坦桑尼亚艾滋病毒感染母亲的社会支持与产前抑郁症状对婴儿生长发育的关系。

Associations Between Social Support and Symptoms of Antenatal Depression with Infant Growth and Development Among Mothers Living with HIV in Tanzania.

机构信息

Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.

Tufts University School of Medicine, Boston, MA, USA.

出版信息

AIDS Behav. 2023 Nov;27(11):3584-3595. doi: 10.1007/s10461-023-04073-5. Epub 2023 May 4.

Abstract

Children born to mothers living with HIV may experience greater risk of poor growth and development outcomes than their HIV-unexposed peers. Few studies have examined the relationship between maternal depression and social support with infant growth and development in the context of HIV. We conducted a prospective cohort study of 2,298 pregnant women living with HIV in Dar es Salaam, Tanzania, assessing antenatal depression (Hopkins Symptoms Checklist-25) and social support (Duke-UNC Functional Social Support Questionnaire) at 12-27 weeks of gestation. At one-year age, infant anthropometry and caregiver-reported infant development were assessed. Generalized estimating equations were used to assess mean differences (MD) and relative risks (RR) for growth and developmental outcomes. Symptoms consistent with maternal antenatal depression had 67% prevalence and were associated with infant wasting (RR 2.61; 95% confidence interval (CI) 1.03-6.65; z = 2.02; p = 0.04), but no other growth or developmental outcomes. Greater maternal social support was not associated with infant growth outcomes. Greater affective support was associated with better cognitive (MD 0.18; CI 0.01-0.35; z = 2.14; p = 0.03) and motor (MD 0.16; CI 0.01-0.31; z = 2.04; p = 0.04) development scores. Greater instrumental support was associated with better cognitive (MD 0.26; CI 0.10-0.42; z = 3.15; p < 0.01), motor (MD 0.17; CI 0.02-0.33; z = 2.22; p = 0.03), and overall (MD 0.19; CI 0.03-0.35; z = 2.35; p = 0.02) development scores. Depressive symptoms were associated with greater risk of wasting, while social support was associated with better infant development scores. Strategies to improve mental health and social support for mothers living with HIV during the antenatal period may benefit infant growth and development.

摘要

与未感染 HIV 的婴儿相比,感染 HIV 的母亲所生的婴儿在生长和发育方面可能面临更大的风险。很少有研究在 HIV 背景下,研究产妇抑郁和社会支持与婴儿生长和发育之间的关系。我们在坦桑尼亚达累斯萨拉姆进行了一项针对 2298 名感染 HIV 的孕妇的前瞻性队列研究,在妊娠 12-27 周时评估产前抑郁(Hopkins 症状清单-25)和社会支持(杜克大学 UNC 功能社会支持问卷)。在一岁时,评估婴儿的人体测量学和照顾者报告的婴儿发育情况。使用广义估计方程评估生长和发育结果的平均差异(MD)和相对风险(RR)。符合产妇产前抑郁的症状有 67%的患病率,与婴儿消瘦有关(RR 2.61;95%置信区间(CI)1.03-6.65;z=2.02;p=0.04),但与其他生长或发育结果无关。母亲的社会支持增加与婴儿的生长结果无关。更多的情感支持与更好的认知(MD 0.18;CI 0.01-0.35;z=2.14;p=0.03)和运动(MD 0.16;CI 0.01-0.31;z=2.04;p=0.04)发育评分相关。更多的工具支持与更好的认知(MD 0.26;CI 0.10-0.42;z=3.15;p<0.01)、运动(MD 0.17;CI 0.02-0.33;z=2.22;p=0.03)和整体(MD 0.19;CI 0.03-0.35;z=2.35;p=0.02)发育评分相关。抑郁症状与消瘦风险增加有关,而社会支持与婴儿发育评分提高有关。在产前期间为感染 HIV 的母亲提供改善心理健康和社会支持的策略可能有益于婴儿的生长和发育。

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