Bind Rebecca H, Biaggi Alessandra, Bairead Aoife, Du Preez Andrea, Hazelgrove Katie, Waites Freddie, Conroy Susan, Dazzan Paola, Osborne Sarah, Pawlby Susan, Sethna Vaheshta, Pariante Carmine M
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
Minds In Mind, Ireland.
BJPsych Open. 2021 May 25;7(3):e100. doi: 10.1192/bjo.2021.52.
Little is known about the effects of depression before birth on the quality of the mother-infant interaction.
To understand whether depression, either in pregnancy or in lifetime before pregnancy, disrupts postnatal mother-infant interactions.
We recruited 131 pregnant women (51 healthy, 52 with major depressive disorder (MDD) in pregnancy, 28 with a history of MDD but healthy pregnancy), at 25 weeks' gestation. MDD was confirmed with the Structured Clinical Interview for DSM-IV Disorders. Neonatal behaviour was assessed at 6 days with the Neonatal Behavioural Assessment Scale, and mother-infant interaction was assessed at 8 weeks and 12 months with the Crittenden CARE-Index.
At 8 weeks and 12 months, dyads in the depression and history-only groups displayed a reduced quality of interaction compared with healthy dyads. Specifically, at 8 weeks, 62% in the depression group and 56% in the history-only group scored in the lowest category of dyadic synchrony (suggesting therapeutic interventions are needed), compared with 37% in the healthy group (P = 0.041); 48% and 32%, respectively, scored the same at 12 months, compared with 14% in the healthy group (P = 0.003). At 6 days, neonates in the depression and history-only groups exhibited decreased social-interactive behaviour, which, together with maternal socioeconomic difficulties, was also predictive of interaction quality, whereas postnatal depression was not.
Both antenatal depression and a lifetime history of depression are associated with a decreased quality of mother-infant interaction, irrespective of postnatal depression. Clinicians should be aware of this, as pregnancy provides an opportunity for identification and intervention to support the developing relationship.
关于出生前抑郁症对母婴互动质量的影响，人们了解甚少。
了解孕期或孕前一生中的抑郁症是否会破坏产后母婴互动。
我们招募了131名孕妇（51名健康孕妇、52名孕期患有重度抑郁症（MDD）的孕妇、28名有MDD病史但孕期健康的孕妇），妊娠25周时入组。采用《精神疾病诊断与统计手册》第四版障碍的结构化临床访谈来确诊MDD。在出生6天时，使用新生儿行为评估量表评估新生儿行为，在8周和12个月时，使用克里滕登关爱指数评估母婴互动。
在8周和12个月时，与健康的母婴二元组相比，抑郁症组和仅有病史组的母婴互动质量较低。具体而言，在8周时，抑郁症组62%的母婴二元组和仅有病史组中56%的母婴二元组在二元同步性最低类别中得分（表明需要治疗干预），而健康组为37%（P = 0.041）；在12个月时，这一比例分别为48%和32%，而健康组为14%（P = 0.003）。在出生6天时，抑郁症组和仅有病史组的新生儿社交互动行为减少，这与母亲的社会经济困难一起，也可预测互动质量，而产后抑郁症则不能。
无论产后抑郁症如何，产前抑郁症和抑郁症病史均与母婴互动质量下降有关。临床医生应意识到这一点，因为孕期为识别和干预提供了机会，以支持正在发展的母婴关系。
