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理解产后一个月和六个月时的抑郁症与产后一年时母婴结合失败之间的关系:来自日本环境与儿童研究(JECS)的结果。

Understanding the relationship between postpartum depression one month and six months after delivery and mother-infant bonding failure one-year after birth: results from the Japan Environment and Children's study (JECS).

机构信息

Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.

Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.

出版信息

Psychol Med. 2020 Jan;50(1):161-169. doi: 10.1017/S0033291719002101. Epub 2019 Sep 2.

Abstract

BACKGROUND

Postpartum depression is a major mental health issue. It not only adversely affects the mother's quality of life, but also mother-infant bonding. However, the relationship between postpartum depression (at multiple points after childbirth) and mother-infant bonding failure one year after birth is not well understood. This study investigates the relationship between postpartum depression at 1-month and 6-month after birth and mother-infant bonding failure at 1 year after birth with a large cohort.

METHODS

Data from 83 109 mothers from the Japan Environment and Children's Study were analyzed. Mother-infant bonding 1-year after delivery was assessed using the Mother-to-Infant Bonding Scale Japanese version (MIBS-J). Postpartum depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) at 1-month and 6-month after delivery. Twenty covariates during pregnancy and one month after delivery were controlled for deriving the odds ratios (ORs) describing postpartum depression to mother-infant bonding.

RESULTS

EPDS Total Score crude ORs and adjusted ORs against the MIBS-J Total Score at 1-month and 6-month after delivery were calculated. Crude ORs were 1.111 (95% CI 1.110-1.112) and 1.122 (95% CI 1.121-1.124) respectively. In the fully adjusted model, ORs were 1.088 (95% CI 1.086-1.089) and 1.085 (95% CI 1.083-1.087), respectively.

CONCLUSIONS

This study demonstrated prospectively, in a large-scale cohort, that depression at multiple postpartum points, including associations with each EPDS and MIBS-J factors, may be a robust predictor of mother-infant bonding failure 1-year after birth.

摘要

背景

产后抑郁症是一个主要的心理健康问题。它不仅对母亲的生活质量产生不利影响,还会影响母婴结合。然而,产后抑郁症(分娩后多个时间点)与产后 1 年母婴结合失败之间的关系尚不清楚。本研究使用大型队列调查产后 1 个月和 6 个月的产后抑郁症与产后 1 年母婴结合失败之间的关系。

方法

分析了来自日本环境与儿童研究的 83109 名母亲的数据。使用日本版母婴结合量表(MIBS-J)评估产后 1 年的母婴结合情况。使用产后抑郁量表(EPDS)在产后 1 个月和 6 个月测量产后抑郁症。在怀孕期间和产后 1 个月控制了 20 个协变量,以得出描述产后抑郁症与母婴结合的比值比(OR)。

结果

计算了 EPDS 总分与产后 1 个月和 6 个月 MIBS-J 总分的粗比值比(OR)和调整后 OR。粗 OR 分别为 1.111(95%CI 1.110-1.112)和 1.122(95%CI 1.121-1.124)。在完全调整模型中,OR 分别为 1.088(95%CI 1.086-1.089)和 1.085(95%CI 1.083-1.087)。

结论

本研究前瞻性地在一个大型队列中表明,包括与每个 EPDS 和 MIBS-J 因素相关的产后多个时间点的抑郁,可能是产后 1 年母婴结合失败的一个强有力的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b45/6945325/b9d29a6c5071/S0033291719002101_fig1.jpg

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