Cho June, Su Xiaogang, Holditch-Davis Diane
1 School of Nursing, University of Nevada, Las Vegas, NV, USA.
2 Department of Mathematical Sciences, University of Texas at El Paso, El Paso, TX, USA.
Biol Res Nurs. 2019 May;21(3):253-263. doi: 10.1177/1099800419829592. Epub 2019 Feb 14.
To examine the concurrent use of self-report questionnaires and hormonal biomarkers, specifically levels of testosterone and cortisol, along with demographic variables and corrected age (CA) in the assessment of mental health and healthy behaviors among mothers of very-low-birthweight (VLBW, BW < 1,500 g) infants at five time points over 2 years post birth.
Data on 40 mothers from a neonatal intensive care unit of a tertiary medical center in the southeast United States were collected from the medical record, standard questionnaires for the mother (depressive symptoms, perceived stress, anxiety, mental health status, parenting stress, and healthy lifestyle behaviors), and biochemical measurement of maternal testosterone and cortisol using enzyme immunoassay at birth, 40 weeks' postmenstrual age, and 6, 12, and 24 months CA.
Maternal self-report of mental health improved from birth to 6 or 12 months then worsened at 24 months. Mixed linear models showed that mothers with higher testosterone levels had more depressive symptoms and smoked more, whereas mothers with higher cortisol levels had healthier behaviors and exercised more. Testosterone levels were negatively correlated with cortisol levels. Marital status, education, and health insurance were the most predictive demographic variables for the levels of hormonal biomarkers, mental health, and healthy behaviors.
The use of self-report and biochemical measurement was effective in assessing maternal mental health and healthy behaviors over 2 years post birth, when mothers of VLBW infants tend to experience more mental health problems and parenting difficulties than mothers of normal-BW full-term infants.
研究在评估极低出生体重（VLBW，出生体重<1500克）婴儿的母亲在产后2年的5个时间点的心理健康和健康行为时，自我报告问卷与激素生物标志物（特别是睾酮和皮质醇水平）以及人口统计学变量和校正年龄（CA）的同时使用情况。
从美国东南部一家三级医疗中心的新生儿重症监护病房收集了40名母亲的数据，这些数据来自病历、母亲的标准问卷（抑郁症状、感知压力、焦虑、心理健康状况、育儿压力和健康生活方式行为），以及在出生时、月经龄40周、校正年龄6个月、12个月和24个月时使用酶免疫测定法对母亲的睾酮和皮质醇进行的生化测量。
母亲的心理健康自我报告从出生到6个月或12个月有所改善，然后在24个月时恶化。混合线性模型显示，睾酮水平较高的母亲有更多的抑郁症状且吸烟更多，而皮质醇水平较高的母亲有更健康的行为且锻炼更多。睾酮水平与皮质醇水平呈负相关。婚姻状况、教育程度和健康保险是激素生物标志物水平、心理健康和健康行为最具预测性的人口统计学变量。
在产后2年评估母亲的心理健康和健康行为时，使用自我报告和生化测量是有效的，此时极低出生体重婴儿的母亲往往比正常出生体重足月婴儿的母亲经历更多的心理健康问题和育儿困难。
