早产婴儿父母的产后抑郁症状：患病率及其对儿童早期认知功能的影响。
Postnatal Depressive Symptoms Among Mothers and Fathers of Infants Born Preterm: Prevalence and Impacts on Children's Early Cognitive Function.
作者信息
Cheng Erika R, Kotelchuck Milton, Gerstein Emily D, Taveras Elsie M, Poehlmann-Tynan Julie
机构信息
*Section of Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN; †Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA; ‡Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO; §Department of Human Development and Family Studies, Waisman Center, University of Wisconsin, Madison, WI.
出版信息
J Dev Behav Pediatr. 2016 Jan;37(1):33-42. doi: 10.1097/DBP.0000000000000233.
OBJECTIVE
Preterm birth is associated with lower cognitive functioning. One potential pathway is postnatal parental depression. The authors assessed depressive symptoms in mothers and fathers after preterm birth, and identified the impacts of both prematurity and parental depressive symptoms on children's early cognitive function.
METHOD
Data were from the nationally representative Early Childhood Longitudinal Study, Birth Cohort (n = 5350). Depressive symptoms at 9 months were assessed by the Center for Epidemiologic Studies Depression Scale (CESD) and children's cognitive function at 24 months by the Bayley Short Form, Research Edition. Weighted generalized estimating equation models examined the extent to which preterm birth, and mothers' and fathers' postnatal depressive symptoms impacted children's cognitive function at 24 months, and whether the association between preterm birth and 24-month cognitive function was mediated by parental depressive symptoms.
RESULTS
At 9 months, fathers of very preterm (<32 weeks gestation) and moderate/late preterm (32-37 weeks gestation) infants had higher CESD scores than fathers of term-born (≥37 weeks gestation) infants (p value = .02); preterm birth was not associated with maternal depressive symptoms. In multivariable analyses, preterm birth was associated with lower cognitive function at 24 months; this association was unaffected by adjustment for parental depressive symptoms. Fathers', but not mothers', postnatal depressive symptoms predicted lower cognitive function in the fully adjusted model (β = -0.11, 95% confidence interval, -0.18 to -0.03).
CONCLUSION
Fathers of preterm infants have more postnatal depressive symptomology than fathers of term-born infants. Fathers' depressive symptoms also negatively impact children's early cognitive function. The national findings support early identification and treatment of fathers of preterm infants with depressive symptoms.
目的
早产与较低的认知功能相关。一个潜在途径是产后父母抑郁。作者评估了早产之后母亲和父亲的抑郁症状，并确定了早产和父母抑郁症状对儿童早期认知功能的影响。
方法
数据来自具有全国代表性的儿童早期纵向研究出生队列（n = 5350）。通过流行病学研究中心抑郁量表（CESD）评估9个月时的抑郁症状，通过贝利简版研究版评估24个月时儿童的认知功能。加权广义估计方程模型研究了早产以及母亲和父亲的产后抑郁症状对24个月时儿童认知功能的影响程度，以及早产与24个月认知功能之间的关联是否由父母抑郁症状介导。
结果
在9个月时，极早产（孕周<32周）和中度/晚期早产（孕周32 - 37周）婴儿的父亲的CESD得分高于足月儿（孕周≥37周）的父亲（p值 = 0.02）；早产与母亲的抑郁症状无关。在多变量分析中，早产与24个月时较低的认知功能相关；这种关联不受父母抑郁症状调整的影响。在完全调整模型中，父亲而非母亲的产后抑郁症状预示着较低的认知功能（β = -0.11，95%置信区间，-0.18至-0.03）。
结论
早产婴儿的父亲比足月儿的父亲有更多的产后抑郁症状。父亲的抑郁症状也对儿童的早期认知功能产生负面影响。全国性研究结果支持对有抑郁症状的早产婴儿父亲进行早期识别和治疗。
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