Coburn S S, Luecken L J, Rystad I A, Lin B, Crnic K A, Gonzales N A
Department of Psychology, Arizona State University, Tempe, AZ, USA.
Division of Gastroenterology, Hepatology, and Nutrition, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, USA.
Matern Child Health J. 2018 Jun;22(6):786-793. doi: 10.1007/s10995-018-2448-7.
Recent research suggests that health disparities among low-SES and ethnic minority populations may originate from prenatal and early life exposures. Postpartum maternal depressive symptoms have been linked to poorer infant physical health, yet prenatal depressive symptoms not been thoroughly examined in relation to infant health.
In a prospective study of low-income Mexican American mothers and their infants, women (N = 322, median age 27.23, IQR = 22.01-32.54) completed surveys during pregnancy (median gestation 39.50, IQR = 38.71-40.14 weeks) and 12 weeks after birth. We investigated (1) if prenatal depressive symptoms predicted infant physical health concerns at 12 weeks of age, (2) whether these associations occurred above and beyond concurrent depressive symptoms, and (3) if birth weight, gestational age, and breastfeeding were mediators of prenatal depression predicting subsequent infant health.
Higher prenatal depressive symptoms were associated with more infant physical health concerns at 12 weeks (p < .001), after accounting for 12-week maternal depressive symptoms, breastfeeding, gestational age, and birth weight. Twelve-week maternal depressive symptoms were concurrently associated with more infant health concerns (p < .01). Birth weight, gestational age, and breastfeeding were not associated with maternal depression or infant health concerns.
Results establish a link between prenatal depressive symptoms and an elevated risk of poor health evident shortly after birth. These findings underscore the importance of the prenatal period as a possible sensitive period for infants' health, and the need for effective interventions for depression during pregnancy to mitigate potentially teratogenic effects on the developing fetus and reduce risks for later health concerns.
近期研究表明,社会经济地位低下群体和少数族裔人群之间的健康差异可能源于产前和生命早期接触的因素。产后母亲的抑郁症状与婴儿较差的身体健康状况有关,但产前抑郁症状与婴儿健康的关系尚未得到充分研究。
在一项针对低收入墨西哥裔美国母亲及其婴儿的前瞻性研究中,女性(N = 322,中位年龄27.23岁,四分位距 = 22.01 - 32.54岁)在孕期(中位孕周39.50周,四分位距 = 38.71 - 40.14周)和产后12周完成了调查。我们研究了:(1)产前抑郁症状是否能预测婴儿12周龄时的身体健康问题;(2)这些关联是否独立于同时期的抑郁症状之外存在;(3)出生体重、孕周和母乳喂养是否为产前抑郁预测后续婴儿健康的中介因素。
在考虑了产后12周母亲的抑郁症状、母乳喂养、孕周和出生体重后,较高的产前抑郁症状与婴儿12周时更多的身体健康问题相关(p <.001)。产后12周母亲的抑郁症状同时也与更多的婴儿健康问题相关(p <.01)。出生体重、孕周和母乳喂养与母亲抑郁或婴儿健康问题无关。
研究结果表明产前抑郁症状与出生后不久出现的健康状况不佳风险升高之间存在关联。这些发现强调了孕期作为婴儿健康可能的敏感期的重要性,以及在孕期对抑郁症进行有效干预以减轻对发育中胎儿潜在致畸影响并降低后期健康问题风险的必要性。