母婴围产期抑郁症状与 2-3 岁儿童行为相关：APrON 纵向研究结果。
Maternal and paternal perinatal depressive symptoms associate with 2- and 3-year-old children's behaviour: findings from the APrON longitudinal study.
机构信息
Faculty of Nursing and Cumming School of Medicine, Departments of Pediatrics, Psychiatry, & Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada.
Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada.
出版信息
BMC Pediatr. 2019 Nov 13;19(1):435. doi: 10.1186/s12887-019-1775-1.
BACKGROUND
Prenatal and postnatal depressive symptoms are common in expectant and new mothers and fathers. This study examined the association between four patterns of probable perinatal depression (mother depressed, father depressed, both depressed, neither depressed) in co-parenting mothers and fathers and their children's internalizing and externalizing behaviours at 24 and 36 months of age. The influence of sociodemographic, risk and protective factors was also examined.
METHODS
Depressive symptoms were measured during pregnancy and at 3 months postpartum and children's behaviour was assessed at 24 and 36 months of age. Families (n = 634) provided data on their children's internalizing (i.e. emotionally reactive, anxious/depressed, somatic complaints, withdrawn and total) and externalizing (i.e. attention problems, aggression and total) behaviour. Marginal models were employed to determine the relationship between children's behaviour over the two time points and the four patterns of probable parental depression. Sociodemographic variables as well as risk (stress) and protective (social support) factors were included in these models.
RESULTS
In the perinatal period 19.40% (n = 123) of mothers scored as probably depressed and 10.57% (n = 67) of fathers. In 6.31% (n = 40) of the participating families, both parents scored as probably depressed and in 63.72% (n = 404) neither parent scored as depressed. For children's emotionally reactive, withdrawn and total internalizing behaviours, both mothers' probable depression and mothers and fathers' co-occurring probable depression predicted higher scores, while for children's aggressive behaviour, attention problems, and total externalizing behaviours, only mothers' probable depression predicted higher scores, controlling for sociodemographic, risk and protective factors.
CONCLUSIONS
While probable perinatal depression in mothers predicted 2 and 3 year-old children's behavioural problems, co-occurrence of depression in mothers and fathers had an increased association with internalizing behavioural problems, after considering sociodemographic, risk and protective factors. Health care providers are encouraged to consider the whole family in preventing and treating perinatal depression.
背景
产前和产后抑郁症状在孕妇和新妈妈、爸爸中很常见。本研究探讨了在共同育儿的母亲和父亲中，四种可能的围产期抑郁模式（母亲抑郁、父亲抑郁、父母双方抑郁、父母双方均不抑郁）与 24 个月和 36 个月儿童的内化和外化行为之间的关系。还研究了社会人口统计学、风险和保护因素的影响。
方法
在怀孕期间和产后 3 个月测量抑郁症状，在 24 个月和 36 个月时评估儿童的行为。家庭（n=634）提供了有关其子女内化（即情绪反应、焦虑/抑郁、躯体抱怨、退缩和总分）和外化（即注意力问题、攻击和总分）行为的数据。边缘模型用于确定两个时间点儿童行为与四种可能父母抑郁模式之间的关系。在这些模型中纳入了社会人口统计学变量以及风险（压力）和保护（社会支持）因素。
结果
在围产期，19.40%（n=123）的母亲和 10.57%（n=67）的父亲可能抑郁。在参与家庭中，有 6.31%（n=40）的父母双方都可能抑郁，而 63.72%（n=404）的父母双方都没有抑郁。对于儿童的情绪反应、退缩和内化总分，母亲可能的抑郁和母亲和父亲共同的可能抑郁都预示着更高的分数，而对于儿童的攻击行为、注意力问题和外化总分，只有母亲可能的抑郁预示着更高的分数，考虑到社会人口统计学、风险和保护因素。
结论
虽然母亲可能的围产期抑郁预测了 2 岁和 3 岁儿童的行为问题，但在考虑了社会人口统计学、风险和保护因素后，母亲和父亲共同发生的抑郁与内化行为问题的关联度更高。鼓励医疗保健提供者在预防和治疗围产期抑郁时考虑整个家庭。
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