University of Calgary, Alberta, Canada.
Hospital for Sick Children, Toronto, Ontario, Canada.
J Am Acad Child Adolesc Psychiatry. 2018 Sep;57(9):645-657.e8. doi: 10.1016/j.jaac.2018.06.012. Epub 2018 Jul 20.
Observed associations between maternal prenatal stress and children's socioemotional development have varied widely in the literature. The objective of the current study was to provide a synthesis of studies examining maternal prenatal anxiety and depression and the socioemotional development of their children.
Eligible studies through to February 2018 were identified using a comprehensive search strategy. Included studies examined the association between maternal prenatal depression or anxiety and the future development of their children's socioemotional development (eg, difficult temperament, behavioral dysregulation) up to 18 years later. Two independent coders extracted all relevant data. Random-effects meta-analyses were used to derive mean effect sizes and test for potential moderators.
A total of 71 studies met full inclusion criteria for data analysis. The weighted average effect size for the association between prenatal stress and child socioemotional problems was as follows: odds ratio (OR) = 1.66 (95% CI = 1.54-1.79). Effect sizes were stronger for depression (OR = 1.79; 95% CI = 1.61-1.99) compared to anxiety (OR = 1.50; 95% CI = 1.36-1.64). Moderator analyses indicated that effect sizes were stronger when depression was more severe and when socio-demographic risk was heightened.
Findings suggest that maternal prenatal stress is associated with offspring socioemotional development, with the effect size for prenatal depression being more robust than for anxiety. Mitigating stress and mental health difficulties in mothers during pregnancy may be an effective strategy for reducing offspring behavioral difficulties, especially in groups with social disadvantage and greater severity of mental health difficulties.
文献中观察到的孕妇产前压力与儿童社会情感发展之间的关联差异很大。本研究的目的是综合研究孕妇产前焦虑和抑郁与子女社会情感发展（例如，困难气质、行为失调）的关系。
通过全面的搜索策略，确定截至 2018 年 2 月的合格研究。纳入的研究检查了母亲产前抑郁或焦虑与他们孩子的社会情感发展（例如，困难气质、行为失调）未来发展之间的关联，直到 18 岁以后。两名独立的编码员提取所有相关数据。使用随机效应荟萃分析得出平均效应大小，并检验潜在的调节因素。
共有 71 项研究符合数据分析的全部纳入标准。产前压力与儿童社会情感问题之间关联的加权平均效应大小如下：比值比（OR）= 1.66（95%置信区间（CI）= 1.54-1.79）。与焦虑（OR=1.50；95%置信区间（CI）=1.36-1.64）相比，抑郁（OR=1.79；95%CI=1.61-1.99）的效应大小更强。调节分析表明，当抑郁程度更严重和社会人口风险增加时，效应大小更强。
研究结果表明，孕妇产前压力与子女社会情感发展有关，产前抑郁的效应大小比焦虑更稳健。在怀孕期间减轻母亲的压力和心理健康问题可能是减少子女行为问题的有效策略，特别是在社会劣势和心理健康问题更严重的群体中。
