Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Nursing, Sugiyama Jogakuen University, Nagoya, Japan.
Psychiatry Clin Neurosci. 2017 Oct;71(10):733-741. doi: 10.1111/pcn.12541. Epub 2017 Jul 7.
Although the association between maternal depression and bonding failure during pregnancy and after delivery has been investigated, the causal relationships remain unclear.
A total of 751 women (mean [SD] age, 32.1 [4.4] years) completed the Mother-Infant Bonding Questionnaire and the Edinburgh Postnatal Depression Scale during early pregnancy before week 25 (T1), during late pregnancy around week 36 (T2), and at 5 days after delivery (T3). We created a structural regression model to clarify the relationships between depressive mood and bonding failure during pregnancy and at 5 days after delivery. The model was tested with structural equation modeling.
Our non-recursive model fit the data well, and we found that: (i) during T2, bonding failure predicted depressive mood (P < 0.01, r = 0.23); (ii) at T3, bonding failure predicted depressive mood (P < 0.05, r = 0.31); (iii) during T1, depressive mood was correlated with bonding failure (P < 0.01, r = 0.45); (iv) depressive mood during T1 predicted depressive mood during T2 (P < 0.01, r = 0.58); (v) depressive mood during T2 predicted depressive mood at T3 (P < 0.01, r = 0.45); (vi) bonding failure during T1 predicted bonding failure during T2 (P < 0.01, r = 0.84); and (vii) bonding failure during T2 predicted bonding failure at T3 (P < 0.01, r = 0.44). The determinant coefficients of depressive mood and bonding failure at T3 were 0.41 and 0.28, respectively.
Our large-scale cohort study indicates that bonding failure predicts depressive mood during pregnancy and 5 days after delivery. These findings suggest that protection and support for pregnant women with depressive mood and bonding failure may prevent both issues during pregnancy and the early stage after delivery.
尽管已经研究了孕期和产后抑郁与母子亲密关系不良之间的关联，但因果关系仍不清楚。
共有 751 名女性（平均[标准差]年龄为 32.1[4.4]岁）在妊娠 25 周前（T1）、妊娠晚期 36 周左右（T2）和产后 5 天（T3）完成了母婴亲密关系问卷和爱丁堡产后抑郁量表。我们创建了一个结构回归模型来阐明孕期和产后 5 天抑郁情绪与母子亲密关系不良之间的关系。该模型使用结构方程模型进行了测试。
我们的非递归模型很好地拟合了数据，我们发现：（i）在 T2 时，母子亲密关系不良预测抑郁情绪（P < 0.01，r = 0.23）；（ii）在 T3 时，母子亲密关系不良预测抑郁情绪（P < 0.05，r = 0.31）；（iii）在 T1 时，抑郁情绪与母子亲密关系不良相关（P < 0.01，r = 0.45）；（iv）T1 时的抑郁情绪预测 T2 时的抑郁情绪（P < 0.01，r = 0.58）；（v）T2 时的抑郁情绪预测 T3 时的抑郁情绪（P < 0.01，r = 0.45）；（vi）T1 时的母子亲密关系不良预测 T2 时的母子亲密关系不良（P < 0.01，r = 0.84）；（vii）T2 时的母子亲密关系不良预测 T3 时的母子亲密关系不良（P < 0.01，r = 0.44）。T3 时抑郁情绪和母子亲密关系不良的决定系数分别为 0.41 和 0.28。
我们的大规模队列研究表明，母子亲密关系不良预测孕期和产后 5 天的抑郁情绪。这些发现表明，对有抑郁情绪和母子亲密关系不良的孕妇进行保护和支持，可能会预防孕期和产后早期的这两个问题。
