目的 研究3月龄婴儿母亲产后抑郁情绪与婴儿发育水平之间的关联,为控制母亲抑郁情绪发生率的上升,改善家庭养育照护环境,提高婴儿发育水平、促进儿童全面早期发展具有重要意义。方法 采用横断面的研究方法,于2019年1—12月在重庆市妇幼保健院、柳州市妇幼保健院、马鞍山市妇幼保健院和青岛市妇幼保健院招募415例3月龄母婴对,使用爱丁堡产后抑郁量表评估母亲的抑郁情绪,使用年龄发育与发育进程问卷中文版的3月龄问卷评估小婴儿的发育。结果 3月龄婴儿母亲产后出现抑郁情绪的人数占27.0%(112/415),母亲有抑郁情绪组的婴儿在沟通(CM)、粗大动作(GM)、精细动作(FM)、解决问题(CG)、个人社会(PS) 5个能区发育异常检出率(分别为31.3%、25.9%、28.6%、31.3%、33.0%)均显著高于母亲无抑郁情绪组(分别为18.8%、10.6%、23.4%、20.8%、25.1%),χ2检验显示沟通、粗大动作、解决问题3个能区发育异常检出率在两组间差异有统计学意义(χ2=7.332、15.331、4.958,P<0.05)。控制重要混杂因素后,发现3月龄婴儿母亲的抑郁情绪是婴儿粗大动作发育异常的独立危险因素[aOR=2.293,95%CI:1.240~4.243,P<0.05]。结论 3月龄婴儿母亲抑郁情绪会增加婴儿大动作能区发育异常的可能性,应在母亲产后采取积极干预措施降低母亲抑郁情绪的发生,促进婴儿神经心理行为的早期健康发育。
Abstract
Objective To investigate the association between postpartum depression in mothers of 3-month-old infants and infant developmental levels, in order to provide evidence for improve family nurturing environment and promote early childhood development. Methods Totally 415 mothers and infants were recruited in this cross-sectional study from four maternal and child health care institutions, including Chongqing Maternal and Child Health Hospital, Liuzhou Maternal and Child Health Hospital, Maanshan Maternal and Child Health Hospital and Qingdao Maternal and Child Health Hospital from January to December 2019. Maternal depression was assessed using the Edinburgh Postpartum Depression Scale, and the infant's development was assessed using the Chinese version of the Age Development and Developmental Progress Questionnaire Questionnaire for 3-month-old infants. Results A total of 112 mothers were detected with postpartum depression (27.0%). For infants whose mothers were detected with postpartum depression, the detection rates of abnormal development in communication (CM), gross motor (GM), fine motor (FM), problem solving (CG), personal social (PS) (31.3%, 25.9%, 28.6%, 31.3%, 33.0%) were higher than those whose mothers had no postpartum depression(18.8%, 10.6%, 23.4%, 20.8%, 25.1%), and differences were significant in CM, GM and CG domains(χ2=7.332, 15.331, 4.958, P<0.05). After controlling for important confounding factors, maternal depression was found to be an independent risk factor for the infant's gross motor development (aOR=2.293, 95%CI:1.240 - 4.243). Conclusions Depressed mood of mothers of 3-month-old infants will increase the possibility of abnormal development of gross motor in infants. Active intervention measures should be taken after delivery to reduce the occurrence of maternal depression and to promote the early healthy development of infant neuropsychological behavior.
关键词
母亲 /
抑郁情绪 /
婴儿发育 /
3月龄婴儿
Key words
mother /
depression /
infant development /
3 months old infants
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 林雪梅,杨建辉,陈佩珊,等.母亲孕期或产后抑郁情绪对子代情绪和行为的影响:Meta分析[J].中华实用儿科临床杂志,2022,37(4):284-289.
[2] Xayyabouapha A, Sychareun V, Quyen BTT, et al. Prevalence and risk factors associated with postpartum depressive symptoms among women in vientiane capital, Lao PDR[J]. Front Public Health,2022,10:791385.
