Martini Julia, Petzoldt Johanna, Knappe Susanne, Garthus-Niegel Susan, Asselmann Eva, Wittchen Hans-Ulrich
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Department of Child and Adolescent Psychiatry, Faculty of Medicine of the Technische Universität Dresden, Schubertstr. 42, 01307 Dresden, Germany.
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
Early Hum Dev. 2017 Dec;115:23-31. doi: 10.1016/j.earlhumdev.2017.08.005. Epub 2017 Sep 1.
Excessive infant crying, feeding and sleeping problems are likely to emerge from the complex interplay of various factors.
To investigate the role of infant (e.g., temperament), maternal (e.g., anxiety and depressive disorders), and familial (e.g., social support) factors as potential precursors of infant regulatory problems.
Prospective-longitudinal study.
286 mother-infant dyads were investigated from early pregnancy until 16 months postpartum via questionnaires and interviews.
Regulatory problems at 2, 4 and 16 months postpartum assessed by standardized diagnostic interviews.
Fussy infant temperament and maternal anxiety disorders were associated with excessive infant crying (OR=1.16, 95%CI:1.05-1.29, OR=3.28, 95%CI:1.16-9.26) and feeding problems (OR=1.05, 95%CI:1.01-1.11, OR=2.27, 95%CI:1.36-3.80) whereas maternal depressive disorders were associated with infant sleeping problems (OR=2.55, 95%CI:1.06-6.11). Moreover, high maternal age (OR=0.86, 95%CI:0.75-0.98) was associated with a lower risk for excessive crying and being a single mother (OR=0.16, 95%CI:0.03-0.73) and cognitive reappraisal to regulate emotions (OR: 0.59, 95%CI:0.36-0.96) was associated with a lower risk for sleeping problems.
Excessive infant crying and feeding problems may be related to interactional deficits of anxious mothers who perceive their infants as "difficult" during soothing or feeding situations. Sleeping problems may be transmitted already during pregnancy by an altered sleep-wake-rhythm of mothers with a history of depression or by a genetic predisposition. Therapeutic interventions should focus on maternal anxiety and depression, behavior management techniques to cope with difficult situations with "fussy" infants and potential protective factors (e.g. favorable maternal emotion regulation) to address crying, feeding and sleeping problems.
婴儿过度哭闹、喂养和睡眠问题可能源于多种因素的复杂相互作用。
研究婴儿因素（如气质）、母亲因素（如焦虑和抑郁障碍）和家庭因素（如社会支持）作为婴儿调节问题潜在先兆的作用。
前瞻性纵向研究。
通过问卷调查和访谈对286对母婴进行从孕早期到产后16个月的调查。
产后2个月、4个月和16个月时通过标准化诊断访谈评估调节问题。
婴儿易激惹气质和母亲焦虑障碍与婴儿过度哭闹（比值比=1.16，95%置信区间：1.05 - 1.29；比值比=3.28，95%置信区间：1.16 - 9.26）及喂养问题（比值比=1.05，95%置信区间：1.01 - 1.11；比值比=2.27，95%置信区间：1.36 - 3.80）相关，而母亲抑郁障碍与婴儿睡眠问题相关（比值比=2.55，95%置信区间：1.06 - 6.11）。此外，母亲高龄（比值比=0.86，95%置信区间：0.75 - 0.98）与过度哭闹风险较低相关，单身母亲（比值比=0.16，95%置信区间：0.03 - 0.73）以及通过认知重评调节情绪（比值比：0.59，95%置信区间：0.36 - 0.96）与睡眠问题风险较低相关。
婴儿过度哭闹和喂养问题可能与焦虑母亲在安抚或喂养时将婴儿视为“难带”的互动缺陷有关。睡眠问题可能在孕期就已通过有抑郁史母亲改变的睡眠 - 觉醒节律或遗传易感性传递。治疗干预应聚焦于母亲的焦虑和抑郁、应对“易激惹”婴儿困难情况的行为管理技巧以及解决哭闹、喂养和睡眠问题的潜在保护因素（如良好的母亲情绪调节）。
