Kleine I, Falconer S, Roth S, Counsell S J, Redshaw M, Kennea N, Edwards A D, Nosarti C
Centre for the Developing Brain, Faculty of Life Sciences & Medicine, King's College London, St Thomas' Hospital, London, SE1 7EH, UK.
Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
J Psychiatr Res. 2020 Dec;131:160-168. doi: 10.1016/j.jpsychires.2020.09.010. Epub 2020 Sep 14.
Maternal ante- and postnatal anxiety have been associated with children's socio-emotional development. Moreover, maternal anxiety has been studied as both a contributing factor and consequence of preterm birth, and children born preterm are more likely to develop behavioural problems compared to term-born controls. This study investigated the association between maternal anxiety measured soon after birth and mental health in 215 ex-preterm children, born at <33 weeks, who participated in the Evaluation of Preterm Imaging Study. Children were followed-up at a median age of 4.6 years (range 4.2-6.6), and received behavioural and cognitive evaluation. Maternal trait anxiety was assessed with the Spielberger State-Trait Anxiety Index at term corrected age. Primary outcome measures were children's Strengths and Difficulties Questionnaire (SDQ) and Social Responsiveness Scale 2 (SRS-2) scores, indicative of generalised psychopathology and autism symptomatology, respectively. IQ was assessed with the Wechsler Preschool and Primary Scales of Intelligence. The final sample, after excluding participants with missing data and multiple pregnancy (n = 75), consisted of 140 children (51.4% male). Results showed that increased maternal trait anxiety at term corrected age was associated with children's higher SDQ scores (β = 0.25, 95% CI 0.09-0.41, p = 0.003, f = 0.08) and SRS-2 scores (β = 0.15, 95% CI 0.02-0.28, p = 0.03, f = 0.04). Our findings indicate that children born preterm whose mothers are more anxious in the early postnatal period may show poorer mental health outcomes at pre-school age. Further research is needed to investigate preventative measures that can be offered to high-risk premature babies and their families.
孕产妇产前和产后焦虑与儿童的社会情感发展有关。此外，孕产妇焦虑已被作为早产的一个促成因素和后果进行研究，与足月儿相比，早产出生的儿童更有可能出现行为问题。本研究调查了215名出生孕周小于33周的早产儿童出生后不久测得的孕产妇焦虑与心理健康之间的关联，这些儿童参与了早产影像研究评估。儿童在中位年龄4.6岁（范围4.2 - 6.6岁）时接受随访，并接受行为和认知评估。在足月矫正年龄时，使用斯皮尔伯格状态 - 特质焦虑量表评估孕产妇特质焦虑。主要结局指标分别为儿童的长处与困难问卷（SDQ）和社会反应量表2（SRS - 2）得分，分别指示广泛性精神病理学和自闭症症状学。使用韦氏学前和小学智力量表评估智商。在排除数据缺失和多胎妊娠的参与者（n = 75）后，最终样本由140名儿童组成（51.4%为男性）。结果显示，足月矫正年龄时孕产妇特质焦虑增加与儿童更高的SDQ得分（β = 0.25，95%置信区间0.09 - 0.41，p = 0.003，f = 0.08）和SRS - 2得分（β = 0.15，95%置信区间0.02 - 0.28，p = 0.03，f = 0.04）相关。我们的研究结果表明，出生后早期母亲更焦虑的早产儿童在学龄前可能表现出更差的心理健康结果。需要进一步研究以调查可为高危早产婴儿及其家庭提供的预防措施。
