Lemola Sakari, Stadlmayr Werner, Grob Alexander
University of Basel.
University Hospital Bern.
Infant Ment Health J. 2009 Jan;30(1):57-81. doi: 10.1002/imhj.20203.
The aim of this study was to investigate the impact of fetal alcohol exposure, maternal depressive symptoms, and low emotional support from the husband on infant irritability in the first one and a half years of life. Four models describing the interplay of these factors were assessed: A direct effect model, an interaction or threshold model, a mediational model and a transactional model.
A sample of initially 458 women was assessed in a prospective 3-wave study across the first 17 months after childbirth. Fetal alcohol exposure was questioned retrospectively six weeks after birth. Infant irritability was reported by the mothers and fathers.
Support for the direct effect model and the interaction model could be found: Fetal alcohol exposure and low emotional support from the husband were associated with increased infant irritability at 5 months. The impact of fetal alcohol exposure was moderated by postnatal depressive symptoms. More irritability was reported if both risk factors, prenatal alcohol exposure and maternal depressive symptoms, were present. Infant irritability and maternal depressive symptoms were associated cross-sectionally. At the age of 17 months only a main effect of prenatal alcohol exposure on irritability could be found.
Direct effects of fetal alcohol exposure, maternal depressive symptoms, and low emotional support from the husband on infant irritability as well as an interaction between fetal alcohol exposure and maternal depressive symptoms were revealed. The interaction can be understood in terms of a diathesis-stress model. However, no longitudinal associations between maternal depressive symptoms and infant irritability could be found.
本研究旨在调查孕期酒精暴露、母亲抑郁症状以及丈夫给予的情感支持不足对婴儿出生后一岁半内易怒性的影响。评估了描述这些因素相互作用的四个模型：直接效应模型、交互或阈值模型、中介模型和相互作用模型。
在一项前瞻性三阶段研究中，对最初的458名女性样本在产后的前17个月进行了评估。在出生六周后回顾性询问孕期酒精暴露情况。婴儿的易怒性由父母报告。
发现了对直接效应模型和交互模型的支持：孕期酒精暴露和丈夫给予的情感支持不足与5个月大婴儿的易怒性增加有关。孕期酒精暴露的影响受到产后抑郁症状的调节。如果同时存在产前酒精暴露和母亲抑郁症状这两个风险因素，则报告的易怒性更高。婴儿易怒性和母亲抑郁症状存在横断面关联。在17个月大时，仅发现产前酒精暴露对易怒性有主效应。
揭示了孕期酒精暴露、母亲抑郁症状以及丈夫给予的情感支持不足对婴儿易怒性的直接影响，以及孕期酒精暴露和母亲抑郁症状之间的相互作用。这种相互作用可以用素质-应激模型来理解。然而，未发现母亲抑郁症状与婴儿易怒性之间的纵向关联。
