Department of Psychology, Georgetown University, Washington, DC.
Department of Psychology, Georgetown University, Washington, DC.
Acad Pediatr. 2019 Jan-Feb;19(1):18-26. doi: 10.1016/j.acap.2018.05.006. Epub 2018 May 29.
We investigated links between childcare experiences-specifically, care instability and mothers' perceptions of care access-and maternal depressive symptoms in an effort to illuminate policy-amenable mechanisms through which childcare experiences can support maternal mental health.
Data were taken from the nationally representative Early Childhood Longitudinal Study-Birth Cohort. We used regression models with lagged dependent variables to estimate associations between aspects of childcare instability and perceptions of care availability and maternal depressive symptoms. We did so on the full sample and then on subgroups of mothers for whom childcare instability may be especially distressing: mothers who are low income, working, single, or non-native speakers of English.
Childcare instability-length in months in the longest arrangement and number of arrangements-was not associated with maternal depressive symptoms. However, mothers' perceptions of having good choices for care were associated with a reduced likelihood of clinical depressive symptoms, even after controlling for prior depressive symptoms and concurrent parenting stress; this latter association was observed both in the full sample (adjusted odds ratio [AOR] = 0.77; 95% confidence interval [CI] = 0.63-0.96) and among subgroups of employed mothers (AOR = 0.71; CI = 0.57-0.87) and single mothers (AOR = 0.72; CI = 0.52-0.99).
Although dimensions of care instability did not associate with maternal depressive symptoms, mothers' perceptions of available care options did. If replicated, findings would highlight a previously unconsidered avenue-increasing care accessibility and awareness of available options-for promoting maternal mental health in a population likely to experience depression but unlikely to be treated.
本研究旨在探讨儿童保育经历（具体而言，保育不稳定和母亲对保育可及性的感知）与产妇抑郁症状之间的关系，以阐明通过儿童保育经历支持产妇心理健康的政策可行机制。
本研究的数据来自全国代表性的早期儿童纵向研究-出生队列。我们使用具有滞后因变量的回归模型来估计保育不稳定方面与对保育可用性和产妇抑郁症状的看法之间的关联。我们在全样本中进行了这样的分析，然后在保育不稳定可能特别令人痛苦的母亲亚组中进行了分析：收入低、工作、单身或非英语母语者的母亲。
保育不稳定的时长（最长安排的月数和安排的次数）与产妇抑郁症状无关。然而，母亲对保育有良好选择的看法与减少临床抑郁症状的可能性相关，即使在控制了先前的抑郁症状和同期的育儿压力后也是如此；这种关联在全样本（调整后的优势比 [AOR] = 0.77；95%置信区间 [CI] = 0.63-0.96）和就业母亲（AOR = 0.71；CI = 0.57-0.87）和单身母亲（AOR = 0.72；CI = 0.52-0.99）亚组中均观察到。
尽管保育不稳定的维度与产妇抑郁症状无关，但母亲对可用保育选择的看法与产妇抑郁症状有关。如果得到复制，这些发现将突出一个以前未被考虑的途径-增加保育可及性和对可用选择的认识-以促进可能经历抑郁但不太可能得到治疗的人群的产妇心理健康。
