Abdollahi Fatemeh, Rezai Abhari Farideh, Zarghami Mehran
Department of Public Health, Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran. AND Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
Acta Med Iran. 2017 Feb;55(2):109-114.
While studies have shown the disastrous effects of post-partum depression (PPD) on children's behaviors, there is relatively lack of reliable data in Asian countries. This study examined the relative significance of maternal PPD in children's developmental disabilities at age four. In a longitudinal study design (2009), 1801 pregnant women attending in primary health centers of Mazandaran province in the north of Iran provided self-reports of depression from two to twelve postpartum weeks using Edinburgh Postnatal Depression Scale (EPDS). Approximately four years later, the women experiencing PPD and twice as the ones who did not experience this disorder were considered as case (N=204) and control (N=467) groups. The association between maternal depression at different times and childhood developmental disabilities based on Ages and Stages Questionnaire (ASQ) and other health problems reported by the child were analyzed using two-sample t-test, chi-square test, and logistic regression models. The presence of PPD only was not a predictor of child's developmental disabilities at age four. Childhood developmental disabilities in communication, gross motor and personal-social domains of ASQ were associated with the current and concurrent maternal depressive symptoms (OR=2.59, 95% CI=1.16-5.78; OR=4.34, 95% CI=2.10-8.96; OR=5.66, 95% CI=1.94-16.54 and OR=3.35, 95% CI=1.31-8.58; OR=4.15, 95% CI=2.72-13.87; OR=6.17, 95% CI=1.95-19.53 respectively). PPD, the current depressive symptoms, and depression at both occasions were associated with more health problems in children. Childhood developmental disabilities in some domains of ASQ were significantly related to the maternal depression chronicity or recurrence. Also, child's difficulties were more prevalent in association with maternal depression regardless of onset time.
虽然研究表明产后抑郁症（PPD）对儿童行为有灾难性影响，但亚洲国家相对缺乏可靠数据。本研究调查了母亲产后抑郁症在儿童四岁时发育障碍中的相对重要性。在一项纵向研究设计（2009年）中，伊朗北部马赞德兰省初级卫生中心的1801名孕妇使用爱丁堡产后抑郁量表（EPDS），提供了产后两周至十二周的抑郁自评报告。大约四年后，经历产后抑郁症的女性以及未经历该疾病女性的两倍被视为病例组（N = 204）和对照组（N = 467）。使用两样本t检验、卡方检验和逻辑回归模型分析了不同时期母亲抑郁与基于年龄和发育阶段问卷（ASQ）的儿童发育障碍以及儿童报告的其他健康问题之间的关联。仅产后抑郁症的存在并不是儿童四岁时发育障碍的预测因素。ASQ沟通、大运动和个人社交领域的儿童发育障碍与当前及同时期母亲的抑郁症状相关（OR = 2.59，95% CI = 1.16 - 5.78；OR = 4.34，95% CI = 2.10 - 8.96；OR = 5.66，95% CI = 1.94 - 16.54以及OR = 3.35，95% CI = 1.31 - 8.58；OR = 4.15，95% CI = 2.72 - 13.87；OR = 6.17，95% CI = 1.95 - 19.53）。产后抑郁症、当前抑郁症状以及两次抑郁均与儿童更多的健康问题相关。ASQ某些领域的儿童发育障碍与母亲抑郁的慢性或复发显著相关。此外，无论发病时间如何，儿童的困难在与母亲抑郁相关时更为普遍。
