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母亲围产期及并发抑郁症状与儿童行为问题:一项同胞对照研究。

Maternal perinatal and concurrent depressive symptoms and child behavior problems: a sibling comparison study.

作者信息

Gjerde Line C, Eilertsen Espen Moen, Reichborn-Kjennerud Ted, McAdams Tom A, Zachrisson Henrik Daae, Zambrana Imac Maria, Røysamb Espen, Kendler Kenneth S, Ystrom Eivind

机构信息

Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.

Department of Psychology, University of Oslo, Oslo, Norway.

出版信息

J Child Psychol Psychiatry. 2017 Jul;58(7):779-786. doi: 10.1111/jcpp.12704. Epub 2017 Feb 23.

Abstract

BACKGROUND

Previous studies have found significant associations between maternal prenatal and postpartum depression and child behavior problems (CBP). The present study investigates whether associations remain in a prospective, longitudinal design adjusted for familial confounding.

METHODS

The sample comprised 11,599 families including 17,830 siblings from the Norwegian Mother and Child Cohort study. Mothers reported depressive symptoms at gestational weeks 17 and 30, as well as 6 months, 1.5, 3, and 5 years postpartum. Fathers' depression was measured at gestational week 17. At the last three time-points, child internalizing and externalizing problems were concurrently assessed. We performed multilevel analyses for internalizing and externalizing problems separately, using parental depression as predictors. Analyses were repeated using a sibling comparison design to adjust for familial confounding.

RESULTS

All parental depressive time-points were significantly and positively associated with child internalizing and externalizing problems. After sibling comparison, however, only concurrent maternal depression was significantly associated with internalizing [estimate = 2.82 (1.91-3.73, 95% CI)] and externalizing problems [estimate = 2.40 (1.56-3.23, 95% CI)]. The effect of concurrent maternal depression on internalizing problems increased with child age.

CONCLUSIONS

Our findings do not support the notion that perinatal maternal depression is particularly detrimental to children's psychological development, as the most robust effects were found for maternal depression occurring during preschool years.

摘要

背景

先前的研究发现,母亲产前和产后抑郁与儿童行为问题(CBP)之间存在显著关联。本研究调查了在调整家庭混杂因素的前瞻性纵向设计中,这种关联是否仍然存在。

方法

样本包括来自挪威母婴队列研究的11,599个家庭,共17,830名兄弟姐妹。母亲报告了妊娠第17周和第30周以及产后6个月、1.5年、3年和5年时的抑郁症状。父亲的抑郁情况在妊娠第17周进行测量。在最后三个时间点,同时评估了儿童的内化和外化问题。我们分别以内化和外化问题为对象,使用父母抑郁作为预测因素进行多层次分析。使用兄弟姐妹比较设计重复分析以调整家庭混杂因素。

结果

所有父母抑郁时间点均与儿童内化和外化问题显著正相关。然而,在兄弟姐妹比较后,只有同时期的母亲抑郁与内化问题[估计值 = 2.82(1.91 - 3.73,95%可信区间)]和外化问题[估计值 = 2.40(1.56 - 3.23,95%可信区间)]显著相关。同时期母亲抑郁对内化问题的影响随儿童年龄增长而增加。

结论

我们的研究结果不支持围产期母亲抑郁对儿童心理发展特别有害的观点,因为最显著的影响是在学龄前母亲发生抑郁时发现的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbcb/5484352/b9d6019c010a/JCPP-58-779-g001.jpg

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