Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Department Youth Health Care, GGD Hart voor Brabant, 's-Hertogenbosch, The Netherlands.
Eur J Public Health. 2018 Dec 1;28(6):1062-1068. doi: 10.1093/eurpub/cky125.
Socioeconomically disadvantaged children often have psychosocial problems. This study examined the mediating role of maternal depressive symptoms during pregnancy, infancy and early childhood in the association between maternal education, as indicator of socioeconomic status (SES), and child's psychosocial problems.
Included were 3410 children from the Amsterdam Born Children and their Development (ABCD) study. To assess the child's psychosocial problems at age 5-6 years, mothers and teachers completed the Strengths and Difficulties Questionnaire (SDQ). Maternal depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and the Depressive Anxiety and Stress Scale 21. Mediation analysis was performed to calculate the direct effect of maternal education on SDQ score and indirect effects through maternal depressive symptoms.
The mean mother-reported SDQ total score was significantly higher (P < 0.001) for children of low-educated mothers (6.74 ± 4.41) compared with children of highly educated mothers (4.47 ± 3.73). Levels of maternal depressive symptoms were also higher in low-educated mothers during pregnancy, infancy and early childhood. Maternal depressive symptoms explained 27.5% of the association between maternal education and mother-reported SDQ scores and 22.9% for combined mother/teacher SDQ scores. Maternal depressive symptoms during pregnancy had the strongest indirect effect.
Maternal depressive symptoms during pregnancy mediate the association between low maternal education and child's psychosocial problems. Early recognition and treatment of maternal depressive symptoms is important to prevent psychosocial problems in children, especially in those with low education.
社会经济地位较低的儿童通常存在心理社会问题。本研究探讨了妊娠、婴儿期和幼儿期母亲抑郁症状在母亲教育（作为社会经济地位的指标）与儿童心理社会问题之间的中介作用。
纳入了来自阿姆斯特丹出生儿童及其发育（ABCD）研究的 3410 名儿童。为了评估 5-6 岁儿童的心理社会问题，母亲和教师使用长处和困难问卷（SDQ）进行评估。使用流行病学研究中心抑郁量表和抑郁焦虑和应激量表 21 评估母亲的抑郁症状。进行中介分析以计算母亲教育对 SDQ 评分的直接影响和通过母亲抑郁症状的间接影响。
母亲报告的 SDQ 总分均值在受教育程度较低的母亲的孩子中明显较高（P<0.001）（6.74±4.41），而受教育程度较高的母亲的孩子中则较低（4.47±3.73）。在妊娠、婴儿期和幼儿期，低教育水平母亲的抑郁症状水平也较高。母亲抑郁症状解释了母亲教育与母亲报告的 SDQ 评分之间关联的 27.5%，以及母亲/教师联合 SDQ 评分的 22.9%。妊娠期间的母亲抑郁症状具有最强的间接效应。
妊娠期间的母亲抑郁症状中介了低母亲教育与儿童心理社会问题之间的关联。早期识别和治疗母亲的抑郁症状对于预防儿童的心理社会问题很重要，尤其是在那些受教育程度较低的儿童中。
