑郁或焦虑或产后抑郁或焦虑的母亲的婴儿，或产后抑郁或焦虑的婴儿，其发生≥6 次生病/急诊就诊的可能性要高 1.1 至 1.2 倍。仅患有产后抑郁症的婴儿的住院风险略有增加（RR=1.2（95%置信区间 1.0，1.4））；70%的诊断发生在婴儿住院之后。
需要了解产妇抑郁和焦虑与婴儿急性护理之间关联的时间性，这将指导减少该人群中产妇精神疾病和改善婴儿护理的策略。
