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母亲焦虑轨迹与儿童发育迟缓风险:来自所有家庭(AOF)妊娠队列的研究结果。

Trajectories of maternal distress and risk of child developmental delays: Findings from the All Our Families (AOF) pregnancy cohort.

机构信息

Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta T2N 1N4, Canada.

Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia.

出版信息

J Affect Disord. 2019 Apr 1;248:1-12. doi: 10.1016/j.jad.2018.12.132. Epub 2018 Dec 27.

Abstract

BACKGROUND

Existing literature on the impact of the course of maternal distress symptoms in the perinatal period and beyond has mainly focused on one source of distress (e.g., anxiety or depression) and only selected aspects of child development. This study examined the relative impact of trajectories of maternal depression, anxiety, and stress symptoms from mid-pregnancy to early childhood on child communication, gross motor, fine motor, problem solving, and personal social development at three years of age.

METHODS

Data were analyzed from 1983 mother-child dyads who participated in the three-year follow-up of the All Our Families (AOF) study. Maternal distress and child development across five domains were measured using validated tools. Latent class analysis (LCA) was conducted to identify trajectories of maternal distress over time. Multivariable logistic regression was used to explore the relationship between the trajectories and child development while adjusting for the covariates.

RESULTS

At age three years, 5.2% of children were at risk communication delay; 12.7% for gross motor delay; 15.4% for fine motor delay; 11.2 for problem solving delay; and 5.6% for personal-social delay on ASQ-3 domains. Multivariable analysis showed children born to mothers with persistent high anxiety symptoms from pregnancy to 3-years postpartum had an increased risk of delays in communication and personal-social domains.

LIMITATIONS

The use of self-reported maternal mental health symptoms and maternal reported child development are the study limitations.

CONCLUSIONS

The impact of high levels of maternal anxiety symptoms on the increased risk of child developmental delay in communication and personal-social domains highlights the importance of early intervention and addressing maternal anxiety from pregnancy through early childhood.

摘要

背景

现有关于围产期及之后母婴焦虑症状进展对儿童发展影响的文献主要集中在单一来源的焦虑(如焦虑或抑郁),且仅选择了儿童发展的部分方面进行研究。本研究考察了从中孕期至幼儿期的母亲抑郁、焦虑和压力症状轨迹对儿童交流、粗大运动、精细运动、解决问题和个人社会发展在三岁时的相对影响。

方法

本研究分析了来自 1983 对母婴对子的数据,这些母婴对子参与了 All Our Families(AOF)研究的三年随访。使用经过验证的工具测量了母婴的焦虑和五个领域的儿童发展。采用潜在类别分析(LCA)来识别随时间推移的母婴焦虑轨迹。多变量逻辑回归用于探索轨迹与儿童发展之间的关系,同时调整协变量。

结果

在三岁时,5.2%的儿童有交流延迟风险;12.7%有粗大运动延迟风险;15.4%有精细运动延迟风险;11.2%有解决问题延迟风险;5.6%有个人社会延迟风险(ASQ-3 领域)。多变量分析显示,从怀孕到产后 3 年一直有持续性高焦虑症状的母亲所生的孩子,在交流和个人社会领域出现发育迟缓的风险增加。

局限性

本研究的局限性在于使用了自我报告的母亲心理健康症状和母亲报告的儿童发展数据。

结论

高水平的母亲焦虑症状对儿童交流和个人社会领域发育迟缓风险增加的影响强调了从怀孕到幼儿期早期干预和解决母亲焦虑的重要性。

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