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母亲抑郁轨迹与婴儿八个月时神经发育的关联。

Associations between maternal depression trajectories and infant neurodevelopment at eight months.

机构信息

Shenzhen Birth Cohort Center, Nanshan Maternity & Child Healthcare Hospital of Shenzhen, Shenzhen 518067, China; Department of Science and Education, Nanshan Maternity & Child Healthcare Hospital of Shenzhen, Shenzhen 518067, China.

Department of Science and Education, Nanshan Maternity & Child Healthcare Hospital of Shenzhen, Shenzhen 518067, China.

出版信息

Early Hum Dev. 2024 Dec;199:106138. doi: 10.1016/j.earlhumdev.2024.106138. Epub 2024 Nov 1.

Abstract

BACKGROUND

Maternal depression is an increasingly recognized risk factor of child neurodevelopment difficulties. Few studies have investigated the association between the severity and duration of maternal depression and child development. We aimed to identify whether trajectories of maternal depressive symptoms from pregnancy to six months postpartum are associated with child development at eight months.

METHODS

We included 988 mother-child pairs who participated in Shenzhen Birth Cohort Study, which was conducted in Shenzhen Nanshan Maternity & Child Healthcare Hospital of China. Maternal depressive symptoms were evaluated by the Edinburgh Postnatal Depression Scale (EPDS) at late pregnancy, 1, 3 and 6 months postpartum. Child emotional and behavioral development were assessed by Ages and Stages Questionnaires: Social-Emotional (ASQ-se) and Ages and Stages Questionnaires-Third Edition (ASQ-3) at aged 8 months. Latent profile analysis (LPA) was used to identify the trajectories of maternal depressive symptoms. Univariate and multivariate linear regression were conducted to explore the association between the depressive symptoms trajectories and child development.

RESULTS

Four trajectories of maternal depressive symptoms were identified by LPA: low (n = 597), subclinical (n = 91), moderately low and increasing (n = 246) and persistently high (54). Multivariable regression model showed that children of mothers with persistently high depressive symptoms were more likely to have lower scores in three ASQ-3 domains: fine motor (beta [95%C]): -2.30 [-4.32, -0.29], problem-solving (-3.72 [-5.81, -1.62]) and personal-social motor (-2.56 [-4.98, -0.15]), but higher ASQ-se scores (9.49 [5.09, 13.9]). Compared to children of mothers with low depressive symptoms, subclinical depressive symptoms were prediposed to having lower scores in two ASQ-3 domains: communication motor (-2.48 [-4.32, -0.64]) and gross motor (-2.35 [-4.2,-0.51]) and lower ASQ-se scores(4.86 [2.54, 7.18]).

CONCLUSION

Higher levels of maternal depression symptoms were associated with increased risk of child developmental delay, highlighting the importance of early intervention and addressing maternal depression from pregnancy through early childhood.

摘要

背景

产妇抑郁是儿童神经发育困难的一个日益被认识到的风险因素。很少有研究调查产妇抑郁的严重程度和持续时间与儿童发育之间的关系。我们旨在确定从妊娠到产后 6 个月期间产妇抑郁症状的轨迹是否与 8 个月时的儿童发育有关。

方法

我们纳入了 988 对母婴对,他们参加了中国深圳出生队列研究,该研究在深圳市南山区妇幼保健院进行。在妊娠晚期、产后 1、3 和 6 个月时,采用爱丁堡产后抑郁量表(EPDS)评估产妇的抑郁症状。在 8 个月时,采用年龄和阶段问卷:社会情感(ASQ-se)和年龄和阶段问卷第三版(ASQ-3)评估儿童的情绪和行为发育。采用潜在剖面分析(LPA)识别产妇抑郁症状的轨迹。采用单变量和多变量线性回归探讨抑郁症状轨迹与儿童发育之间的关系。

结果

通过 LPA 确定了产妇抑郁症状的 4 种轨迹:低(n=597)、亚临床(n=91)、中低且增加(n=246)和持续高(n=54)。多变量回归模型显示,持续高抑郁症状母亲的孩子在三个 ASQ-3 领域的得分较低:精细运动(β[95%CI]):-2.30[-4.32,-0.29],解决问题(-3.72[-5.81,-1.62])和个人-社会运动(-2.56[-4.98,-0.15]),但 ASQ-se 得分较高(9.49[5.09,13.9])。与低抑郁症状母亲的孩子相比,亚临床抑郁症状更有可能在两个 ASQ-3 领域的得分较低:沟通运动(-2.48[-4.32,-0.64])和粗大运动(-2.35[-4.2,-0.51])和较低的 ASQ-se 得分(4.86[2.54,7.18])。

结论

产妇抑郁症状水平较高与儿童发育迟缓的风险增加相关,这突显了从妊娠到幼儿期早期干预和解决产妇抑郁的重要性。

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