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产前和产后母亲抑郁症状与儿童中期后代认知和行为的关联:一项前瞻性队列研究。

Associations of Prenatal and Postnatal Maternal Depressive Symptoms with Offspring Cognition and Behavior in Mid-Childhood: A Prospective Cohort Study.

机构信息

School of Psychology, Laval University, Quebec, QC G1V 0A6, Canada.

Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA.

出版信息

Int J Environ Res Public Health. 2019 Mar 20;16(6):1007. doi: 10.3390/ijerph16061007.

Abstract

Exposure to maternal depressive symptoms in the peri-pregnancy periods may be associated with poorer child development, but research is often limited to only maternal assessments of behavior and cognition. This study investigates the specific periods of prenatal and postnatal exposure to maternal depressive symptoms in association with child development using reports from teachers and mothers. This study is based on 1225 mother⁻child pairs from Project Viva, a prospective pre-birth cohort study. Mothers reported depressive symptoms on the Edinburgh Postpartum Depression Scale (EPDS) in mid-pregnancy as well as at 6 months and 12 months postpartum. Teachers and mothers reported child executive functions using the Behavioral Rating Inventory of Executive Function (BRIEF) and behavior using the Strengths and Difficulties Questionnaire (SDQ). Children completed the Kaufman Brief Intelligence Test (KBIT-2), the Wide Range Assessment of Visual Motor Abilities (WRAVMA), and the Visual Memory Index of the Wide Range Assessment of Memory and Learning (WRAML). We used multivariable linear regression models to examine associations of prenatal and postpartum depressive symptoms with outcomes. Many of the crude associations observed were attenuated after adjusting for demographic factors and maternal IQ, yet some remained significant. For example, high prenatal maternal depressive symptoms were associated with poorer scores on the BRIEF Behavior Regulation Index and some SDQ scales based on reports from teachers and mothers. High prenatal maternal depressive symptoms were associated with poorer behavioral development. Postpartum symptoms did not show strong associations with outcomes once we adjusted for the prenatal period.

摘要

孕期前后母亲抑郁症状的暴露可能与儿童发育较差有关,但研究往往仅限于母亲对行为和认知的评估。本研究使用教师和母亲的报告,调查了与儿童发育相关的产前和产后暴露于母亲抑郁症状的具体时期。本研究基于项目 Viva 的 1225 对母婴对,这是一项前瞻性的产前队列研究。母亲在妊娠中期以及产后 6 个月和 12 个月时使用爱丁堡产后抑郁量表(EPDS)报告抑郁症状。教师和母亲使用行为评定量表的执行功能评定量表(BRIEF)和行为评定量表的困难问卷(SDQ)报告儿童的执行功能和行为。儿童完成了 Kaufman 简明智力量表(KBIT-2)、广泛视觉运动能力评估(WRAVMA)和广泛记忆与学习评估的视觉记忆指数(WRAML)。我们使用多变量线性回归模型来检验产前和产后抑郁症状与结果之间的关系。在调整人口统计学因素和母亲智商后,许多观察到的粗关联减弱,但仍有一些关联具有统计学意义。例如,高产前母亲抑郁症状与教师和母亲报告的 BRIEF 行为调节指数和一些 SDQ 量表的评分较差有关。高产前母亲抑郁症状与较差的行为发育有关。一旦我们调整了产前时期,产后症状与结果之间就没有很强的关联。

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