母婴产后抑郁轨迹对婴儿社会情感发展的影响。
Impact of trajectories of maternal postpartum depression on infants' socioemotional development.
机构信息
Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713GZ, Groningen, the Netherlands.
Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
出版信息
Pediatr Res. 2024 Jul;96(2):519-524. doi: 10.1038/s41390-023-02697-w. Epub 2023 Jun 19.
BACKGROUND
We assessed (a) the effects of postpartum depression (PPD) trajectories until 6 months postpartum on infants' socioemotional development (SED) at age 12 months, and (b) the mediating role of maternal self-efficacy (MSE), and the additional effect of postpartum anxiety at age 12 months.
METHODS
We used data from POST-UP trial (n = 1843). PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 1, 3, and 6 months. Infants' SED was assessed at 12 months using the Ages and Stages Questionnaire-Social-Emotional (ASQ-SE). Structural equations were applied to estimate the effect of PPD trajectories on infants' SED and mediation by MSE. The additional effects of postpartum anxiety were assessed with conditional regression.
RESULTS
Higher levels of PPD over time were associated with a lower SED (coefficient for log-EPDS 3.5, 95% confidence interval 2.8; 4.2, e.g., an increase in the EPDS score from 9 to 13 worsens the ASQ-SE by 1.3 points). About half of this relationship was mediated by MSE. Postpartum anxiety had an independent adverse effect on SED.
CONCLUSIONS
PPD and postpartum anxiety have a negative impact on infants' SED. MSE as a mediator may be a potential target for preventive interventions to alleviate the negative effects of maternal psychopathology on infants' SED.
IMPACT
The trajectories of postpartum depression (PPD) from 1 month to 6 months were negatively related to infants' socioemotional development (SED) at age 12 months, underlining the importance of repeated assessment of PPD. Maternal self-efficacy (MSE) mediated the association between PPD and SED, implying MSE could be a potential target for preventive interventions. An additional independent negative effect of postpartum anxiety was identified, implying the assessment of postpartum anxiety also has a surplus value to identify mothers at risk.
背景
我们评估了（a）产后抑郁症（PPD）轨迹直至产后 6 个月对婴儿 12 个月时社会情感发育（SED）的影响，以及（b）母亲自我效能感（MSE）的中介作用，以及产后 12 个月时焦虑的附加影响。
方法
我们使用 POST-UP 试验的数据（n=1843）。产后抑郁症使用爱丁堡产后抑郁量表（EPDS）在 1、3 和 6 个月时进行评估。婴儿的 SED 在 12 个月时使用年龄和阶段问卷-社会情感（ASQ-SE）进行评估。结构方程用于估计 PPD 轨迹对婴儿 SED 的影响以及 MSE 的中介作用。产后焦虑的附加影响通过条件回归进行评估。
结果
随着时间的推移，PPD 水平越高，SED 越低（log-EPDS 系数为 3.5，95%置信区间为 2.8；4.2，例如，EPDS 评分从 9 增加到 13，ASQ-SE 降低 1.3 分）。这种关系约有一半是通过 MSE 介导的。产后焦虑对 SED 有独立的不良影响。
结论
PPD 和产后焦虑对婴儿的 SED 有负面影响。作为中介的 MSE 可能是减轻产妇精神病理学对婴儿 SED 负面影响的潜在干预目标。
影响
1 个月至 6 个月的产后抑郁症（PPD）轨迹与 12 个月时婴儿的社会情感发育（SED）呈负相关，强调了对 PPD 进行反复评估的重要性。母亲自我效能感（MSE）介导了 PPD 和 SED 之间的关联，这意味着 MSE 可能是预防干预的潜在目标。还确定了产后焦虑的额外独立负向影响，这意味着评估产后焦虑也具有识别高危母亲的附加价值。
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