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新冠疫情期间多种疾病及社会相关压力源对母婴心理健康的影响:来自巴基斯坦农村一个出生队列的研究结果

An examination of multiple illness and social related stressors during the COVID-19 pandemic on maternal and child mental health; findings from a birth cohort in rural Pakistan.

作者信息

Maselko Joanna, Collins Amanda, Baranov Victoria, Bhalotra Sonia, Escobar Carias Michelle S, Frost Allison, Haight Sarah C, Bibi Amina, Sikander Siham

机构信息

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.

Carolina Population Center, University of North Carolina, Chapel Hill, USA.

出版信息

BMC Public Health. 2025 Mar 18;25(1):1047. doi: 10.1186/s12889-025-22280-8.

Abstract

PURPOSE

In an effort to improve preparation for future pandemics, researchers continue to examine the myriad psychosocial pathways through which the COVID-19 pandemic impacted mental health. Moving beyond extant research on factors such as financial difficulties or social isolation, we present findings on two less documented pathways: (a) COVID illness and death within one's social network and (b) experiencing pandemic-related basic needs stressors, beyond financial difficulties, on the mental health of mothers and children in South Asia.

METHODS

Data come from the 2021-2022 wave of the Bachpan birth cohort (6-year-old children, n = 814 mother-child dyads) in rural Pakistan. Multivariable regressions were used to estimate the association between COVID illness/death among family/friend/community members and basic needs stressors (e.g. difficulties with food, housing, medical care) with 4 outcomes: maternal anxiety (GAD-7) and depression symptoms (PHQ-9), and child emotional/behavioral problems (SDQ-TD) and anxiety (SCAS).

RESULTS

Maternal mental health was independently predicted by illness within the mother's network and basic needs stressors, even after accounting for pre-pandemic socioeconomic status, depression, and pandemic-related financial stressors. Specifically, having a family member/friend who became ill was associated with 1.29 higher PHQ-9 scores (95% CI: 0.34, 2.24), compared to those who did not know anyone affected. Increased basic needs stressors were also associated with higher PHQ-9 and GAD-7 levels and children's behavioral/emotional problems and anxiety. Social network proximity to COVID illness/death was not associated with child mental health outcomes.

CONCLUSION

These findings provide evidence of additional pathways through which prolonged global events, like the pandemic, can have multigenerational mental health impacts.

摘要

目的

为努力改进对未来大流行的应对准备,研究人员继续研究新冠疫情影响心理健康的众多社会心理途径。除了现有关于经济困难或社会隔离等因素的研究,我们呈现了两条较少被记录的途径的研究结果:(a)个人社交网络中的新冠疾病和死亡情况,以及(b)南亚地区母亲和儿童在经历与疫情相关的基本需求压力源(除经济困难外)时的心理健康状况。

方法

数据来自巴基斯坦农村地区2021 - 2022年的巴赫潘出生队列(6岁儿童,n = 814对母婴)。采用多变量回归来估计家庭/朋友/社区成员中的新冠疾病/死亡情况与基本需求压力源(如食物、住房、医疗困难)与以下4个结果之间的关联:母亲焦虑(广泛性焦虑障碍量表 - 7,GAD - 7)、抑郁症状(患者健康问卷 - 9,PHQ - 9),以及儿童情绪/行为问题(优势与困难问卷 - 总分,SDQ - TD)和焦虑(儿童焦虑量表,SCAS)。

结果

即使在考虑了疫情前的社会经济地位、抑郁以及与疫情相关的经济压力源之后,母亲社交网络中的疾病和基本需求压力源仍能独立预测母亲的心理健康状况。具体而言,与不认识任何受影响者的母亲相比,有家庭成员/朋友生病的母亲PHQ - 9得分高出1.29(95%置信区间:0.34,2.24)。基本需求压力源增加也与更高的PHQ - 9和GAD - 7水平以及儿童的行为/情绪问题和焦虑相关。社交网络中与新冠疾病/死亡的接近程度与儿童心理健康结果无关。

结论

这些研究结果为长期的全球事件(如疫情)可能产生多代心理健康影响的其他途径提供了证据。

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