Wright Tanya, Stevens Suzanne, Wouldes Trecia A
University of Auckland and Starship Hospital, Auckland District Health Board.
University of Auckland.
Infant Ment Health J. 2018 Nov;39(6):707-717. doi: 10.1002/imhj.21742. Epub 2018 Oct 19.
Research on Mother-Baby Units (MBUs) has mainly focused on maternal psychiatric outcomes, not the well-being of infants. This study investigated infant development and mental health along with maternal characteristics and the mother-infant relationship in 45 dyads (60% New Zealand European, 20% Māori, 11% Pacific) admitted to a new MBU. Maternal psychopathology was measured with the Health of the Nations Outcome Scale (HoNOS, J.K Wing et al., 1998) and Global Assessment of Functioning (GAF; I.M. Aas, 2010). The Parent-Infant Relationship Global Assessment Scale (PIR-GAS, Zero to Three, 2005) measured the mother-infant relationship. Infant measures included Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (Zero to Three Press, 2005) and the Ages & Stages-3 (J. Squires, E. Twombly, D. Bricker, & L. Potter, 2009). Maternal mental illness and functioning improved during the admission and were positively associated with longer inpatient duration and no illicit substance use. Well-being of the infants was concerning. In addition to lower birth weights and poorer health status, at discharge 51% were lagging behind developmentally, and 51% were exhibiting signs of infant mental health concerns. Relationally, 67% of mother-infant dyads had features of, and 29% met criteria for, a disordered relationship. Poorer mother-infant relationships were associated with a maternal diagnosis of schizophrenia or bipolar disorder, use of the Mental Health Act, leaving the MBU early, limited social support, and infant mental health diagnosis.
母婴病房(MBUs)的研究主要集中在母亲的精神科结局上,而非婴儿的福祉。本研究调查了45对母婴(60%为新西兰欧洲裔、20%为毛利人、11%为太平洋岛民)入住新的母婴病房后的婴儿发育和心理健康情况,以及母亲的特征和母婴关系。采用《国民健康结果量表》(HoNOS,J.K.温等人,1998年)和功能总体评估(GAF;I.M.阿斯,2010年)来测量母亲的精神病理学情况。使用《母婴关系总体评估量表》(PIR-GAS,零至三岁组织,2005年)来测量母婴关系。婴儿测量指标包括《婴儿及幼儿心理健康与发育障碍诊断分类》(零至三岁出版社,2005年)和《年龄与阶段-3》(J.斯奎尔斯、E.特温布利、D.布里克和L.波特,2009年)。母亲的精神疾病和功能在住院期间有所改善,且与更长的住院时间和无非法药物使用呈正相关。婴儿的福祉令人担忧。除了出生体重较低和健康状况较差外,出院时51%的婴儿在发育上滞后,51%表现出婴儿心理健康问题的迹象。在关系方面,67%的母婴二元组具有紊乱关系的特征,29%符合紊乱关系的标准。较差的母婴关系与母亲被诊断为精神分裂症或双相情感障碍、使用《精神健康法》、提前离开母婴病房、社会支持有限以及婴儿心理健康诊断有关。