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芬兰脑出生队列研究中孕期母婴抑郁和焦虑症状的发展过程。

The courses of maternal and paternal depressive and anxiety symptoms during the prenatal period in the FinnBrain Birth Cohort study.

机构信息

University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland.

University of Turku, Department of Psychology, Turku, Finland.

出版信息

PLoS One. 2018 Dec 17;13(12):e0207856. doi: 10.1371/journal.pone.0207856. eCollection 2018.

Abstract

Maternal prenatal symptoms of depression and anxiety have been suggested to impose differential effects on later offspring development, depending on their characteristics, such as timing, intensity and persistence. Paternal symptoms have been less investigated. While knowledge on these trajectory characteristics is essential for improved comprehension of prenatal stress, prospective studies including both expecting parents have been scarce. We aim at identifying and comparing the trajectories of prenatal depressive and anxiety symptoms in both parents in a pregnancy cohort design. The sample included 3202 mothers and 2076 fathers who were recruited to the FinnBrain Birth Cohort study (www.finnbrain.fi). Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and general anxiety by the anxiety scale of the Symptom Checklist -90 (SCL-90) repeatedly at 14, 24, and 34 gestational weeks. Five differential depressive and four anxiety symptom trajectories were identified across pregnancy both in mothers and in fathers. The trajectories of consistently low depressive or anxiety symptoms were associated with higher educational level in both parents, and with nulliparity and non-smoking during pregnancy in mothers. Parents with consistently high or increasing levels of symptoms had more often prenatal SSRI medication. The congruences between elevated depressive and anxiety symptoms at any point in pregnancy, as well as parental trajectories within families were low. However, in this population-based sample, the self-reported symptom levels of both parents were generally very low. Variance in timing and persistence of parent-reported prenatal depressive and anxiety symptoms is potentially important, while symptom trajectories are very similar in mothers and fathers. These differential symptom trajectories and the significance of their correlates should be acknowledged when studying prenatal stress exposures and the related outcomes in children.

摘要

母体产前抑郁和焦虑症状被认为会根据其特征(如时间、强度和持续时间)对后代的后期发育产生不同的影响。然而,对父亲的症状研究较少。虽然了解这些轨迹特征对于更好地理解产前压力至关重要,但包括准父母在内的前瞻性研究却很少。我们旨在通过妊娠队列设计来识别和比较父母双方产前抑郁和焦虑症状的轨迹。该样本包括 3202 名母亲和 2076 名父亲,他们被招募到芬兰大脑出生队列研究(www.finnbrain.fi)中。使用爱丁堡产后抑郁量表(EPDS)评估抑郁症状,使用症状清单-90(SCL-90)的焦虑量表在 14、24 和 34 孕周时反复评估一般焦虑。在母亲和父亲中,整个孕期都发现了五种不同的抑郁症状轨迹和四种不同的焦虑症状轨迹。在父母双方中,始终处于低水平的抑郁或焦虑症状与较高的教育水平有关,与母亲在怀孕期间的初产和不吸烟有关。始终处于高水平或症状水平不断增加的父母,怀孕期间更常使用 SSRI 类药物。在孕期任何时候,父母双方同时出现的抑郁和焦虑症状升高,以及家庭内的父母轨迹之间的一致性都较低。然而,在这个基于人群的样本中,父母双方自我报告的症状水平通常非常低。父母报告的产前抑郁和焦虑症状的时间和持续变化的差异可能很重要,而母亲和父亲的症状轨迹非常相似。在研究产前应激暴露和儿童相关结局时,应认识到这些不同的症状轨迹及其相关性的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc94/6296666/119139c5b296/pone.0207856.g001.jpg

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