Liu Xiaoli, Yang Chenlu, Yang Yuning, Huang Xiaona, Wang Yinping, Gao Yaqing, Song Qiying, Wang Yan, Zhou Hong
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China.
PeerJ. 2021 Mar 30;9:e11060. doi: 10.7717/peerj.11060. eCollection 2021.
The associations among maternal depressive symptoms (MDS), mother-child interactions and early child development are poorly understood. This study aimed to explore the role of mother-child interactions on the associations between MDS and child development.
A cross-sectional study with a multistage sampling method was conducted in rural areas of Central and Western China. MDS, child development outcomes (communication, gross motor function, fine motor function, problem solving and personal social skills) and mother-child interactions were assessed by The Edinburgh Postpartum Depression Scale, the Chinese version of the Ages and Stages Questionnaires and the Multiple Indicator Cluster Surveys, respectively. Regression-based statistical mediation and moderation were conducted using the PROCESS macro for SPSS.
A total of 2,548 participants (mothers: 1,274; children: 1,274) were included in our analyses. MDS was negatively associated with child development outcomes and mother-child interactions partly mediated these associations. The proportion of the mediating effect of mother-child interactions was 7.7% for communication, 8.2% for gross motor, 10.3% for fine motor, 10.1% for problem-solving and 9.5% for personal social domains. In addition, the interaction effects of MDS and mother-child interactions on the communication domain were significant ( = 0.070, 95% CI 0.016, 0.124; = 0.011). The associations between MDS and child communication abilities were weaker at the high level (simple slope = -0.019, = - 0.458, = 0.647) of mother-child interactions than at the mean level (simple slope = -0.089, = - 3.190, = 0.002) and the low level (simple slope = -0.158, = - 4.231, < 0.001). Similar moderating effects were not observed in the other child development outcomes.
Our results suggest the important role of mother-child interactions on the associations between MDS and early childhood development. Due to the cross-sectional design of this study, these associations require further investigation in prospective studies.
目前对孕产妇抑郁症状（MDS）、母婴互动与儿童早期发育之间的关联了解甚少。本研究旨在探讨母婴互动在MDS与儿童发育关联中的作用。
在中国中西部农村地区采用多阶段抽样方法进行横断面研究。分别采用爱丁堡产后抑郁量表、中文版年龄与发育进程问卷和多指标类集调查对MDS、儿童发育结果（沟通、大运动功能、精细运动功能、问题解决和个人社交技能）及母婴互动进行评估。使用SPSS的PROCESS宏程序进行基于回归的统计中介和调节分析。
我们的分析共纳入2548名参与者（母亲1274名，儿童1274名）。MDS与儿童发育结果呈负相关，母婴互动部分介导了这些关联。母婴互动在沟通领域的中介效应比例为7.7%，大运动领域为8.2%，精细运动领域为10.3%，问题解决领域为10.1%，个人社交领域为9.5%。此外，MDS与母婴互动在沟通领域的交互效应显著（β = 0.070，95%CI 0.016，0.124；p = 0.011）。在母婴互动高水平（简单斜率 = -0.019，t = -0.458，p = 0.647）时，MDS与儿童沟通能力之间的关联比在平均水平（简单斜率 = -0.089，t = - 3.190，p = 0.002）和低水平（简单斜率 = -0.158，t = -4.231，p < 0.001）时更弱。在其他儿童发育结果中未观察到类似的调节效应。
我们的结果表明母婴互动在MDS与幼儿发育关联中起重要作用。由于本研究为横断面设计，这些关联需要在前瞻性研究中进一步探讨。
