3 个月大婴儿母婴联结受损的风险因素：来自日本的一项纵向基于人群的研究。
Risk factors for impaired maternal bonding when infants are 3 months old: a longitudinal population based study from Japan.
机构信息
Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Japan.
Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, 20014, Turku, Finland.
出版信息
BMC Psychiatry. 2019 Mar 8;19(1):87. doi: 10.1186/s12888-019-2068-9.
BACKGROUND
Impaired maternal bonding has been associated with antenatal and postnatal factors, especially postpartum depression. Only a few population-based, longitudinal studies have examined the association between maternal depression and bonding in outside western countries. In addition, little is known about the association between psychosocial factors during pregnancy and impaired maternal bonding. The aim of this study was to investigate risk factors associated with impaired maternal bonding 3 months after delivery using Japanese population-based, longitudinal study from pregnancy period to 3 months after delivery.
METHODS
This study was performed at the public health care center in Hekinan city, Aichi prefecture, Japan. Mothers who participated the infant's health check-up 3 months after delivery from July 2013 to Jun 2015 completed the Postpartum Bonding Questionnaire (PBQ) and the Edinburgh Postnatal Depression Scale (EPDS) 1 month after delivery. Information was also provided from home visit at 1 month after delivery, birth registration form, and pregnancy notification form. The study included 1060 mothers with a mean age of 29.90 years, who had given birth at a mean of 38.95 weeks.
RESULTS
Bivariate and multivariate logistic regression analyses were conducted to identify the association between antenatal and postnatal factors and impaired maternal bonding. The main findings were that maternal negative feelings about pregnancy (OR = 2.16, 95% CI = 1.02-4.56) and postpartum depression at 1 month after delivery (OR = 7.85, 95% CI = 3.44-17.90) were associated with higher levels of impaired maternal bonding 1 months after delivery. Mothers who had delivered their first child had increased odds of a moderate level of impaired maternal bonding 3 months after delivery (OR = 1.85, 95% CI = 1.22-2.81).
CONCLUSIONS
The findings emphasize the importance of identifying mothers with depression and those with maternal negative feelings towards pregnancy to assess possible impaired maternal bonding.
背景
母婴联系受损与产前和产后因素有关，尤其是产后抑郁。只有少数基于人群的纵向研究调查了产后抑郁症与母婴联系之间的关系，这些研究都来自西方国家以外的地区。此外，人们对怀孕期间心理社会因素与母婴联系受损之间的关系知之甚少。本研究旨在使用基于日本人群的纵向研究，从怀孕期到产后 3 个月，调查与产后 3 个月母婴联系受损相关的危险因素。
方法
本研究在日本爱知县日进市的公共医疗保健中心进行。2013 年 7 月至 2015 年 6 月，参加婴儿产后 3 个月健康检查的母亲在产后 1 个月时完成了产后母婴联系问卷（PBQ）和爱丁堡产后抑郁量表（EPDS）。还通过产后 1 个月家访、出生登记表格和妊娠通知表格提供了信息。该研究共纳入了 1060 名平均年龄为 29.90 岁的母亲，平均分娩孕周为 38.95 周。
结果
采用二变量和多变量逻辑回归分析来确定产前和产后因素与母婴联系受损之间的关系。主要发现是，母亲对怀孕的负面感受（OR=2.16，95%CI=1.02-4.56）和产后 1 个月的产后抑郁（OR=7.85，95%CI=3.44-17.90）与产后 1 个月母婴联系受损程度较高有关。初产妇产后 3 个月母婴联系中度受损的可能性增加（OR=1.85，95%CI=1.22-2.81）。
结论
这些发现强调了识别有抑郁和对怀孕有负面感受的母亲的重要性，以便评估母婴联系受损的可能性。
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