Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Victoria, Geelong, Australia.
Murdoch Children's Research Institute, Victoria, Parkville, Australia.
Arch Womens Ment Health. 2021 Jun;24(3):513-523. doi: 10.1007/s00737-020-01081-5. Epub 2020 Oct 27.
Early maternal-infant bonding problems are often forerunners of later emotional and behavioural difficulties. Interventions typically target the perinatal period but many risks may be established well before pregnancy. Here we examine the extent to which adolescent and young adult depression and anxiety symptoms predict perinatal maternal-infant bonding difficulties. The Victorian Intergenerational Health Cohort Study (VIHCS, est. 2006) is following offspring born to the Victorian Adolescent Health Cohort Study (VAHCS; est. 1992). VAHCS participants were assessed for depression and anxiety symptoms nine times during adolescence and young adulthood (age 14-29 years), and then contacted bi-annually (from age 29-35 years) to identify pregnancies. The Postpartum Bonding Questionnaire (PBQ) was administered to mothers at 2 and 12 months postpartum. A total of 395 women (606 infants) completed the 2-month and/or 12-month postpartum interviews. For most infants (64%), mothers had experienced depression and/or anxiety before pregnancy. Preconception depression and anxiety symptoms that persisted from adolescence into young adulthood predicted maternal-infant bonding problems at 2 months (β = 0.30, 95% CI 0.04, 0.55) and 12 months postpartum (β = 0.40, 95% CI 0.16, 0.63). Depression and anxiety symptoms occurring in young adulthood only, also predicted bonding problems at 12 months postpartum (β = 0.37, 95% CI 0.02, 0.71). Associations between preconception depression and anxiety symptoms and anxiety-related maternal-infant bonding problems at 12 months postpartum remained after adjustment for antenatal and concurrent postpartum depressive symptoms. This study puts forward a case for extending preconception health care beyond contraception and nutrition to a broader engagement in supporting the mental health of young women from adolescence.
早期母婴结合问题往往是后期情绪和行为困难的先兆。干预措施通常针对围产期，但许多风险可能在怀孕前很久就已经建立。在这里，我们研究了青少年和年轻成人的抑郁和焦虑症状在多大程度上预测围产期母婴结合困难。维多利亚代际健康队列研究（VIHCS，成立于 2006 年）正在跟踪维多利亚青少年健康队列研究（VAHCS；成立于 1992 年）中出生的后代。VAHCS 参与者在青少年和年轻成人时期（14-29 岁）进行了九次抑郁和焦虑症状评估，然后每两年联系一次（从 29-35 岁）以确定怀孕情况。产后结合问卷（PBQ）在产后 2 个月和 12 个月时对母亲进行了评估。共有 395 名妇女（606 名婴儿）完成了 2 个月和/或 12 个月的产后访谈。对于大多数婴儿（64%），母亲在怀孕前经历过抑郁和/或焦虑。从青少年期持续到成年早期的孕前抑郁和焦虑症状预测了产后 2 个月（β=0.30，95%CI 0.04，0.55）和 12 个月时的母婴结合问题（β=0.40，95%CI 0.16，0.63）。仅在成年早期出现的抑郁和焦虑症状也预测了产后 12 个月时的结合问题（β=0.37，95%CI 0.02，0.71）。在调整了产前和同时产后抑郁症状后，孕前抑郁和焦虑症状与产后 12 个月时与焦虑相关的母婴结合问题之间的关联仍然存在。这项研究提出了一个案例，即除了避孕和营养之外，将孕前保健扩展到更广泛地支持年轻女性从青少年时期开始的心理健康。
