Aoyagi Sona-Sanae, Tsuchiya Kenji J
School of Education, Meisei University, Tokyo, Japan.
Fujikura Social Health Research Institute Ltd., Tokyo, Japan.
J Obstet Gynaecol Res. 2019 Sep;45(9):1809-1820. doi: 10.1111/jog.14064. Epub 2019 Jul 18.
The etiology of maternal postpartum depression (PPD) remains inconclusive, and there is no consensus concerning whether maternal PPD affects children's developmental outcomes. Consequently, in this literature review, we examined whether maternal PPD affects children's physical, neuromotor, language and general cognitive development.
We conducted an electronic search using PubMed to select case-control and cohort studies that addressed maternal depression, depressive episodes or depressive symptoms among postpartum (within 6 months) women. We omitted studies that focused on a specific population (e.g. preterm infants).
The methodological problems of prior studies indicate that their findings must be interpreted with caution. Insufficient and or inconsistent evidence has supported associations between maternal PPD and children's developmental trajectories. Nevertheless, some key studies have revealed findings that require further analysis, including the associations between maternal PPD and children's stunted growth/being underweight in developed countries, the slight delay in children's fine motor development, and in children's language development.
Although several studies have investigated the longstanding effects of maternal PPD on children's physical and neurodevelopment, no conclusive evidence has elucidated a relationship between maternal PPD and all four domains of child development - physical, neuromotor, language and general cognitive ability. Therefore, large-scale, longitudinal studies with a long-term follow-up period - extending to school age and beyond - are needed. Moreover, confounding factors should be carefully considered. Specifically, household income, parental education, breastfeeding, bonding/attachment and paternal mental health may be associated with maternal mental health and children's neurodevelopment.
产后抑郁症(PPD)的病因尚无定论,对于产后抑郁症是否会影响儿童的发育结果也未达成共识。因此,在这篇文献综述中,我们研究了产后抑郁症是否会影响儿童的身体、神经运动、语言和一般认知发展。
我们使用PubMed进行了电子检索,以选择针对产后(6个月内)妇女的抑郁症、抑郁发作或抑郁症状的病例对照研究和队列研究。我们排除了针对特定人群(如早产儿)的研究。
先前研究的方法学问题表明,其研究结果必须谨慎解读。支持产后抑郁症与儿童发育轨迹之间关联的证据不足且或不一致。尽管如此,一些关键研究揭示了需要进一步分析的结果,包括在发达国家产后抑郁症与儿童发育迟缓/体重不足之间的关联、儿童精细运动发育的轻微延迟以及儿童语言发育的延迟。
尽管有几项研究调查了产后抑郁症对儿童身体和神经发育的长期影响,但尚无确凿证据阐明产后抑郁症与儿童发育的所有四个领域——身体、神经运动、语言和一般认知能力之间的关系。因此,需要进行大规模、长期随访的纵向研究,随访期延长至学龄期及以后。此外,应仔细考虑混杂因素。具体而言,家庭收入、父母教育程度、母乳喂养、情感联结/依恋以及父亲心理健康可能与母亲心理健康和儿童神经发育有关。