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早发型父母产后抑郁、依恋模式和感知社会支持是否会影响早产儿的神经发育结局?

Do early parental postnatal depression, attachment style and perceived social support affect neurodevelopmental outcomes of premature infants?

机构信息

Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, Ankara, Turkey.

Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey.

出版信息

Infant Behav Dev. 2020 May;59:101444. doi: 10.1016/j.infbeh.2020.101444. Epub 2020 Mar 31.

DOI:10.1016/j.infbeh.2020.101444
PMID:32244071
Abstract

BACKGROUND

The birth of a premature infant is both a stressful event for both parents and associated with an increased rate of postnatal depression (PND). Additionally some mothers may have delayed feelings of attachment to their babies because of the medical procedures or possible medical complications. Social support is known as an important factor for well-being in the postnatal period. However there is scarce data about these factors for fathers. We aimed to identify the impact of parental PND, attachment style and social support on premature infant development considering the prematurity degree and risk groups.

METHODS

This prospective study was conducted by including 96 infants who were born preterm. Mothers and fathers were given Edinburgh Postnatal Depression Scale (EPDS), Adult Attachment Style Scale (AASS), and Multidimensional Scale of Perceived Social Support (MSPSS) to fill out when their infants' corrected age was 3 months. The developmental evaluation was conducted with Bayley III at the corrected 6 months and 18 months of age.

RESULTS

Postnatal depression scores were more in mothers than fathers, the rates of secure attachment and social support were similar between mothers and fathers. Factors associated with the neurodevelopmental outcomes including prematurity degree and risk groups, EPDS, AASS and MSPSS scores were analyzed for both parents. In multivariate analysis, fathers' depression scores were inversely associated with cognitive development (p = 0.030, R = 0.080, B=-0.283) and mothers' anxious/ambivalent attachment style was inversely associated with language development (p = 0.011, R = 0.108, B=-0.329) at the age of corrected 6 months old.

CONCLUSIONS

Our findings underscore that the efforts to improve developmental outcomes of premature infants should include parental well-being taking into account new fathers' depressive symptomatology and maternal anxious/ambivalent attachment.

摘要

背景

早产儿的出生对父母来说既是一件压力事件,也与产后抑郁(PND)的发生率增加有关。此外,一些母亲可能由于医疗程序或可能的医疗并发症而对婴儿的依恋感延迟。社会支持被认为是产后幸福感的重要因素。然而,关于父亲的这些因素的数据很少。我们旨在确定父母的 PND、依恋风格和社会支持对早产儿发育的影响,同时考虑早产儿的成熟度和风险群体。

方法

这项前瞻性研究纳入了 96 名早产儿。当婴儿的校正年龄为 3 个月时,母亲和父亲填写了爱丁堡产后抑郁量表(EPDS)、成人依恋风格量表(AASS)和多维感知社会支持量表(MSPSS)。在纠正 6 个月和 18 个月时进行了发育评估。

结果

母亲的产后抑郁评分高于父亲,母亲和父亲的安全依恋和社会支持率相似。对包括早产儿成熟度和风险群体、EPDS、AASS 和 MSPSS 评分在内的与神经发育结果相关的因素进行了分析。在多变量分析中,父亲的抑郁评分与认知发育呈负相关(p=0.030,R=0.080,B=-0.283),母亲的焦虑/矛盾依恋风格与语言发育呈负相关(p=0.011,R=0.108,B=-0.329)在纠正 6 个月时。

结论

我们的发现强调,为了改善早产儿的发育结果,应该考虑到新父亲的抑郁症状和母亲的焦虑/矛盾依恋,关注父母的幸福感。

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