Pedroso Jéssica, Buccini Gabriela, Venancio Sonia Isoyama, Pérez-Escamilla Rafael, Gubert Muriel Bauermann
Postgraduate Program in Human Nutrition, Center for Epidemiological Studies in Health and Nutrition - NESNUT, University of Brasilia, Brasilia, Brazil.
Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut.
Matern Child Nutr. 2020 Oct;16(4):e12997. doi: 10.1111/mcn.12997. Epub 2020 Apr 30.
We examined the association between household food insecurity and early child development and whether or not maternal depression and anxiety modifies this association. The cross-sectional study included 468 mother-infant pairs recruited at primary health centers of the Federal District, Brazil. Mothers answered a questionnaire that evaluated early child development (outcome), household food insecurity (independent variable), maternal depression and trait anxiety (effect modifiers). Variables were collected with validated questionnaires for the Brazilian population. Pearson's χ test and logistic regression analyses were conducted. Infants who lived in a moderate or severe food insecure household had 2.52 times (95% confidence interval [CI] [1.13, 5.65]) the odds of having early child development delays compared with infants in secure households. Maternal depression and anxiety modified the strength of association between household food insecurity and early child development, which is an innovative finding. Among infants with depressed mothers, those experiencing mild (adjusted odds ratio [aOR] 3.33, 95% CI [1.17, 9.46]) and moderate/severe household food insecurity (aOR 10.13, 95% CI [2.18, 47.10]) had higher odds of having early child development delays, compared with infants in food secure households. Among infants with both anxious and depressed mothers, these associations were even stronger for mild (aOR 4.69, 95% CI [1.41, 15.59]) and moderate/severe household food insecurity (aOR 16.07, 95% CI [2.70, 95.66]). In conclusion, household food insecurity is a risk factor for early child development delays, and this association is modified by maternal depression and anxiety. Future studies should evaluate the impact of intervention packages that address maternal depression and anxiety and household food insecurity on preventing early child development delays.
我们研究了家庭粮食不安全与儿童早期发育之间的关联,以及母亲的抑郁和焦虑是否会改变这种关联。这项横断面研究纳入了在巴西联邦区初级卫生中心招募的468对母婴。母亲们回答了一份评估儿童早期发育(结果)、家庭粮食不安全(自变量)、母亲抑郁和特质焦虑(效应修饰因素)的问卷。使用针对巴西人群的经过验证的问卷收集变量。进行了Pearson卡方检验和逻辑回归分析。与生活在粮食安全家庭的婴儿相比,生活在中度或重度粮食不安全家庭的婴儿出现儿童早期发育迟缓的几率高出2.52倍(95%置信区间[CI][1.13,5.65])。母亲的抑郁和焦虑改变了家庭粮食不安全与儿童早期发育之间的关联强度,这是一个创新性发现。在母亲抑郁的婴儿中,与粮食安全家庭的婴儿相比,经历轻度(调整优势比[aOR]3.33,95%CI[1.17,9.46])和中度/重度家庭粮食不安全(aOR10.13,95%CI[2.18,47.10])的婴儿出现儿童早期发育迟缓的几率更高。在母亲既焦虑又抑郁的婴儿中,对于轻度(aOR4.69,95%CI[1.41,15.59])和中度/重度家庭粮食不安全(aOR16.07,95%CI[2.70,95.66]),这些关联甚至更强。总之,家庭粮食不安全是儿童早期发育迟缓的一个风险因素,并且这种关联会因母亲的抑郁和焦虑而改变。未来的研究应该评估解决母亲抑郁和焦虑以及家庭粮食不安全问题的干预措施对预防儿童早期发育迟缓的影响。