Surkan Pamela J, Park Soim, Sheng Ziyue, Zaidi Ahmed, Atif Najia, Osborne Lauren M, Rahman Atif, Malik Abid
Department of International Health (PJ Surkan, S Park, and Z Sheng), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Department of International Health (PJ Surkan, S Park, and Z Sheng), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Acad Pediatr. 2025 Jan-Feb;25(1):102551. doi: 10.1016/j.acap.2024.07.018. Epub 2024 Aug 2.
Given that infant development is influenced by caregiver mental health, we tested whether an intervention to reduce antenatal anxiety could affect infant development. A secondary aim was to test depressive symptoms, maternal responsiveness, and maternal infant bonding as mediators of this relationship.
Between 2020 and 2022, pregnant women participated in a randomized controlled trial of the Happy Mother-Healthy Baby (HMHB) program based on cognitive behavioral therapy. We collected data on child development from 202 intervention and 198 control participants in a public hospital in Pakistan. Child development was measured using the Ages and Stages Questionnaires-Version 3 at six weeks postpartum. Using intent-to-treat analyses, we examined whether the intervention was associated with performance on the five ASQ-3 domains. Causal mediation analysis was used to assess depressive symptoms, bonding, and maternal-infant responsiveness as mediators.
Socio-demographic characteristics were evenly distributed between study arms. Intervention arm infants showed a 2.1-point increase (95% CI: 0.12, 4.17) in communication scores compared to controls. Though not achieving statistical significance, intervention infants also showed a 2.0-point increase (95% CI: -0.06, 4.09) in gross motor development performance. Bonding, depression, and responsiveness were mediators between the intervention and infant communication (B=1.94 (95% CI: 0.86, 3.25) depression; B= 0.57 (95% CI: 0.09, 1.16) bonding; B= 0.53 (95% CI: 0.01, 1.21) and responsiveness (B= 1.94 (95% CI: 0.86, 3.25)). Bonding, responsiveness, and depression mediated 25%, 23%, and 87% of the total association, respectively.
HMHB positively affected infant communication at six-week follow-up. Larger studies with longer follow-up are needed to confirm and extend these findings.
ClinicalTrials.gov NCT03880032; https://clinicaltrials.gov/ct2/show/NCT03880032.
鉴于婴儿发育受照料者心理健康的影响，我们测试了一项减轻产前焦虑的干预措施是否会影响婴儿发育。第二个目标是测试抑郁症状、母亲反应性和母婴联结作为这种关系的中介因素。
在2020年至2022年期间，孕妇参与了一项基于认知行为疗法的“快乐母亲-健康宝宝”（HMHB）项目的随机对照试验。我们从巴基斯坦一家公立医院的202名干预组参与者和198名对照组参与者中收集了儿童发育数据。在产后六周使用《年龄与阶段问卷》第三版来测量儿童发育情况。采用意向性分析，我们研究了该干预措施是否与五个ASQ-3领域的表现相关。使用因果中介分析来评估抑郁症状、联结和母婴反应性作为中介因素。
社会人口学特征在研究组间分布均匀。与对照组相比，干预组婴儿的沟通得分提高了2.1分（95%置信区间：0.12，4.17）。尽管未达到统计学显著性，但干预组婴儿的大运动发育表现也提高了2.0分（95%置信区间：-0.06，4.09）。联结、抑郁和反应性是干预与婴儿沟通之间的中介因素（抑郁：B=1.94（95%置信区间：0.86，3.25）；联结：B=0.57（95%置信区间：0.09，1.16）；反应性：B=0.53（95%置信区间：0.01，1.21））。联结、反应性和抑郁分别介导了总关联的25%、23%和87%。
在六周随访时，HMHB对婴儿沟通有积极影响。需要进行更大规模、更长随访期的研究来证实和扩展这些发现。
ClinicalTrials.gov NCT03880032；https://clinicaltrials.gov/ct2/show/NCT03880032 。
