National Network for Infant Mental Health, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), PO Box 4623, Nydalen, N-0405, Oslo, Norway.
Department of Nursing and Health promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied sciences, Oslo, Norway.
Arch Womens Ment Health. 2018 Apr;21(2):235-242. doi: 10.1007/s00737-017-0792-z. Epub 2017 Oct 23.
Studies suggest that perinatal depression and breastfeeding co-vary, but determining the relationship between breastfeeding and perinatal depression has proved challenging. A bidirectional association has been suggested, implying that depression may impact on breastfeeding and that breastfeeding might influence depressive symptoms. The present study aimed to contribute to the understanding of the relationship between perinatal depression and breastfeeding in a population-based sample where we used structural equation modeling (SEM) techniques to investigate cross-lagged and autoregressive effects as well as concurrent associations. The present study was part of a large-scale Norwegian prospective study. Nurses and midwives at nine well-baby clinics recruited participants. All the well-baby clinics had implemented the Edinburgh method, which combines the use of the Edinburgh Postnatal Depression Scale (EPDS) with an immediate follow-up conversation. Completed EPDS forms were recorded, as well as the mothers' reports of breastfeeding behaviors. Depressive symptoms measured prenatally during the last trimester, at 4 and 6 months postpartum did not predict breastfeeding behavior at 4, 6, or 12 months postpartum, respectively. Furthermore, breastfeeding at 4 and 6 months postpartum did not predict depressive symptomatology at 6 or 12 months postpartum. There were no significant concurrent associations between breastfeeding and depressive symptoms at 4, 6, or 12 months postpartum. Depressive symptoms predicted subsequent depressive symptoms and breastfeeding predicted subsequent breastfeeding. There was no evidence of a relationship between depressive symptoms and breastfeeding. Potential explanations and implications are discussed.
研究表明，围产期抑郁和母乳喂养是相互关联的，但确定母乳喂养和围产期抑郁之间的关系具有挑战性。有人提出了一种双向关联，即抑郁可能会影响母乳喂养，而母乳喂养可能会影响抑郁症状。本研究旨在为理解围产期抑郁和母乳喂养之间的关系做出贡献，在基于人群的样本中，我们使用结构方程模型（SEM）技术来调查交叉滞后和自回归效应以及并发关联。本研究是挪威一项大规模前瞻性研究的一部分。九家婴儿诊所的护士和助产士招募了参与者。所有的婴儿诊所都实施了爱丁堡方法，该方法将爱丁堡产后抑郁量表（EPDS）的使用与即时后续对话相结合。记录了完成的 EPDS 表格以及母亲对母乳喂养行为的报告。产前在最后三个月、产后 4 个月和 6 个月测量的抑郁症状分别与产后 4 个月、6 个月或 12 个月的母乳喂养行为无关。此外，产后 4 个月和 6 个月的母乳喂养与产后 6 个月或 12 个月的抑郁症状无关。产后 4 个月、6 个月或 12 个月时，母乳喂养和抑郁症状之间没有显著的并发关联。抑郁症状预测随后的抑郁症状，母乳喂养预测随后的母乳喂养。抑郁症状和母乳喂养之间没有关系的证据。讨论了潜在的解释和影响。
