Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy.
Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy.
J Affect Disord. 2022 Feb 1;298(Pt A):182-189. doi: 10.1016/j.jad.2021.10.080. Epub 2021 Oct 30.
Preterm birth has been recognized as a risk factor for perinatal depression (PND), with consequences for parenting and child development; however, the impact of severity of prematurity on parental PND course has not been studied extensively. Exploring the PND trajectory across postpartum period, investigating whether it changed according to birth weight and parental role, can help developing effective interventions.
At 3 (T1), 9 (T2) and 12 (T3) months postpartum, the Edinburgh Postnatal Depression Scale (EPDS) was administered to 177 parental couples, differentiated in 38 parents of extremely low birth weight (ELBW), 56 of very low birth weight (VLBW) and 83 of full-term (FT) infants. Trajectories were modeled by Growth Curve Models.
As a function of time, results revealed a general decrease in PND across the year. Considering birth weight, ELBW parents showed higher PND levels at T1 and a higher reduction of symptoms over time than VLBW and FT ones. Given also parental role, ELBW mothers showed higher PND levels at T1 and a higher decrease of symptoms over time than VLBW and FT mothers and fathers.
Limitations included modest sample size, self-report measures, and unmeasured potential confounders.
Findings suggest that premature birth in relation to its severity may lead to different affective reactions in mothers and fathers; particularly mothers, in case of more serious preterm condition, are at higher risk for PND in the first trimester, however showing improvement over time. Interventions should be promoted, and tailored, according to the risk connected to severity of prematurity.
早产已被认为是围产期抑郁（PND）的一个风险因素，对育儿和儿童发展都有影响；然而，早产严重程度对父母 PND 病程的影响尚未得到广泛研究。探索整个产后期间的 PND 轨迹，研究其是否根据出生体重和父母角色而变化，可以帮助制定有效的干预措施。
在产后 3 个月（T1）、9 个月（T2）和 12 个月（T3），177 对父母夫妇接受了爱丁堡产后抑郁量表（EPDS）的评估，分为 38 名极低出生体重儿（ELBW）父母、56 名极低出生体重儿（VLBW）和 83 名足月产（FT）婴儿的父母。采用增长曲线模型对轨迹进行建模。
随着时间的推移，结果显示 PND 在一年内普遍下降。考虑到出生体重，ELBW 父母在 T1 时 PND 水平较高，且随时间的推移症状减轻程度较高，而 VLBW 和 FT 父母则较低。考虑到父母角色，ELBW 母亲在 T1 时 PND 水平较高，且随时间的推移症状减轻程度较高，而 VLBW 和 FT 母亲和父亲则较低。
研究的局限性包括样本量适中、自我报告的测量方法以及未测量的潜在混杂因素。
研究结果表明，早产及其严重程度可能导致母亲和父亲的情绪反应不同；特别是在更严重的早产情况下，母亲在孕早期患 PND 的风险更高，但随着时间的推移，情况会有所改善。应根据与早产严重程度相关的风险来促进和定制干预措施。
