Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Psychol Med. 2019 Dec;49(16):2727-2735. doi: 10.1017/S0033291718003689. Epub 2018 Dec 18.
Self-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother-infant bonding problems.
The Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3-9. VIHCS enrolment began in 2006 (when participants were aged 28-29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother-infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum.
Five hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20-29) reported higher levels of perinatal depressive symptoms and mother-infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42-7.39; mother-infant bonding problems adjusted β = 7.51, 95% CI 3.09-11.92]. There was no evidence that self-harm in adolescence (ages 15-17) was associated with either perinatal outcome.
Self-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother-infant bonding problems.
年轻人的自残行为与后期社会和情感发展中的问题有关。然而，尚不清楚年轻女性的自残行为在成为父母后是否仍然是脆弱性的标志。本研究前瞻性描述了孕前自残、产妇抑郁症状和母婴联系问题之间的关联。
维多利亚代际健康队列研究（VIHCS）是澳大利亚维多利亚青少年健康队列研究（VAHCS）的后续研究。从 14 岁到 35 岁，共进行了 10 次（波）评估，包括第 3 波至第 9 波的自我报告自残情况。VIHCS 的招募工作于 2006 年开始（当参与者年龄为 28-29 岁时），通过每 6 个月联系 VAHCS 女性来确定 7 年内的怀孕情况。在妊娠晚期、产后 2 个月和 12 个月时，用爱丁堡产后抑郁量表评估围产期抑郁症状。在产后 2 个月和 12 个月时，用产后母婴联系问卷评估母婴联系问题。
共纳入 384 名女性的 564 次妊娠。十分之一的女性（9.7%）报告有孕前自残。在年轻成人（20-29 岁）期报告自残的女性在所有围产期时间点的围产期抑郁症状和母婴联系问题的评分更高[围产期抑郁症状调整后的β=5.40，95%置信区间（CI）3.42-7.39；母婴联系问题调整后的β=7.51，95%CI 3.09-11.92]。没有证据表明青春期（15-17 岁）的自残与任何围产期结局有关。
成年早期的自残行为可能是未来围产期心理健康和母婴联系问题脆弱性的指标。
