Ibanez Gladys, Bernard Jonathan Y, Rondet Claire, Peyre Hugo, Forhan Anne, Kaminski Monique, Saurel-Cubizolles Marie-Josèphe
Paris-Descartes University, INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research team, Center for Epidemiology and Biostatistics (U1153), Paris, France; School of Medicine, Department of General Practice, UPMC University Paris 06, Paris, France.
INSERM, Center for Research in Epidemiology and Population Health (CESP), U1018, Team "Epidemiology of diabetes, obesity and kidney disease: lifelong approach", F-94807 Villejuif, France; Univ Paris-Sud, UMRS 1018, F-94807, Villejuif, France.
PLoS One. 2015 Aug 28;10(8):e0135849. doi: 10.1371/journal.pone.0135849. eCollection 2015.
Studies have shown that depression or anxiety occur in 10-20% of pregnant women. These disorders are often undertreated and may affect mothers and children's health. This study investigates the relation between antenatal maternal depression, anxiety and children's early cognitive development among 1380 two-year-old children and 1227 three-year-old children.
In the French EDEN Mother-Child Cohort Study, language ability was assessed with the Communicative Development Inventory at 2 years of age and overall development with the Ages and Stages Questionnaire at 3 years of age. Multiple regressions and structural equation modeling were used to examine links between depression, anxiety during pregnancy and child cognitive development.
We found strong significant associations between maternal antenatal anxiety and poorer children's cognitive development at 2 and 3 years. Antenatal maternal depression was not associated with child development, except when antenatal maternal anxiety was also present. Both postnatal maternal depression and parental stimulation appeared to play mediating roles in the relation between antenatal maternal anxiety and children's cognitive development. At 3 years, parental stimulation mediated 13.2% of the effect of antenatal maternal anxiety while postnatal maternal depression mediated 26.5%.
The partial nature of these effects suggests that other mediators may play a role. Implications for theory and research on child development are discussed.
研究表明,10%至20%的孕妇会出现抑郁或焦虑症状。这些病症往往治疗不足,可能会影响母婴健康。本研究调查了1380名两岁儿童和1227名三岁儿童的产前母亲抑郁、焦虑与儿童早期认知发展之间的关系。
在法国EDEN母婴队列研究中,两岁时用《沟通发展量表》评估语言能力,三岁时用《年龄与阶段问卷》评估总体发育情况。采用多元回归和结构方程模型来检验孕期抑郁、焦虑与儿童认知发展之间的联系。
我们发现,产前母亲焦虑与两岁和三岁儿童较差的认知发展之间存在强烈的显著关联。产前母亲抑郁与儿童发育无关,除非同时存在产前母亲焦虑。产后母亲抑郁和父母的刺激似乎在产前母亲焦虑与儿童认知发展的关系中都起到了中介作用。在三岁时,父母的刺激介导了产前母亲焦虑影响的13.2%,而产后母亲抑郁介导了26.5%。
这些影响的部分性质表明其他中介因素可能也起作用。文中讨论了对儿童发展理论和研究的启示。