Park Hyojun, Sundaram Rajeshwari, Gilman Stephen E, Bell Griffith, Louis Germaine M Buck, Yeung Edwina H
Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Obesity (Silver Spring). 2018 Jan;26(1):160-166. doi: 10.1002/oby.22039. Epub 2017 Nov 1.
Equivocal findings have been reported on the association between maternal depression and children's growth, possibly because of the limited attention to its disproportionate impact by child sex. The relationship between the timing of maternal depression and children's growth was assessed in a population-based prospective birth cohort, with particular attention to sex differences.
The Upstate KIDS Study comprised 4,394 children followed through 3 years of age from 2008 to 2010. Maternal depression was measured antenatally by linkage with hospital discharge records before delivery and postnatally by depressive symptoms reported from questionnaires. Children's growth was measured by sex- and age-specific weight, height, weight for height, and BMI. Adjusted linear mixed effects models were used to estimate growth outcomes for the full sample and separately by plurality and sex.
Antenatal depression was associated with lower weight for age (-0.24 z score units; 95% confidence interval [CI]: -0.43, -0.05) and height for age (-0.26 z score units; 95% CI: -0.51, -0.02) among singleton boys. Postnatal depressive symptoms were associated with higher weight for height (0.21 z score units; 95% CI: 0.01, 0.42) among singleton girls.
The findings of this study suggest that antenatal depression was associated with lower weight and smaller height only for boys, whereas postnatal depressive symptoms were associated with higher weight for height only for girls. The timing of depression and the mechanisms of sex-specific responses require further examination.
关于母亲抑郁与儿童生长之间的关联,已有一些模棱两可的研究结果报道,这可能是因为对其在不同性别儿童中产生的不均衡影响关注有限。在一个基于人群的前瞻性出生队列中,评估了母亲抑郁发生时间与儿童生长之间的关系,并特别关注了性别差异。
上州儿童研究纳入了2008年至2010年间随访至3岁的4394名儿童。通过与分娩前医院出院记录建立联系,在产前测量母亲抑郁情况;产后则通过问卷报告的抑郁症状进行测量。儿童生长情况通过按性别和年龄划分的体重、身高、身高别体重和BMI来衡量。采用调整后的线性混合效应模型,对全样本以及按多胎情况和性别分别估算生长结果。
在单胎男孩中,产前抑郁与年龄别体重较低(z评分单位为 -0.24;95%置信区间[CI]:-0.43,-0.05)和年龄别身高较低(z评分单位为 -0.26;95%CI:-0.51,-0.02)相关。在单胎女孩中,产后抑郁症状与身高别体重较高(z评分单位为0.21;95%CI:0.01,0.42)相关。
本研究结果表明,产前抑郁仅与男孩的体重较低和身高较小有关,而产后抑郁症状仅与女孩的身高别体重较高有关。抑郁发生时间以及性别特异性反应的机制需要进一步研究。