University College Cork, Cork, Ireland
Department of Paediatrics and Child Health, University College Cork, Cork, Ireland; and The Irish Centre for Maternal and Child Health Research (INFANT), Cork University Hospital, Cork, Ireland
Rural Remote Health. 2023 Jan;23(1):8126. doi: 10.22605/RRH8126. Epub 2023 Jan 10.
Maternal mental illness has a significant influence on negative maternal and childhood outcomes. Few studies have focused on both maternal depression and anxiety, or explored the interplay of maternal mental illness and the mother-infant bond. We aimed to examine the relationship between early postnatal attachment and mental illness at 4 and 18 months postpartum.
This was a secondary analysis of 168 mothers recruited from the BabySmart Study. All women delivered healthy term infants. Depression and anxiety symptoms were measured via the Edinburgh Postnatal Depression Scale (EPDS) and Beck's Depression and Anxiety Inventory at 4 and 18 months respectively. Maternal Postnatal Attachment Scale (MPAS) was completed at 4 months. Negative binomial regression analysis investigated associated risk factors at both time points.
The prevalence of postpartum depression fell from 12.5% at 4 months to 10.7% at 18 months. Anxiety rates increased from 13.1% to 17.9% at similar time points. At 18 months, both symptoms were new in almost two-thirds of women, 61.1% and 73.3% respectively. There was a strong correlation between the anxiety scale of the EPDS and the total EPDS p-score (R=0.887, p<0.001). Early postpartum anxiety was an independent risk factor for later anxiety and depression. High attachment scores were an independent protective factor for depression at 4 months (RR=0.943, 95%CI: 0.924-0.962, p<0.001) and 18 months (RR=0.971, 95%CI: 0.949-0.997, p=0.026), and protected against early postpartum anxiety (RR=0.952, 95%CI: 0.933-0.97, p<0.001).
The prevalence of postnatal depression at 4 months was similar to national and international rates, although clinical anxiety increased over time with almost 1 in 5 women scoring in the clinical anxiety range at 18 months. Strong maternal attachment was associated with decreased reported symptoms of both depression and anxiety. The effect of persistent maternal anxiety on maternal and infant health needs to be determined.
产妇精神疾病对母婴不良结局有重大影响。很少有研究同时关注产妇抑郁和焦虑，或探讨产妇精神疾病与母婴纽带的相互作用。我们旨在探讨产后 4 个月和 18 个月时母婴早期依恋与精神疾病之间的关系。
这是对来自 BabySmart 研究的 168 名母亲进行的二次分析。所有女性均产下健康足月婴儿。分别在产后 4 个月和 18 个月时使用爱丁堡产后抑郁量表（EPDS）和贝克抑郁和焦虑量表测量抑郁和焦虑症状。在产后 4 个月时完成母亲产后依恋量表（MPAS）。使用负二项回归分析在两个时间点探讨相关危险因素。
产后抑郁的患病率从 4 个月时的 12.5%降至 18 个月时的 10.7%。焦虑率在相似的时间点从 13.1%上升到 17.9%。在 18 个月时，几乎三分之二的女性（分别为 61.1%和 73.3%）出现新的抑郁和焦虑症状。EPDS 焦虑量表与 EPDS 总分 p 评分之间具有很强的相关性（R=0.887，p<0.001）。产后早期焦虑是以后出现焦虑和抑郁的独立危险因素。高依恋评分是 4 个月时（RR=0.943，95%CI：0.924-0.962，p<0.001）和 18 个月时（RR=0.971，95%CI：0.949-0.997，p=0.026）抑郁的独立保护因素，且能预防产后早期焦虑（RR=0.952，95%CI：0.933-0.97，p<0.001）。
产后 4 个月时的产后抑郁患病率与全国和国际水平相似，尽管随着时间的推移，临床焦虑呈上升趋势，18 个月时有近五分之一的女性出现临床焦虑。较强的母婴依恋与报告的抑郁和焦虑症状减少有关。持续性产妇焦虑对母婴健康的影响需要进一步确定。
