Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.
Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
BMC Pregnancy Childbirth. 2024 May 2;24(1):336. doi: 10.1186/s12884-024-06483-2.
Childhood obesity has increased and is considered one of the most serious public health challenges of the 21 century globally, and may be exacerbated by postpartum depression (PPD). The purpose of this study was to examine the association between PPD at 1 and 6 month postpartum, infant feeding practices, and body mass index (BMI) z-score of the child at one and three years of age.
This study used data from an ongoing prospective maternal-child birth cohort performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan with the period of recruitment from May 13, 2010 to November 28, 2013. Out of 2,309 total number of mothers, 1,279 mother-child dyads were assessed in the study. We performed multivariable linear regression analysis to examine the association between PPD and child's BMI z-score stratified by the child's age at 1 year and 3 years of age.
The prevalence of PPD at 1 month postpartum (17%) was found to be higher than at 6 months (12%). In multivariable linear regression analysis we observed that children at 3 years who had mothers with PPD at 6 months had, on average, a BMI z-score 0.25 higher than children of mothers who did not have PPD at 6 months (ß coefficient 0.25, 95% CI [0.04 to 0.46], p value 0.02), holding all other covariates constant. Also, initiation of weaning food when child is at six months of age was associated with higher BMI z-score of the child at 3 years after adjusting for all covariates (ß coefficient = 0.18, 95% CI [0.03 to 0.34], p-value < 0.05).
The significant association between PPD at 6 months and child's BMI z-score at 3 years of age, in conjunction with birth trends and high prevalence of PPD, can add to the body of evidence that there is need for multiple assessment across the first postpartum year to rule out PPD as early screening and early interventions may benefit both maternal health and child development outcomes. These findings can indicate the need for establishing support systems for care-giving activities for mothers with PPD.
儿童肥胖症呈上升趋势,被认为是 21 世纪全球最严重的公共卫生挑战之一,而产后抑郁症 (PPD) 可能会使其恶化。本研究旨在探讨产后 1 个月和 6 个月时 PPD 与婴儿喂养方式以及儿童 1 岁和 3 岁时体重指数 (BMI) z 评分之间的关系。
本研究使用了日本东京都国立儿童健康与发展中心 (NCCHD) 正在进行的前瞻性母婴生育队列的数据,招募时间为 2010 年 5 月 13 日至 2013 年 11 月 28 日。在总共 2309 位母亲中,有 1279 对母婴被纳入研究。我们进行了多变量线性回归分析,以检查按儿童 1 岁和 3 岁时的年龄分层的 PPD 与儿童 BMI z 评分之间的关系。
我们发现,产后 1 个月时 PPD 的患病率(17%)高于产后 6 个月时(12%)。在多变量线性回归分析中,我们观察到,在 6 个月时患有 PPD 的母亲所生的 3 岁儿童的 BMI z 评分平均比 6 个月时未患有 PPD 的母亲所生的儿童高 0.25 (ß 系数 0.25,95%置信区间 [0.04 至 0.46],p 值 0.02),所有其他协变量保持不变。此外,在调整所有协变量后,当儿童 6 个月大时开始添加辅食与儿童 3 岁时的 BMI z 评分较高相关(ß 系数=0.18,95%置信区间 [0.03 至 0.34],p 值 <0.05)。
产后 6 个月时 PPD 与儿童 3 岁时 BMI z 评分之间的显著关联,加上生育趋势和 PPD 的高患病率,可以为以下观点提供更多证据,即需要在整个产后第一年进行多次评估,以排除 PPD,因为早期筛查和早期干预可能有益于母婴健康和儿童发育结果。这些发现表明,需要为患有 PPD 的母亲建立护理支持系统。