Neri Erica, Agostini Francesca, Salvatori Paola, Biasini Augusto, Monti Fiorella
Department of Psychology, University of Bologna Bologna, Italy.
Paediatric and Neonatal Intensive Care Unit, Bufalini Hospital, Cesena Italy.
Front Psychol. 2015 Sep 1;6:1234. doi: 10.3389/fpsyg.2015.01234. eCollection 2015.
Maternal depression and anxiety represent risk factors for the quality of early mother-preterm infant interactions, especially in the case of preterm birth. Despite the presence of many studies on this topic, the comorbidity of depressive and anxious symptoms has not been sufficiently investigated, as well as their relationship with the severity of prematurity and the quality of early interactions. The Aim of this study was to evaluate the quality of early mother-infant interactions and the prevalence of maternal depression and anxiety comparing dyads of extremely low birth weight (ELBW) and very low birth weight (VLBW) preterm infants with full-term ones. Seventy seven preterm infants (32 ELBW; 45 VLBW) and 120 full term (FT) infants and their mothers were recruited. At 3 months of corrected age, 5 min of mother-infant interactions were recorded and later coded through the Global Ratings Scales. Mothers completed the Edinburgh Postnatal Depression Scale and Penn State Worry Questionnaire. Infant levels of development were assessed through the Griffiths Mental Development Scales. A relation emerged among the severity of prematurity, depression, anxiety, and the quality of interactions. When compared with the FT group, the ELBW interactions were characterized by high maternal intrusiveness and low remoteness, while the VLBW dyads showed high levels of maternal sensitivity and infant communication. Depression was related to maternal remoteness and negative affective state, anxiety to low sensitivity, while infant interactive behaviors were impaired only in case of comorbidity. ELBW's mothers showed the highest prevalence of depressive and anxious symptoms; moreover, only in FT dyads, low maternal sensitivity, negative affective state and minor infant communication were associated to the presence of anxious symptoms. The results confirmed the impact of prematurity on mother-infant interactions and on maternal affective state. Early diagnosis can help to plan supportive interventions.
母亲抑郁和焦虑是早期母婴互动质量的风险因素，尤其是在早产的情况下。尽管关于这一主题已有许多研究，但抑郁和焦虑症状的共病情况以及它们与早产严重程度和早期互动质量的关系尚未得到充分研究。本研究的目的是比较极低出生体重（ELBW）和超低出生体重（VLBW）早产儿与足月儿的母婴二元组，评估早期母婴互动质量以及母亲抑郁和焦虑的患病率。招募了77名早产儿（32名ELBW；45名VLBW）和120名足月儿（FT）及其母亲。在矫正年龄3个月时，记录5分钟的母婴互动，随后通过全球评分量表进行编码。母亲们完成了爱丁堡产后抑郁量表和宾夕法尼亚州立大学忧虑问卷。通过格里菲斯心理发展量表评估婴儿的发育水平。早产严重程度、抑郁、焦虑和互动质量之间出现了一种关系。与FT组相比，ELBW组的互动特点是母亲过度介入且距离感低，而VLBW二元组则表现出较高的母亲敏感性和婴儿沟通水平。抑郁与母亲的距离感和消极情绪状态有关，焦虑与低敏感性有关，而婴儿的互动行为仅在共病情况下受损。ELBW组母亲的抑郁和焦虑症状患病率最高；此外，仅在FT二元组中，母亲低敏感性、消极情绪状态和婴儿沟通较少与焦虑症状的存在有关。结果证实了早产对母婴互动和母亲情感状态的影响。早期诊断有助于规划支持性干预措施。
