Lara-Cinisomo Sandraluz, Zhu Kefu, Fei Kexin, Bu Yumeng, Weston Alexandria P, Ravat Uma
University of Illinois at Urbana-Champaign, Champaign, IL, USA.
BMC Womens Health. 2018 Feb 1;18(1):31. doi: 10.1186/s12905-018-0520-5.
Childhood and adulthood traumatic experiences negatively impact maternal-infant bonding and increase risk of postpartum depression (PPD). Lower oxytocin levels have also been associated with PPD and compromised mother-infant bonding. Despite advances in these areas of investigation, much of the research has not included Latinas, who are important because they have high rates of fertility, traumatic events, and PPD.
To address gaps identified in the literature, we explored associations between traumatic life events, PPD, and bonding subscale scores (e.g., Impaired Bonding, Rejection and Anger, Anxiety about Care) in a sample of 28 Latinas. We also examined associations between these factors and oxytocin (OT). Wilcoxon signed-rank tests were employed to examine differences in subscale scores over time. Kruskal-Wallis one-way analysis of variance was used to examine differences in bonding subscale scores and OT by maternal depression status and traumatic events. We also explored interaction effects of traumatic events and OT AUC on bonding subscale scores.
Women with PPD at 8 weeks had significantly higher Rejection and Anger subscale scores (p = 0.054) than non-PPD women, where higher scores represent more compromised bonding. Significant differences in Rejection and Anger (p = 0.042) and Anxiety about Care (p = 0.005) by adulthood traumatic histories were observed at 8 weeks postpartum. There was also a significant difference in Anxiety about Care scores at 4 weeks postpartum (p = 0.024) and Impaired Bonding at 8 weeks postpartum (p = 0.041) by trauma events involving an infant. There was a significant interaction between OT and childhood sexual abuse on Impaired Bonding (p = 0.038).
We observed differential responses in bonding subscale scores by traumatic histories. Women who experienced a trauma involving an infant had higher compromised bonding scores, whereas those with adulthood traumatic histories, such as intimate partner violence, had lower scores. We also found an interaction between childhood trauma and oxytocin levels on bonding scores, suggesting a physiological response to early abuse that can have implications on mothers' bonding perceptions. These preliminary results suggest the need for additional research on the long-term emotional and physiological effects of traumatic events occurring prior to parturition.
儿童期和成年期的创伤经历会对母婴联结产生负面影响,并增加产后抑郁症(PPD)的风险。较低的催产素水平也与产后抑郁症及母婴联结受损有关。尽管在这些研究领域取得了进展,但大部分研究并未纳入拉丁裔女性,而她们很重要,因为其生育率、创伤事件发生率和产后抑郁症发病率都很高。
为弥补文献中发现的空白,我们在28名拉丁裔女性样本中,探讨了创伤性生活事件、产后抑郁症和联结分量表得分(如联结受损、拒绝与愤怒、育儿焦虑)之间的关联。我们还研究了这些因素与催产素(OT)之间的关联。采用Wilcoxon符号秩检验来检验分量表得分随时间的差异。使用Kruskal-Wallis单向方差分析来检验母婴抑郁状态和创伤事件对联结分量表得分及催产素的差异。我们还探讨了创伤事件和催产素曲线下面积对联结分量表得分的交互作用。
产后8周患产后抑郁症的女性,其拒绝与愤怒分量表得分(p = 0.054)显著高于未患产后抑郁症的女性,得分越高表明联结受损越严重。产后8周时,观察到成年创伤史在拒绝与愤怒方面(p = 0.042)和育儿焦虑方面(p = 0.005)存在显著差异。涉及婴儿的创伤事件在产后4周时育儿焦虑得分(p = 0.024)以及产后8周时联结受损得分(p = 0.041)也存在显著差异。催产素与童年性虐待在联结受损方面存在显著交互作用(p = 0.038)。
我们观察到创伤史对联结分量表得分有不同的反应。经历过涉及婴儿的创伤的女性,其联结受损得分更高,而经历过成年创伤史(如亲密伴侣暴力)的女性得分较低。我们还发现童年创伤与催产素水平在联结得分上存在交互作用,这表明对早期虐待的生理反应可能会影响母亲的联结认知。这些初步结果表明,有必要对分娩前发生的创伤事件的长期情绪和生理影响进行更多研究。