Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States.
Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States.
Biol Psychol. 2019 Oct;147:107614. doi: 10.1016/j.biopsycho.2018.10.016. Epub 2018 Nov 2.
The current study evaluated a mechanistic pathway by which prenatal stress increases the risk of postpartum depressive (PPD) symptoms via observed dyadic emotional, behavioral, and attentional dysregulation and associated cortisol responses during mother-infant interactions.
Participants included 322 low-income Mexican American mother-infant dyads. Depressive symptoms, economic hardship, and negative life events were assessed at a prenatal visit. Dysregulation in dyadic (mother-infant) interactions and cortisol responses to mother-infant interaction were evaluated at 12 weeks after the birth. Twenty-four weeks after the birth, PPD symptoms were predicted from prenatal stress (negative life events and economic hardship) and prenatal depressive symptoms, mediated through dyadic dysregulation and maternal and infant cortisol responses.
More negative life events in the prenatal period predicted more dyadic dysregulation at 12 weeks postpartum. Dyadic dysregulation and economic hardship predicted elevated 12-week infant cortisol total response and reactivity, and higher total infant cortisol response predicted higher maternal PPD symptoms at 24 weeks. Maternal cortisol response was not associated with dyadic dysregulation, either form of prenatal stress, or PPD symptoms.
The results indicate the salience of early psychosocial processes and mother-infant relationship challenges for subsequent maternal affective well-being.
本研究通过观察母婴互动中的情绪、行为和注意力失调以及相关皮质醇反应,评估了产前应激通过何种机制增加产后抑郁(PPD)症状的风险。
参与者包括 322 对低收入的墨西哥裔美国母婴对子。在产前检查时评估抑郁症状、经济困难和负面生活事件。在婴儿出生后 12 周评估母婴互动中的失调和皮质醇对母婴互动的反应。在婴儿出生后 24 周,从产前应激(负面生活事件和经济困难)和产前抑郁症状预测 PPD 症状,通过母婴失调和母婴皮质醇反应的中介作用。
产前时期更多的负面生活事件预测产后 12 周时母婴互动失调更多。母婴互动失调和经济困难预测婴儿 12 周时皮质醇总反应和反应性增加,婴儿皮质醇总反应增加预测 24 周时母亲 PPD 症状增加。皮质醇反应与母婴互动失调、任何一种产前应激或 PPD 症状均无关联。
结果表明早期心理社会过程和母婴关系挑战对随后的母亲情感健康具有重要意义。