Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA.
Department of Psychology, University of Southern California, Los Angeles, CA, 90089, USA.
BMC Pediatr. 2024 Oct 28;24(1):682. doi: 10.1186/s12887-024-05113-2.
A growing body of literature links prenatal mood and substance use to children's cognitive and behavioral development. The relative contribution of these risk factors on children's executive function (EF) in the context of socioeconomic adversities needs further evaluation. To address this gap, we investigated the role of prenatal maternal anxiety and depression on childhood EF, specifically inhibitory control and working memory, within the context of socioeconomic adversities and prenatal substance use. We hypothesized that higher maternal mood symptoms, higher persistent prenatal drinking and smoking, and lower socioeconomic status would be associated with lower EF skills during early childhood.
We used data from 334 mother-child dyads followed prospectively through pregnancy and the offspring's childhood. Prenatal maternal depression and anxiety were assessed via standardized questionnaires. Prenatal alcohol and tobacco consumption were assessed via a timeline follow-back interview. The EF touch battery assessed child inhibitory control and working memory at 3-5 years of age (4.76 ± 0.58 years, 171 females). Separate linear regression models were used to estimate the association of prenatal tobacco, alcohol, anxiety, and depression exposure with our two components of child EF, inhibitory control and working memory, while adjusting for gestational age, sex, and age at assessment. The following variables were also included as covariates: maternal educational achievement, employment status, parity, and household crowding index.
Children of mothers with high trait anxiety scores had reduced inhibitory control compared to children of mothers without trait anxiety or depression (β = -0.12, 95% CI:-0.22,-0.01). Children of mothers in the moderate to high continuous smoking group showed lower inhibitory control (β = - 0.19, 95% CI:-0.38,-0.01) compared to children of mothers in the none smoking group. Additionally, lower maternal education and higher household crowding were each associated with reduced inhibitory control. We found no significant association between prenatal maternal depression, anxiety, or socioeconomic factors with working memory.
These results underscore the need for comprehensive context-specific intervention packages, including mental health support for women to promote healthy inhibitory control development in children.
越来越多的文献将产前情绪和物质使用与儿童的认知和行为发展联系起来。在社会经济逆境的背景下，这些风险因素对儿童执行功能（EF）的相对贡献需要进一步评估。为了解决这一差距，我们调查了产前母亲焦虑和抑郁对儿童 EF 的作用，特别是在社会经济逆境和产前物质使用的情况下，对儿童抑制控制和工作记忆的作用。我们假设，较高的母亲情绪症状、较高的持续产前饮酒和吸烟以及较低的社会经济地位与儿童早期较低的 EF 技能相关。
我们使用了 334 对母婴对子的前瞻性数据，这些母婴对子在孕期和子女的儿童期都得到了跟踪。产前母亲的抑郁和焦虑通过标准化问卷进行评估。产前酒精和烟草消费通过时间线回溯访谈进行评估。EF 触摸电池在 3-5 岁时评估儿童的抑制控制和工作记忆（4.76±0.58 岁，女性 171 名）。使用线性回归模型来估计产前烟草、酒精、焦虑和抑郁暴露与我们的儿童 EF 两个组成部分（抑制控制和工作记忆）之间的关联，同时调整胎龄、性别和评估年龄。还将以下变量作为协变量包括在内：母亲的教育成就、就业状况、生育次数和家庭拥挤指数。
与没有特质焦虑或抑郁的母亲的孩子相比，具有高特质焦虑评分的母亲的孩子的抑制控制能力降低（β=-0.12，95%置信区间：-0.22，-0.01）。与不吸烟的母亲相比，处于中至高连续吸烟组的母亲的孩子的抑制控制能力较低（β=-0.19，95%置信区间：-0.38，-0.01）。此外，较低的母亲教育和较高的家庭拥挤程度都与抑制控制能力降低有关。我们没有发现产前母亲抑郁、焦虑或社会经济因素与工作记忆之间存在显著关联。
这些结果强调了需要制定全面的具体情况干预方案，包括为妇女提供心理健康支持，以促进儿童健康的抑制控制发展。
