Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Starship Child Health, Auckland District Health Board, Auckland, New Zealand.
Infant Ment Health J. 2020 Nov;41(6):770-782. doi: 10.1002/imhj.21870. Epub 2020 Jun 22.
Mother-Baby Unit research has focussed on maternal psychopathology over the course of an admission. Less is known about the baby's well-being, the shared relationship, or the mother's recovery. In an initial sample of 45 women, we describe discharge and post-discharge outcomes for maternal psychopathology (using maternal report and the Global Assessment of Function, GAF) and the mother-infant relationship (using the Child and Adult Relational Experimental Index, CARE Index). Three months post-discharge, one third of women described themselves as "completely recovered," one third were experiencing significant deterioration and 17% were readmitted to inpatient care. Poorer GAF scores were associated with a clinical diagnosis of comorbid personality disorder, antenatal presence of the index illness, partner illicit substance use, maternal perception of her bond, infant social withdrawal, and child protection concern. Post-discharge, the mother-infant relationship results were concerning. Only 17% were regarded as adequate. Improvement was observed across this period in 56% but relational deterioration occurred for 35%. Maternal and relational outcomes were weakly correlated at discharge (r² = 0.29, p = 0.07) but this was lost post-discharge (r² = 0.03, p = 0.89). The shared relationship and infant mental health should both be targets for intervention; both during MBU admission, and post-discharge.
母婴单位的研究主要集中在产妇发病过程中的精神病理学。对于婴儿的健康状况、母婴关系或母亲的康复情况了解较少。在最初的 45 名女性样本中，我们描述了产妇精神病理学（使用产妇报告和全球评估功能，GAF）和母婴关系（使用儿童和成人关系实验指数，CARE 指数）的出院和出院后结果。在出院后 3 个月，三分之一的女性表示自己“完全康复”，三分之一的女性经历了显著恶化，17%的女性再次入院接受住院治疗。较差的 GAF 评分与共病人格障碍的临床诊断、产前存在指数疾病、伴侣非法药物使用、母亲对自己联系的感知、婴儿社会退缩和儿童保护问题有关。出院后，母婴关系的结果令人担忧。只有 17%的人被认为是足够的。在此期间，有 56%的人观察到改善，但有 35%的人出现关系恶化。出院时，母亲和关系结果相关性较弱（r²=0.29，p=0.07），但出院后这种相关性消失（r²=0.03，p=0.89）。共享关系和婴儿心理健康都应该成为干预的目标；包括在母婴单位住院期间和出院后。
