产妇焦虑与抑郁障碍：与婴儿哭闹、喂养及睡眠问题的特定关系。

Maternal anxiety versus depressive disorders: specific relations to infants' crying, feeding and sleeping problems.

作者信息

Petzoldt J, Wittchen H-U, Einsle F, Martini J

机构信息

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.

Professorship Clinical Psychology and Psychotherapy, SRH Fachhochschule für Gesundheit Gera, Gera, Germany.

出版信息

Child Care Health Dev. 2016 Mar;42(2):231-45. doi: 10.1111/cch.12292. Epub 2015 Oct 22.

DOI:10.1111/cch.12292

PMID:26490836

Abstract

BACKGROUND

Maternal depression has been associated with excessive infant crying, feeding and sleeping problems, but the specificity of maternal depression, as compared with maternal anxiety remains unclear and manifest disorders prior to pregnancy have been widely neglected. In this prospective longitudinal study, the specific associations of maternal anxiety and depressive disorders prior to, during and after pregnancy and infants' crying, feeding and sleeping problems were investigated in the context of maternal parity.

METHODS

In the Maternal Anxiety in Relation to Infant Development (MARI) Study, n = 306 primiparous and multiparous women were repeatedly interviewed from early pregnancy until 16 months post partum with the Composite International Diagnostic Interview for Women (CIDI-V) to assess DSM-IV anxiety and depressive disorders. Information on excessive infant crying, feeding and sleeping problems was obtained from n = 286 mothers during postpartum period via questionnaire and interview (Baby-DIPS).

RESULTS

Findings from this study revealed syndrome-specific risk constellations for maternal anxiety and depressive disorders as early as prior to pregnancy: Excessive infant crying (10.1%) was specifically associated with maternal anxiety disorders, especially in infants of younger and lower educated first-time mothers. Feeding problems (36.4%) were predicted by maternal anxiety (and comorbid depressive) disorders in primiparous mothers and infants with lower birth weight. Infant sleeping problems (12.2%) were related to maternal depressive (and comorbid anxiety) disorders irrespective of maternal parity.

CONCLUSIONS

Primiparous mothers with anxiety disorders may be more prone to anxious misinterpretations of crying and feeding situations leading to an escalation of mother-infant interactions. The relation between maternal depressive and infant sleeping problems may be better explained by a transmission of unsettled maternal sleep to the fetus during pregnancy or a lack of daily structure and bedtime routine with the infant. Maternal disorders prior to pregnancy require more attention in research and clinical practice.

摘要

背景

母亲抑郁与婴儿过度哭闹、喂养和睡眠问题有关，但与母亲焦虑相比，母亲抑郁的特异性仍不明确，且孕前的明显疾病一直被广泛忽视。在这项前瞻性纵向研究中，在母亲生育次数的背景下，研究了孕前、孕期和产后母亲焦虑和抑郁障碍与婴儿哭闹、喂养和睡眠问题之间的具体关联。

方法

在母婴焦虑与婴儿发育关系（MARI）研究中，对n = 306名初产妇和经产妇从孕早期到产后16个月进行多次访谈，采用女性综合国际诊断访谈（CIDI-V）评估DSM-IV焦虑和抑郁障碍。在产后期间，通过问卷调查和访谈（婴儿发育问题筛查量表）从n = 286名母亲那里获得了有关婴儿过度哭闹、喂养和睡眠问题的信息。

结果

这项研究的结果显示，早在孕前，母亲焦虑和抑郁障碍就存在特定综合征的风险组合：婴儿过度哭闹（10.1%）与母亲焦虑障碍尤其相关，特别是在年龄较小、受教育程度较低的初产妇的婴儿中。初产妇和低出生体重婴儿的喂养问题（36.4%）可由母亲焦虑（和共病抑郁）障碍预测。婴儿睡眠问题（12.2%）与母亲抑郁（和共病焦虑）障碍有关，与母亲生育次数无关。