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孕期母亲心理健康与儿童心理及行为障碍:一项前瞻性妊娠队列研究。

Positive maternal mental health during pregnancy and mental and behavioral disorders in children: A prospective pregnancy cohort study.

作者信息

Lähdepuro Anna, Lahti-Pulkkinen Marius, Pyhälä Riikka, Tuovinen Soile, Lahti Jari, Heinonen Kati, Laivuori Hannele, Villa Pia M, Reynolds Rebecca M, Kajantie Eero, Girchenko Polina, Räikkönen Katri

机构信息

Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.

Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.

出版信息

J Child Psychol Psychiatry. 2023 May;64(5):807-816. doi: 10.1111/jcpp.13625. Epub 2022 May 6.

Abstract

BACKGROUND

The role of positive maternal mental health during pregnancy in child mental health remains largely unknown. We investigated whether positive maternal mental health during pregnancy is associated with lower hazards of mental and behavioral disorders in children and mitigates the adverse effects of negative maternal mental health.

METHODS

Among 3,378 mother-child dyads of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study, mothers reported their positive mental health biweekly throughout pregnancy with the Positive and Negative Affect Schedule, the Spielberger State Anxiety Inventory Curiosity scale, and a visual analogue scale for social support, and negative mental health with the Center for Epidemiologic Studies Depression Scale. We extracted data on their mental and behavioral disorder diagnoses from a nationwide medical register. This register provided data on their children's mental and behavioral disorder diagnoses as well, from birth until 8.4-12.8 (Median = 10.2, Interquartile Range 9.7-10.8) years of age.

RESULTS

A positive maternal mental health composite score during pregnancy was associated with a lower hazard of any mental and behavioral disorder among all children [Hazard Ratio (HR) = 0.79, 95% Confidence Interval (CI) 0.71 - 0.87] and among children of mothers experiencing clinically relevant depressive symptoms during pregnancy [HR = 0.80, 95%CI 0.64 - 1.00] and/or mental and behavioral disorders before or during pregnancy [HR = 0.69, 95%CI 0.55-0.86]. These associations were independent of covariates.

CONCLUSIONS

Children whose mothers had more positive mental health during pregnancy were less likely to develop mental and behavioral disorders. Protective effects were seen also among children of mothers facing mental health adversities before or during pregnancy.

摘要

背景

孕期母亲心理健康状况良好对儿童心理健康的作用在很大程度上仍不明确。我们调查了孕期母亲心理健康状况良好是否与儿童出现心理和行为障碍的风险较低相关,以及是否能减轻母亲心理健康状况不佳所带来的不利影响。

方法

在先兆子痫和宫内生长受限预测与预防研究的3378对母婴中,母亲们在整个孕期每两周报告一次她们的心理健康状况,使用正负性情绪量表、斯皮尔伯格状态焦虑量表好奇心分量表以及社会支持视觉模拟量表来评估积极心理健康状况,使用流行病学研究中心抑郁量表来评估消极心理健康状况。我们从全国医疗登记系统中提取了她们心理和行为障碍诊断的数据。该登记系统还提供了她们孩子从出生到8.4 - 12.8岁(中位数 = 10.2,四分位间距9.7 - 10.8)心理和行为障碍诊断的数据。

结果

孕期母亲心理健康综合得分较高与所有儿童出现任何心理和行为障碍的风险较低相关[风险比(HR)= 0.79,95%置信区间(CI)0.71 - 0.87],与孕期出现临床相关抑郁症状的母亲的孩子[HR = 0.80,95%CI 0.64 - 1.00]以及/或者孕期前或孕期出现心理和行为障碍的母亲的孩子[HR = 0.69,95%CI 0.55 - 0.86]出现心理和行为障碍的风险较低相关。这些关联独立于协变量。

结论

母亲在孕期心理健康状况更积极的孩子患心理和行为障碍的可能性较小。在孕期前或孕期面临心理健康问题的母亲的孩子中也观察到了保护作用。

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