孕晚期抑郁与婴儿气质发育关联的随访研究
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摘要
目的探讨孕32～36周高水平抑郁情绪对婴儿气质发育的影响。方法以741名孕32～36周进行产前检查的孕妇为研究对象,采用自制问卷获得人口统计学信息,并使用流调中心用抑郁自评量表(CES-D)进行抑郁情绪筛查。产妇分娩后收集分娩结局资料。在产后6个月时进行家庭访视,应用婴儿气质量表评估婴儿气质发育。结果抑郁组母亲中,低年龄、低教育水平、分娩女婴和产后人工喂养比例均高于无抑郁组。控制潜在混杂因素后,抑郁组婴儿6月龄时,适应性(差值=0.33, 95%CI:0.16～0.51, P=0.001)、情绪(差值=0.31, 95%CI:0.006～0.614, P=0.047)、注意分散(差值=0.29, 95%CI:0.13～0.45, P=0.002)和反应阈(差值=0.28, 95%CI:0.02～0.54, P=0.028)4个维度的得分均高于无抑郁组母亲的婴儿。结论孕晚期抑郁情绪可能与婴儿气质发育间存在独立关联。
Objective The aim of this study was to investigate the effect of high-level depression in 32 to 36 weeks of pregnancy on the development of infants’ temperament. Methods A total of 471 pregnant women who were pregnant for 32 to 36 weeks were enrolled in the study. The self-made questionnaire was used to obtain the demographic information, and the De-pression Self-Rating Scale(CES-D) was used to conduct depression screening. Childbirth outcomes were collected after childbirth. Breastfeeding and infant temperament questionnaires were conducted by telephone follow-up at 6 months postpartum. Results The proportions of low age, low education, childbirth, and artificial feeding at 4 months postpartum were significantly higher in the depressed group than those in the non-depression group. After controlling for potential confounding factors, the infants of the mothers in the depressed group had significantly higher scores in the dimensions of temperament,mood, distraction, and response thresholds at 6 months than infants without mothers with depression. The differences were statistically significant(P<0.05). Conclusion High-level depression in the third trimester can independently affect the development of the infant’s temperament.
Objective The aim of this study was to investigate the effect of high-level depression in 32 to 36 weeks of pregnancy on the development of infants’ temperament. Methods A total of 471 pregnant women who were pregnant for 32 to 36 weeks were enrolled in the study. The self-made questionnaire was used to obtain the demographic information, and the De-pression Self-Rating Scale(CES-D) was used to conduct depression screening. Childbirth outcomes were collected after childbirth. Breastfeeding and infant temperament questionnaires were conducted by telephone follow-up at 6 months postpartum. Results The proportions of low age, low education, childbirth, and artificial feeding at 4 months postpartum were significantly higher in the depressed group than those in the non-depression group. After controlling for potential confounding factors, the infants of the mothers in the depressed group had significantly higher scores in the dimensions of temperament,mood, distraction, and response thresholds at 6 months than infants without mothers with depression. The differences were statistically significant(P<0.05). Conclusion High-level depression in the third trimester can independently affect the development of the infant’s temperament.
引文
[1]Zohsel K,Holz NE,Hohm E,et al.Fewer self-reported depressive symptoms in young adults exposed to maternal depressed mood during pregnancy[J].Journal of Affective Disorders,2017,209:155-162.
[2]宫相君.孕期心理应激、环境铅暴露对胎婴儿神经系统发育影响的研究进展[J].卫生研究,2011,40(1):133-136.
[3]Glynn LM,Howland MA,Sandman CA,et al.Prenatal maternal mood patterns predict child temperament and adolescent mental health[J].Journal of Affective Disorders,2018,228:83-90.
[4]石淑华,戴耀华.儿童保健学[M].3版.北京:人民卫生出版社,2014:101-110.
[5]Zhu P,Tao FB,Hao JH,et al.Prenatal Life events stress:implications for preterm birth and infant birthweight[J].American Journal of Obstetrics and Gynecology,2010,203(1):e31-e34.
[6]何津,陈祉妍,郭菲,等.流调中心抑郁量表中文简版的编制[J].中华行为医学与脑科学杂志,2013,22(12):1133-1136.
[7]翁婷婷,严双琴,王琼瑶,等.父母产后抑郁与婴儿气质的相关性研究[J].中国妇幼健康研究,2018,29(3):254-258.
[8]Carey WB.Editorial perspective:whatever happened to temperament?[J].Journal of Child Psychology and Psychiatry,2017,58(12):1381-1382.
