School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
Psychol Med. 2023 Apr;53(6):2437-2447. doi: 10.1017/S0033291721004311. Epub 2021 Nov 25.
Few studies have examined how parenting influences the associations between prenatal maternal stress and children's mental health. The objectives of this study were to examine the sex-specific associations between prenatal maternal stress and child internalizing and externalizing symptoms, and to assess the moderating effects of parenting behaviors on these associations.
This study is based on 15 963 mother-child dyads from the Norwegian Mother, Father, and Child Cohort Study (MoBa). A broad measure of prenatal maternal stress was constructed using 41 self-reported items measured during pregnancy. Three parenting behaviors (positive parenting, inconsistent discipline, and positive involvement) were assessed by maternal report at child age 5 years. Child symptoms of internalizing and externalizing disorders (depression, anxiety, attention-deficit hyperactivity disorder, conduct disorder, and oppositional-defiant disorder) were assessed by maternal report at age 8. Analyses were conducted using structural equation modeling techniques.
Prenatal maternal stress was associated with child internalizing and externalizing symptoms at age 8; associations with externalizing symptoms differed by sex. Associations between prenatal maternal stress and child depression, and conduct disorder and oppositional-defiant disorder in males, became stronger as levels of inconsistent discipline increased. Associations between prenatal maternal stress and symptoms of attention-deficit hyperactivity disorder in females were attenuated as levels of parental involvement increased.
This study confirms associations between prenatal maternal stress and children's mental health outcomes, and demonstrates that these associations may be modified by parenting behaviors. Parenting may represent an important intervention target for improving mental health outcomes in children exposed to prenatal stress.
很少有研究探讨父母教养方式如何影响产前母亲压力与儿童心理健康之间的关系。本研究的目的是检验产前母亲压力与儿童内化和外化症状之间的性别特异性关联，并评估教养行为对这些关联的调节作用。
本研究基于挪威母婴队列研究（MoBa）中的 15963 对母婴对子。使用怀孕期间报告的 41 项自我报告项目构建了产前母亲压力的广泛衡量标准。通过母亲在孩子 5 岁时的报告评估了三种教养行为（积极教养、不一致的纪律和积极参与）。通过母亲在孩子 8 岁时的报告评估了儿童内化和外化障碍（抑郁、焦虑、注意缺陷多动障碍、品行障碍和对立违抗性障碍）的症状。使用结构方程建模技术进行分析。
产前母亲压力与儿童 8 岁时的内化和外化症状相关；与外化症状的关联因性别而异。在男性中，产前母亲压力与抑郁、品行障碍和对立违抗性障碍的关联随着不一致纪律水平的增加而增强。在女性中，产前母亲压力与注意缺陷多动障碍症状的关联随着父母参与水平的增加而减弱。
本研究证实了产前母亲压力与儿童心理健康结果之间的关联，并表明这些关联可能受到教养行为的调节。教养行为可能是改善暴露于产前压力的儿童心理健康结果的重要干预目标。
