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围产期产妇心理健康和婴儿社会情感发展:使用 MPEWS 队列的增长曲线分析。

Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort.

机构信息

Psychology Discipline, Murdoch University, Australia.

Psychology Discipline, Murdoch University, Australia.

出版信息

Infant Behav Dev. 2019 Nov;57:101336. doi: 10.1016/j.infbeh.2019.101336. Epub 2019 Aug 9.

Abstract

Pregnancy and the early post partum period are widely understood as a critical period for the infant's emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children's social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.

摘要

妊娠和产后早期被广泛认为是婴儿情感发展的关键时期,也是塑造社会互动的最早影响因素。本研究旨在了解产前和产后母亲焦虑和抑郁症状对 12 个月大婴儿社会情感结果的潜在影响。该研究使用了澳大利亚孕妇及其子女前瞻性队列研究的纵向数据。数据可用于 282 名母亲及其子女。在妊娠早期、妊娠第三个月、产后 6 个月和 12 个月测量母亲的抑郁和焦虑症状。在 12 个月时使用简短婴儿和幼儿社会情感评估 (BITSEA) 测量儿童的社会和情感发展。通过对 4 波重复测量的增长曲线分析来检查截距和斜率,我们发现母亲最初的抑郁和焦虑症状水平以及这些症状随时间的增长都预示着儿童社会情感发展问题更多。在最终模型中,焦虑症占儿童社会情感问题变异的 19%,抑郁症占 23%。研究结果强调了围产期母亲心理健康作为儿童发展潜在风险因素的重要性。这对政策制定具有重要意义,例如需要将围产期保健的早期识别和早期干预模式纳入当前的临床实践中,特别是要针对有风险的父母制定有针对性的筛查、评估和干预措施,以解决母亲在怀孕期间的心理健康问题,并继续监测经历围产期心理健康困难的幼儿。

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