[9]周明月,刘俊山.婴幼儿气质类型影响因素研究进展[J].安徽预防医学杂志,2018,24(1):44-46,50.
[10]王仲安,王美英,王海莲,等.4~12个月儿童气质与家庭环境因素关系的调查分析[J].中国现代医生,2012,50(17):19-21.
[11]李密密,张国琴,李琰,等.妇幼保健人员对产后抑郁认知的现状调查[J].现代预防医学,2017,44(12):2174-2178.
[12]Dipietro JA,Novak MF,Costigan KA,et al.Maternal psychological distress during pregnancy in relation to child development at age two[J].Child Development,2006,77(3):573-587.
[13]Khashan AS,Abel KM,Mcnamee R,et al.Higher risk of offspring schizophrenia following antenatal maternal exposure to severe adverse life events[J].Archives of General Psychiatry,2008,65(2):146-152.
[14]朱鹏,陶芳标.孕期心理应激对子代神经行为发育影响的研究进展[J].卫生研究,2012,41(4):698-702.
[15]高丽芳,程灏,费春香.160例早产儿的气质特征及其影响因素分析[J].上海医药,2017,23(23):55-57.
[16]蒋晓敏,陶芳标.胰岛素样生长因子系统与胎儿发育及其宫内编程[J].中国妇幼保健,2008,23(17):2468-2470.
[17]Fowden AL.The insulin-like growth factors and feto-placental growth[J].Placenta,2003,24(8/9):803-812.
[18]Huang WL,Harper CG,Evans SF,et al.Repeated prenatal corticosteroid administration delays astrocyte and capillary tight junction maturation in fetal sheep[J].International Journal of Developmental Neuroscience,2001,19(5):487-493.
[2]宫相君.孕期心理应激、环境铅暴露对胎婴儿神经系统发育影响的研究进展[J].卫生研究,2011,40(1):133-136.
[3]Glynn LM,Howland MA,Sandman CA,et al.Prenatal maternal mood patterns predict child temperament and adolescent mental health[J].Journal of Affective Disorders,2018,228:83-90.
[4]石淑华,戴耀华.儿童保健学[M].3版.北京:人民卫生出版社,2014:101-110.
[5]Zhu P,Tao FB,Hao JH,et al.Prenatal Life events stress:implications for preterm birth and infant birthweight[J].American Journal of Obstetrics and Gynecology,2010,203(1):e31-e34.
[6]何津,陈祉妍,郭菲,等.流调中心抑郁量表中文简版的编制[J].中华行为医学与脑科学杂志,2013,22(12):1133-1136.
[7]翁婷婷,严双琴,王琼瑶,等.父母产后抑郁与婴儿气质的相关性研究[J].中国妇幼健康研究,2018,29(3):254-258.
[8]Carey WB.Editorial perspective:whatever happened to temperament?[J].Journal of Child Psychology and Psychiatry,2017,58(12):1381-1382.
[9]周明月,刘俊山.婴幼儿气质类型影响因素研究进展[J].安徽预防医学杂志,2018,24(1):44-46,50.
[10]王仲安,王美英,王海莲,等.4~12个月儿童气质与家庭环境因素关系的调查分析[J].中国现代医生,2012,50(17):19-21.
[11]李密密,张国琴,李琰,等.妇幼保健人员对产后抑郁认知的现状调查[J].现代预防医学,2017,44(12):2174-2178.
[12]Dipietro JA,Novak MF,Costigan KA,et al.Maternal psychological distress during pregnancy in relation to child development at age two[J].Child Development,2006,77(3):573-587.
[13]Khashan AS,Abel KM,Mcnamee R,et al.Higher risk of offspring schizophrenia following antenatal maternal exposure to severe adverse life events[J].Archives of General Psychiatry,2008,65(2):146-152.
[14]朱鹏,陶芳标.孕期心理应激对子代神经行为发育影响的研究进展[J].卫生研究,2012,41(4):698-702.
[15]高丽芳,程灏,费春香.160例早产儿的气质特征及其影响因素分析[J].上海医药,2017,23(23):55-57.
[16]蒋晓敏,陶芳标.胰岛素样生长因子系统与胎儿发育及其宫内编程[J].中国妇幼保健,2008,23(17):2468-2470.
[17]Fowden AL.The insulin-like growth factors and feto-placental growth[J].Placenta,2003,24(8/9):803-812.
[18]Huang WL,Harper CG,Evans SF,et al.Repeated prenatal corticosteroid administration delays astrocyte and capillary tight junction maturation in fetal sheep[J].International Journal of Developmental Neuroscience,2001,19(5):487-493.