School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinargatan 18, Gothenburg, Sweden.
MARCH Center, London, School of Hygiene and Tropical Medicine , London, UK.
BMC Med. 2024 Jul 8;22(1):284. doi: 10.1186/s12916-024-03501-0.
Infant neurodevelopment in the first years after birth is determined by multiple factors, including parental care and maternal mental wellbeing. In this study, we aim to assess the impact of persistent maternal depressive symptoms during the first 3 months postpartum on infant neurodevelopment at 6 months.
Using a longitudinal cohort design, 1253 mother-infant pairs were followed up at 7, 45, and 90 days to assess postpartum depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS); infants were followed up at 6 months to assess neuro-developmental status using the WHO's Infant and Young Child Development (IYCD) tool. A generalized linear regression model was used to assess the association between persistent postpartum depressive symptoms and infant neurodevelopmental delay at 6 months. A generalized linear mixed model (GLMM) with a hospital as a random intercept was used to assess the persistent postpartum depressive symptoms with an IYCD score. Linear regression was used to compare the IYCD scores between exposure groups.
In the study population, 7.5% of mothers had persistent depressive symptoms, and 7.5% of infants had neurodevelopmental delay. Infants born to mothers with persistent depressive symptoms had a higher proportion of neurodevelopmental delay than infants born to women without persistent symptoms (48.6% vs 5.1%; p < 0.001). In the adjusted regression model, infants whose mothers had persistent depressive symptoms at 7, 45, and 90 days had a 5.21-fold increased risk of neurodevelopmental delay (aRR, 5.21; 95% CI, 3.17, 8.55). Mean scores in the motor domain (12.7 vs 15.2; p < 0.001) and language domain (6.4 vs 8.5; p < 0.001) were significant when a mother had persistent depression vs. no depression. Mean scores in the general behavioral domain (5.9 vs 10.4, p < 0.001) and the socio-emotional domain (15.4 vs 17.7; p < 0.001) were significantly different when a mother had persistent depression vs no persistent depression.
Our results suggest that 6-month-old infants are at higher risk for neurodevelopment delays if their mother reports persistent symptoms of depression from 7 to 90 days postpartum. The neurodevelopmental delay can be observed in all functional domains. Preventive intervention to reduce maternal postpartum depression may reduce the impact on infant developmental delay.
婴儿在出生后的头几年的神经发育受多种因素影响，包括父母的照顾和产妇的心理健康。在这项研究中，我们旨在评估产后前 3 个月持续存在的产妇抑郁症状对 6 个月大婴儿神经发育的影响。
使用纵向队列设计，1253 对母婴对在 7、45 和 90 天接受随访，使用爱丁堡产后抑郁量表（EPDS）评估产后抑郁症状；婴儿在 6 个月时接受随访，使用世界卫生组织的婴幼儿发育（IYCD）工具评估神经发育状况。使用广义线性回归模型评估产后持续抑郁症状与 6 个月时婴儿神经发育迟缓之间的关联。使用广义线性混合模型（GLMM），以医院为随机截距，评估具有 IYCD 评分的持续产后抑郁症状。线性回归用于比较暴露组之间的 IYCD 评分。
在研究人群中，7.5%的母亲有持续的抑郁症状，7.5%的婴儿有神经发育迟缓。与没有持续症状的母亲相比，患有持续抑郁症状的母亲所生的婴儿神经发育迟缓的比例更高（48.6%对 5.1%；p<0.001）。在调整后的回归模型中，在 7、45 和 90 天时母亲有持续抑郁症状的婴儿，神经发育迟缓的风险增加了 5.21 倍（ARR，5.21；95%CI，3.17，8.55）。当母亲有持续抑郁时，运动领域的平均得分（12.7 对 15.2；p<0.001）和语言领域的平均得分（6.4 对 8.5；p<0.001）显著低于没有抑郁的母亲。当母亲有持续抑郁时，一般行为领域的平均得分（5.9 对 10.4，p<0.001）和社会情感领域的平均得分（15.4 对 17.7；p<0.001）显著低于没有持续抑郁的母亲。
我们的研究结果表明，如果母亲在产后 7 至 90 天报告持续存在抑郁症状，6 个月大的婴儿患神经发育迟缓的风险更高。神经发育迟缓可在所有功能领域观察到。预防干预措施减少产妇产后抑郁可能会降低对婴儿发育迟缓的影响。