[3] World Health Organization. Thinking healthy: A manual for psychosocial management of perinatal depression[R]. Geneva: World Health Organization,2015.
[4] Oktaviana W, Keliat BA, Wardani IY, et al. Effectiveness health education and infant therapeutic group therapy on baby aged 0-6 months to prevent stunting risk factors: mother depression[J]. J Public Health Res,2021,11(2):2740.
[5] Lee DT, Yip SK, Chiu HF, et al. Detecting postnatal depression in Chinese women: Validation of the Chinese version of the Edinburgh Postnatal Depression Scale[J]. Br J Psychiatry,1998,172:433-437.
[6] 王玉琼,郭秀静.EPDS在成都地区孕妇产后抑郁筛查中的临界值研究[J].中国实用护理杂志,2009,25(5):1-4.
[7] 李莉,任娟.妇女产后抑郁症发生现状及相关因素研究[J].生殖医学杂志,2021,30(7):907-912.
[8] Squires J, Bricker D, Potter L. Revision of a parent-completed development screening tool: Ages and StagesQuestionnaires[J].J Pediatr Psychol, 1997,22(3):313-328.
[9] 卞晓燕,陈静仪,柴臻,等.年龄与发育进程问卷使用指南[M].上海:上海科学技术出版社,2013.
[10] 张颖,杜玉开.431例妇女产后抑郁情况及社会心理影响因素分析[J].医学与哲学(B),2015,36(7):84-86.
[11] 邓爱文,姜婷婷,罗映萍,等.广州市天河区产后抑郁症发生率及相关危险因素分析[J].南方医科大学学报,2014,34(1):113-116.
[12] Upadhyay RP, Chowdhury R, Aslyeh S, et al. Postpartum depression in India:A systematic review and meta-analysis[J]. Bull World Health Organ, 2017,95(10):706-717C.
[13] 钱耀荣,晏晓颖.中国产后抑郁发生率的系统分析[J].中国实用护理杂志,2013,29(12):1-3.
[14] Abdollahi F, Rezai Abhari F, Zarghami M. Post-Partum depression effect on child health and development[J]. Acta Med Iran, 2017,55(2):109-114.
[15] 杨青,赵世能,李姝漩,等.母亲产后抑郁与婴儿早期发育关系队列研究[J].中国公共卫生,2018,34(4):559-562.
[16] Kawai E,Takagai S, Takei N, et al. Maternal postpartum depressive symptoms predict delay in non-verbal communication in 14-month-old infants[J]. Infant Behav Dev, 2017,46:33-45.
[17] Valla L,Wentzel-Larsen T, Smith L, et al. Association between maternal postnatal depressive symptoms and infants' communication skills: A longitudinal study[J]. Infant Behav Dev, 2016,45(Pt A):83-90.
[18] Kuhl PK. Early language acquisition:Cracking the speech code[J]. Nat Rev Neurosci, 2004,5(11):831-843.
[19] van der Waerden J, Bernard JY, De Agostini M, et al. Persistent maternal depressive symptoms trajectories influence children's IQ: The EDEN mother-child cohort[J]. Depress Anxiety, 2017,34(2):105-117.
[20] 崔雪曼.母乳喂养对12个月龄婴儿的社会性反应影响研究[J].中国妇幼保健,2016,31(3):513-516.
[21] Wu Q, Farley T, Cui M. Breastfeeding, maternal psychopathological symptoms, and infant problem behaviors among low-income mothers returning to work[J].Soc Sci Med, 2021,285:114288.
[22] 严双琴,江澜,曹慧,等.母乳喂养对 12 月龄婴儿社会性反应影响[J].中国公共卫生,2015,31(2):172-176.
[23] Claessens Engel AM, Chris Curran F.The effects of maternal depression on child outcomes during the first years of formal schooling[J]. Early Child Res Q, 2015, 32:80-93.
基金
国家自然科学青年基金(81803249);中国疾病预防控制中心青年基金(2018A202)