Department of Psychiatry, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Inserm UMR1178, Univ Paris-Sud, Faculté de Médecine Paris-Sud, 94275, Le Kremlin Bicêtre, France.
Eur Child Adolesc Psychiatry. 2020 Apr;29(4):515-526. doi: 10.1007/s00787-019-01367-9. Epub 2019 Jul 11.
Prenatal maternal depression is associated with developmental disorders in offspring. However, the specific effects of the intensity of prenatal depressive symptoms on infant behavior remain poorly explored. The aim of this work is to explore the links between early neonatal behavior and maternal prenatal depressive symptoms, independently from maternal pre- and postnatal anxiety and early postnatal maternal depressive symptoms. Five hundred and ninety-eight women and their newborns from the MATQUID cohort were prospectively evaluated during the 8th month of pregnancy (T1) and at day 3 postpartum (T2). We analyzed the independent associations between neonates' behavior (Neonatal Behavioral Assessment Scale-NBAS) at T2 and the intensity of maternal prenatal depressive symptoms (CES-D), taking into account confounding factors including depressive symptoms at T2 and anxiety (T1 and T2). The presence of a major depressive episode (MDE) based on MINI at T1 was also studied, independently. Our results show a significant negative correlation between prenatal CES-D scores and NBAS scores on "habituation" (p = 0.0001), "orientation" (p = 0.015), "motor system" (p < 0.0001), "autonomic stability" (p < 0.0001) dimensions, independently of other variables, including pre/postnatal anxiety and postnatal depressive symptoms. A prenatal MDE was independently associated with lower scores on the "orientation" dimension (p = 0.005). This study reports a specific effect of prenatal depressive symptoms on newborn's behavior. These results highlight the crucial necessity for antenatal screening and adjusted treatments of maternal depressive symptoms and not only of MDE. Particular attention must be paid to infants of mothers presenting prenatal depressive symptoms to provide them with early developmental care when necessary.
产前母体抑郁与后代发育障碍有关。然而，产前抑郁症状的严重程度对婴儿行为的具体影响仍未得到充分探索。本研究旨在探讨新生儿早期行为与产妇产前抑郁症状之间的联系，同时考虑了产妇产前和产后焦虑以及产后早期抑郁症状的因素。来自 MATQUID 队列的 598 名妇女及其新生儿在妊娠第 8 个月（T1）和产后第 3 天（T2）进行了前瞻性评估。我们分析了 T2 时新生儿行为（新生儿行为评估量表-NBAS）与产妇产前抑郁症状严重程度（CES-D）之间的独立关联，同时考虑了包括 T2 时抑郁症状和焦虑（T1 和 T2）在内的混杂因素。还研究了基于 MINI 在 T1 时是否存在重度抑郁发作（MDE）的情况。结果显示，产前 CES-D 评分与 NBAS 的“习惯化”（p=0.0001）、“定向”（p=0.015）、“运动系统”（p<0.0001）、“自主稳定性”（p<0.0001）维度的评分呈显著负相关，独立于其他变量，包括产前/产后焦虑和产后抑郁症状。产前 MDE 与“定向”维度的评分较低独立相关（p=0.005）。本研究报告了产前抑郁症状对新生儿行为的特定影响。这些结果强调了对产妇抑郁症状进行产前筛查和调整治疗的重要性，而不仅仅是治疗 MDE。必须特别关注有产前抑郁症状的母亲的婴儿，以便在必要时为他们提供早期发育护理。
