Department of Psychology, University of Calgary, Calgary, Canada.
Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Canada.
Depress Anxiety. 2020 Jun;37(6):576-586. doi: 10.1002/da.23039. Epub 2020 May 17.
Maternal depression and anxiety have been associated with deleterious child outcomes. It is, however, unclear how the chronicity and timing of maternal mental health problems predict child development outcomes. The aim of the current study was to assess the effect of both chronicity and timing of maternal anxiety and depression in pregnancy, infancy, and the toddler period on children's internalizing and externalizing symptoms, as well as social and communication skills at age 5.
Participants were 1,992 mother-child pairs drawn from a large prospective pregnancy cohort. Mothers reported on anxiety and depression symptoms with clinical screening tools at six time points between <25 weeks gestation and 3 years postpartum. Child outcomes were assessed at age 5.
Effect sizes were small for brief incidents of depression/anxiety and increased for intermittent and chronic problems (i.e., three or more timepoints) compared with mothers who had never experienced clinical-level anxiety or depression. Maternal anxiety/depression during pregnancy, infancy, and toddlerhood predicted all child outcomes, even after controlling for depression/anxiety during the other timepoints. However, maternal anxiety and depression during toddlerhood had a stronger association with child internalizing/externalizing symptoms and communication skills than either prenatal or postpartum depression/anxiety.
Increasing number of exposures to clinical-level anxiety and depression is related to poorer child outcomes. Neither prenatal nor postpartum periods emerged as "sensitive" periods. Rather, maternal depression and anxiety during toddlerhood was more strongly associated with child outcomes at age 5. Results highlight the need for continued support for maternal mental health across early childhood.
母亲的抑郁和焦虑与儿童不良结局有关。然而，目前尚不清楚母亲心理健康问题的慢性和时间如何预测儿童发展结果。本研究的目的是评估孕期、婴儿期和幼儿期母亲焦虑和抑郁的慢性和时间对儿童内化和外化症状以及 5 岁时社交和沟通技能的影响。
参与者来自一个大型前瞻性妊娠队列中的 1992 对母婴对。母亲在妊娠 25 周前至产后 3 年内的六个时间点使用临床筛查工具报告焦虑和抑郁症状。在 5 岁时评估儿童的结果。
与从未经历过临床水平焦虑或抑郁的母亲相比，短暂的抑郁/焦虑发作的效应大小较小，而间歇性和慢性问题（即三个或更多时间点）的效应大小较大。孕期、婴儿期和幼儿期的母亲焦虑/抑郁预测了所有儿童结局，即使在控制了其他时间点的抑郁/焦虑后也是如此。然而，与孕期或产后的抑郁/焦虑相比，幼儿期母亲的焦虑和抑郁与儿童的内化/外化症状和沟通技能的相关性更强。
暴露于临床水平的焦虑和抑郁的次数增加与儿童结局较差有关。产前和产后期间都没有出现“敏感”期。相反，幼儿期母亲的抑郁和焦虑与 5 岁时的儿童结局更密切相关。结果强调了在整个儿童早期持续支持母亲心理健康的必要性。
