Li F, Tian Y P, Liu X M, Xia R L, Jin L M, Sun X W, Song X X, Yuan W, Liang H
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; Department of Reproductive Epidemiology and Social Medicine, Shanghai Institute of Planned Parenthood Research, Shanghai 200237, China.
Department of Reproductive Epidemiology and Social Medicine, Shanghai Institute of Planned Parenthood Research, Shanghai 200237, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Apr 10;39(4):455-459. doi: 10.3760/cma.j.issn.0254-6450.2018.04.013.
To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old. In the present study, a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December, 2012. Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy, as well as at 6 months and 12 months postpartum. Neurodevelopment at 2 years was assessed, using the Child Behavior Checklist. We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (s) and 95%s, on children's behavioral problems at 2 years of age. Sensitivity analyses were performed among participants without postpartum depressive symptoms. After adjustment on factors as maternal age, gestation week, average monthly income per person, parental education and children's gender ., maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (=2.61, 95%: 1.36-4.99) and internalizing problems (=1.94, 95%: 1.22-3.08). However, maternal depression in third trimester was found to be associated with higher risks of developing emotional (=6.46, 95%: 3.09-13.53), withdrawn (=2.42, 95%: 1.16-5.02), aggressive (=2.93, 95%: 1.45-5.94), internalizing (=1.79, 95%: 1.01-3.16) or externalizing problems (=2.56, 95%:1.49-4.42). In sensitivity analysis, antenatal maternal depression was found positively associated with children's emotional, internalizing and externalizing problems and the differences all statistically significant. Maternal depression during pregnancy might increase the risks of children's behavioral problems. In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status, monitoring program regarding maternal mental health care should be strengthened.
探索孕期母亲抑郁症状及产前抑郁症状与儿童2岁时行为问题之间的关联。在本研究中，共从上海闵行出生队列研究（S-MBCS）中选取了491对母婴，该研究于2012年4月至12月在上海闵行区妇幼保健院开展。收集了流行病学研究中心关于抑郁的数据，以评估孕期第二和第三个月以及产后6个月和12个月时母亲的抑郁症状。使用儿童行为检查表评估儿童2岁时的神经发育情况。我们使用具有对数链接函数和二项分布的广义线性模型来估计2岁儿童行为问题的风险比（s）和95%置信区间。对没有产后抑郁症状的参与者进行了敏感性分析。在对母亲年龄、孕周、人均月收入、父母教育程度和儿童性别等因素进行调整后，发现孕期第二个月母亲抑郁与出现情绪问题（风险比=2.61，95%置信区间：1.36 - 4.99）和内化问题（风险比=1.94，95%置信区间：1.22 - 3.08）的较高风险相关。然而，发现孕期第三个月母亲抑郁与出现情绪问题（风险比=6.46，95%置信区间：3.09 - 13.53）、退缩问题（风险比=2.42，95%置信区间：1.16 - 5.02）、攻击问题（风险比=2.93，95%置信区间：1.45 - 5.94）、内化问题（风险比=1.79，95%置信区间：1.01 - 3.16）或外化问题（风险比=2.56，95%置信区间：1.49 - 4.42）的较高风险相关。在敏感性分析中，发现产前母亲抑郁与儿童的情绪、内化和外化问题呈正相关，且差异均具有统计学意义。孕期母亲抑郁可能会增加儿童行为问题的风险。为了降低儿童行为问题的发生率并促进母婴健康状况，应加强关于母亲心理保健的监测项目。
