Department of Pediatrics and Adolescent Medicine, Juntendo University, Tokyo, Japan; Department of Public Health, Juntendo University, Tokyo, Japan.
Department of Epidemiology and Public Health, University College London, London, United Kingdom.
J Affect Disord. 2021 Feb 1;280(Pt A):11-16. doi: 10.1016/j.jad.2020.10.073. Epub 2020 Nov 5.
Little is known about how mothers who report higher autistic traits face new parenthood. This study examined the association between antenatal non-clinical autistic traits and the risks of both postpartum depression (PPD) and child mistreatment at one-month postpartum and if these associations were mediated by preexisting social support.
Participants included 73,532 singleton mothers without histories of psychiatric conditions from the Japan Environment and Children's Study, a nationwide birth cohort. Autistic traits were measured during the second/third trimesters using the short-version of the Autism Quotient-Japanese version. Participants were classified into three groups (i.e., typical-range, moderate-range, and high-range). PPD was measured using the Japanese version of the Edinburgh Postnatal Depression Scale, while participants self-reported experiences of child mistreatment (i.e., hit or shake the child); both assessments were conducted at one-month postpartum. Individual social support was reported during pregnancy. Data analyses were conducted through Poisson regressions.
A total of 7,147 (9.7%) participants reported PPD, while 12,994 (17.7%) reported child mistreatment at one-month postpartum. Autistic traits were associated with increased PPD risk (adjusted-relative risk [aRR] =1.74, 95%CI=1.64-1.84 for moderate-range; aRR=2.33, 2.13-2.55 for high-range) and child mistreatment (aRR=1.19, 1.13-1.24 for moderate-range; aRR=1.39, 1.28-1.50 for high-range) independently of confounders. Social support mediated 26-31% of these associations for moderate/high-range groups (both risks).
Self-reported measurements were used.
Mothers who reported moderate-to-high autistic traits in the general population were vulnerable to PPD and newborn mistreatment at one-month postpartum, which was partially explained by the lack of social support during pregnancy.
对于报告具有较高自闭症特征的母亲如何迎接新的育儿生活，我们知之甚少。本研究旨在探讨产前非临床自闭症特征与产后一个月内产后抑郁症（PPD）和儿童虐待的风险之间的关联，并分析这些关联是否受到预先存在的社会支持的影响。
参与者来自日本环境与儿童研究的全国性出生队列，共纳入 73532 名无精神病史的单胎母亲。自闭症特征在妊娠第二/三阶段使用自闭症商数简表-日本版进行测量。参与者被分为三组（即典型范围、中范围和高范围）。产后抑郁症使用爱丁堡产后抑郁量表的日本版进行测量，而参与者自我报告了儿童虐待经历（即打或摇晃孩子）；这两个评估都是在产后一个月进行的。个体社会支持在妊娠期间进行报告。数据通过泊松回归进行分析。
共有 7147 名（9.7%）参与者报告了产后抑郁症，12994 名（17.7%）报告了产后一个月内的儿童虐待。自闭症特征与 PPD 风险增加相关（调整后的相对风险[aRR]为 1.74，95%CI=1.64-1.84，中范围；aRR=2.33，2.13-2.55，高范围）和儿童虐待（aRR=1.19，1.13-1.24，中范围；aRR=1.39，1.28-1.50，高范围），独立于混杂因素。社会支持为中/高范围组（两者的风险）解释了这些关联的 26-31%。
使用了自我报告的测量方法。
在普通人群中报告具有中至高自闭症特征的母亲在产后一个月内易患产后抑郁症和新生儿虐待，这部分原因是妊娠期间缺乏社会支持。
