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母婴依恋独立预测母婴联结质量和产后精神病理学状况。

Maternal-foetal attachment independently predicts the quality of maternal-infant bonding and post-partum psychopathology.

作者信息

Petri Eleonora, Palagini Laura, Bacci Olivia, Borri Chiara, Teristi Valentina, Corezzi Camilla, Faraoni Sara, Antonelli Paolo, Cargioli Claudio, Banti Susanna, Perugi Giulio, Mauri Mauro

机构信息

a Department of Clinical and Experimental Medicine , University of Pisa , Pisa , Italy.

出版信息

J Matern Fetal Neonatal Med. 2018 Dec;31(23):3153-3159. doi: 10.1080/14767058.2017.1365130. Epub 2017 Aug 21.

Abstract

PURPOSE

The aim of this study was to evaluate the association of maternal antenatal attachment and post-partum psychopathology, maternal-infant bonding, while checking for antenatal psychopathology, for lifetime psychiatric diagnosis and for the known risk factors for peripartum depression.

METHODS

One hundred and six women recruited at the first month of pregnancy (T0) were evaluated with the structured interview for DSM-IV TR (SCID-I) to assess the presence of lifetime psychiatric diagnosis and with the Perinatal Depression Predictor Inventory-Revised (PDPI-R), the Edinburgh Postnatal Depression Scale (EPDS), and the State-Trait Anxiety Inventory (STAI). At the sixth month of pregnancy (T1) and at the first month post-partum (T2), all patients were evaluated with the PDPI-R, the EPDS, the STAI, at T1, with the Maternal Antenatal Attachment Scale (MAAS), and at T2 with the Maternal Postnatal Attachment Scale (MPAS).

RESULTS

Multivariate regression analyses showed that maternal-foetal attachment was the variable most significantly associated with postnatal symptoms of depression and anxiety and with quality of maternal-infant attachment. The logistic regression analyses showed that antenatal attachment may predict postnatal depressive and anxiety symptoms (respectively, OR: 0.83 - IC [0.74 - 0.95], p = .005, OR: 0.88 - IC [0.79 - 0.98], p = .02), and the quality of maternal postnatal attachment (OR: 1.17 - IC [1.08 - 1.27], p < .001), also after taking into account the known risk factors for perinatal depression, the sociodemographic variables and lifetime psychiatric diagnosis.

CONCLUSION

The quality of maternal-foetal bonding may independently predict the quality of maternal-infant attachment and post-partum depressive and anxiety symptoms. A comprehensive assessment of maternal risk factors for perinatal psychopathology during pregnancy should include the evaluation of antenatal attachment that could be modifiable by specific interventions promoting the quality of maternal bonding.

摘要

目的

本研究旨在评估孕期母亲的产前依恋与产后精神病理学、母婴联结之间的关联,同时检查产前精神病理学、终生精神疾病诊断以及围产期抑郁症的已知危险因素。

方法

对怀孕第一个月(T0)招募的106名女性进行评估,采用DSM-IV TR结构化访谈(SCID-I)评估终生精神疾病诊断情况,同时使用围产期抑郁症预测量表修订版(PDPI-R)、爱丁堡产后抑郁量表(EPDS)和状态-特质焦虑量表(STAI)。在怀孕第六个月(T1)和产后第一个月(T2),所有患者均接受PDPI-R、EPDS、STAI评估,在T1时使用母亲产前依恋量表(MAAS),在T2时使用母亲产后依恋量表(MPAS)。

结果

多变量回归分析显示,母婴依恋是与产后抑郁和焦虑症状以及母婴依恋质量最显著相关的变量。逻辑回归分析表明,产前依恋可预测产后抑郁和焦虑症状(分别为:OR:0.83 - IC [0.74 - 0.95],p = 0.005,OR:0.88 - IC [0.79 - 0.98],p = 0.02),以及母亲产后依恋质量(OR:1.17 - IC [1.08 - 1.27],p < 0.001),在考虑围产期抑郁症的已知危险因素、社会人口统计学变量和终生精神疾病诊断后亦是如此。

结论

母婴联结质量可独立预测母婴依恋质量以及产后抑郁和焦虑症状。孕期对母亲围产期精神病理学危险因素进行全面评估应包括对产前依恋的评估,产前依恋可通过促进母婴联结质量的特定干预措施加以改善。

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