Am J Psychiatry. 2013 Oct;170(10):1161-8. doi: 10.1176/appi.ajp.2013.12121597.
Maternal depression across the postbirth period has long-term negative consequences for infant development. Little is known of the neurobiological underpinnings, but they could involve oxytocin, a neuropeptide that is dysfunctional in depression and is implicated in birth and parenting.
The authors recruited a community cohort of women with high or low depression scores 2 days after childbirth and measured depression again at 6 and 9 months. When the child was 6, the authors evaluated the families of 46 chronically depressed mothers and 103 mothers reporting no depression since childbirth. The child was assessed for psychiatric diagnoses, social engagement, and empathy. Mother, father, and child were tested for salivary oxytocin level and variation in the rs2254298 single nucleotide polymorphism on the OXTR gene.
Of the children of the chronically depressed mothers, 61% displayed axis I disorders, mainly anxiety and oppositional defiant disorder, compared with 15% of the children of nondepressed mothers. In the depressed mothers' families, salivary oxytocin was lower in mothers, fathers, and children, and the children had lower empathy and social engagement levels. The rs2254298 GG homozygous genotype was overrepresented in depressed mothers and their families, and it correlated with lower salivary oxytocin. Presence of a single rs2254298 A allele (GA or AA genotype) in depressed mothers markedly decreased risk of child psychopathology.
The negative effect of chronic maternal depression on child social outcomes was related to genetic and peripheral biomarkers of the oxytocin system. This suggests a potential for oxytocin-based interventions.
产后时期的产妇抑郁对婴儿发育有长期的负面影响。虽然我们对其神经生物学基础知之甚少,但这些基础可能涉及催产素,一种在抑郁症中功能失调的神经肽,且与分娩和育儿有关。
作者招募了一个有高或低产后抑郁评分的社区队列的女性,并在产后 6 个月和 9 个月再次测量抑郁程度。当孩子 6 个月大时,作者评估了 46 名慢性抑郁母亲和 103 名产后无抑郁报告的母亲的家庭。对孩子进行精神科诊断、社交参与和同理心评估。对母亲、父亲和孩子进行唾液催产素水平和 OXTR 基因上 rs2254298 单核苷酸多态性的变异测试。
慢性抑郁母亲的孩子中,有 61%患有轴 I 障碍,主要是焦虑和对立违抗性障碍,而无抑郁母亲的孩子中只有 15%。在抑郁母亲的家庭中,母亲、父亲和孩子的唾液催产素水平较低,孩子的同理心和社交参与水平较低。rs2254298 GG 纯合基因型在抑郁母亲及其家庭中更为常见,且与较低的唾液催产素水平相关。抑郁母亲携带单个 rs2254298 A 等位基因(GA 或 AA 基因型)显著降低了孩子出现精神病理学的风险。
慢性产妇抑郁对孩子社交结果的负面影响与催产素系统的遗传和外周生物标志物有关。这表明了基于催产素的干预的潜力。