Centre for Environmental and Health Science, Hokkaido University, North 12, West 7, Kita-ku, Sapporo, 060-0812, Japan,
Environ Health Prev Med. 2014 Jan;19(1):30-45. doi: 10.1007/s12199-013-0353-7. Epub 2013 Aug 4.
To examine the association between antenatal depression and infant development after controlling for confounding factors.
A hospital-based prospective cohort study (Hokkaido Study on Environment and Children's Health) was conducted between July 2002 and October 2005 in Sapporo, Japan. Of 309 mothers who delivered at Sapporo Toho Hospital during the study period and who agreed with the clinical assessment of depression, 154 mother-infant pairs were eligible for analysis. Antenatal depression was assessed between the second and third trimesters using the Edinburgh Postnatal Depression Scale (EPDS), and infant development was assessed at 6 months by the Bayley Scales of Infant Development II (BSID-II). Data on potential confounders, including socioeconomic status, birth complications, postnatal depression and child care environment, were obtained from medical records and self-administered questionnaires. Univariable and multivariable analyses were conducted in which the EPDS score was entered as an independent variable and the BSID-II scores as a dependent variable, adjusting for confounders.
Although the antenatal EPDS score tended to be related to the BSID-II score in the univariable analysis, this correlation was lost in the multivariable analysis. However, based on a series of linear regression analyses, antenatal depression was found to be significantly related to shorter gestational age (β = -0.25, 95 % confidence interval (CI) [-1.20, -0.17]), and shorter gestational age was significantly related to a lower BSID-II (mental development) score (β = 0.23, 95 % CI [0.00, 0.00]).
Gestational age is an important confounder in the association between maternal antenatal depression and infant development. A delay in infant development may be related to a shorter gestational period caused by maternal depression during pregnancy.
在控制混杂因素的情况下，研究产前抑郁与婴儿发育之间的关系。
这是一项 2002 年 7 月至 2005 年 10 月在日本札幌市进行的基于医院的前瞻性队列研究（北海道环境与儿童健康研究）。在研究期间，在札幌都合医院分娩的 309 位母亲中，有 154 对母婴符合抑郁的临床评估条件，被纳入本研究。使用爱丁堡产后抑郁量表（EPDS）在妊娠第二和第三个三个月评估产前抑郁，使用贝利婴幼儿发展量表第二版（BSID-II）在 6 个月时评估婴儿发育。从病历和自填问卷中获得了包括社会经济地位、分娩并发症、产后抑郁和儿童照护环境在内的潜在混杂因素的数据。进行了单变量和多变量分析，其中 EPDS 评分作为自变量，BSID-II 评分作为因变量，调整了混杂因素。
虽然 EPDS 评分在单变量分析中与 BSID-II 评分呈正相关，但在多变量分析中这种相关性消失了。然而，通过一系列线性回归分析发现，产前抑郁与更短的妊娠期显著相关（β=-0.25，95%置信区间（CI）[-1.20，-0.17]），而更短的妊娠期与 BSID-II（心理发育）评分较低显著相关（β=0.23，95%CI[0.00，0.00]）。
妊娠期是母亲产前抑郁与婴儿发育之间关系的一个重要混杂因素。婴儿发育迟缓可能与母亲怀孕期间抑郁导致的妊娠期缩短有关。
