Garthus-Niegel S, Ayers S, Martini J, von Soest T, Eberhard-Gran M
Institute and Policlinic of Occupational and Social Medicine,TU Dresden,Faculty of Medicine,Fetscherstr. 74,01307 Dresden,Germany.
Centre for Maternal and Child Health,School of Health Sciences,City University London,London,UK.
Psychol Med. 2017 Jan;47(1):161-170. doi: 10.1017/S003329171600235X. Epub 2016 Sep 29.
Against the background of very limited evidence, the present study aimed to prospectively examine the impact of maternal postpartum post-traumatic stress disorder (PTSD) symptoms on four important areas of child development, i.e. gross motor, fine motor, communication and social-emotional development.
This study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record as well as questionnaire data from 8 weeks and 2 years postpartum were used (n = 1472). The domains of child development that were significantly correlated with PTSD symptoms were entered into regression analyses. Interaction analyses were run to test whether the influence of postpartum PTSD symptoms on child development was moderated by child sex or infant temperament.
Postpartum PTSD symptoms had a prospective relationship with poor child social-emotional development 2 years later. This relationship remained significant even when adjusting for confounders such as maternal depression and anxiety or infant temperament. Both child sex and infant temperament moderated the association between maternal PTSD symptoms and child social-emotional development, i.e. with increasing maternal PTSD symptom load, boys and children with a difficult temperament were shown to have comparatively higher levels of social-emotional problems.
Examining four different domains of child development, we found a prospective impact of postpartum PTSD symptoms on children's social-emotional development at 2 years of age. Our findings suggest that both boys and children with an early difficult temperament may be particularly susceptible to the adverse impact of postpartum PTSD symptoms. Additional studies are needed to further investigate the mechanisms at work.
在证据非常有限的背景下，本研究旨在前瞻性地考察母亲产后创伤后应激障碍（PTSD）症状对儿童发育四个重要领域的影响，即大运动、精细运动、沟通和社会情感发育。
本研究是基于人群的大型阿克什胡斯出生队列研究的一部分。使用了医院出生记录数据以及产后8周和2年的问卷调查数据（n = 1472）。将与PTSD症状显著相关的儿童发育领域纳入回归分析。进行交互分析以检验产后PTSD症状对儿童发育的影响是否因儿童性别或婴儿气质而有所不同。
产后PTSD症状与2年后儿童社会情感发育不良存在前瞻性关联。即使在调整诸如母亲抑郁和焦虑或婴儿气质等混杂因素后，这种关联仍然显著。儿童性别和婴儿气质均调节了母亲PTSD症状与儿童社会情感发育之间的关联，即随着母亲PTSD症状负荷增加，男孩和气质困难的儿童表现出相对较高水平的社会情感问题。
通过考察儿童发育的四个不同领域，我们发现产后PTSD症状对2岁儿童的社会情感发育有前瞻性影响。我们的研究结果表明，男孩和早期气质困难的儿童可能特别容易受到产后PTSD症状的不利影响。需要进一步的研究来深入探究其中的作用机制。
