目的 了解孕妇童年期忽视经历与子代出生体重的关系,并探索孕期抑郁症状和家庭支持在其中的中介和调节作用,为减少不良出生体重的发生提供依据。方法 于2022年9—12月和2023年4—12月分别在某县妇幼保健院和某市综合医院产科医生的协助下,招募就诊的521名孕晚期孕妇为研究对象,收集孕妇童年期不良经历、孕期家庭支持等相关信息,以及子代出生信息。采用SPSS-PROCESS宏程序进行中介调节分析。结果 共521名孕妇及其子代纳入研究,新生儿出生体重中位数为3 160.0 (2 900.0, 3 410.0)g,5.6%的新生儿为低出生体重,2.7%为巨大儿。中介调节作用结果显示,抑郁症状在忽视与出生体重的关系中起部分中介作用(β=-0.051, 95%CI:-0.082~-0.023);忽视对出生体重的影响、抑郁症状对出生体重的影响均受到家庭支持的正向调节(β=0.189, 95%CI:0.100~0.277; β=0.132, 95%CI:0.048~0.216)。结论 孕期抑郁症状及家庭支持在孕妇童年期忽视经历与子代出生体重之间存在中介调节作用。早期识别有童年期忽视经历的孕妇,并针对孕期抑郁及家庭支持情况进行干预有助于减少不良出生体重的发生。
Abstract
Objective To explore the relationship between maternal childhood neglect experiences and offspring birth weight, and to examine the mediating and moderating roles of prenatal depressive symptoms and family support, so as to provide a basis for reducing the incidence of adverse birth weight. Methods From September to December 2022 (and separately from April to December 2023), late-term pregnant women were recruited with the assistance of obstetricians at a county maternal and child health hospital and a municipal general hospital.Data on maternal adverse childhood experiences, prenatal family support, and offspring birth information were collected.Mediation and moderation analysis were conducted using the SPSS-PROCESS macro program. Results A total of 521 pregnant women and their offspring were included in the study.The median birth weight of newborns was 3 160.0 (2 900.0,3 410.0)g, with 5.6% classified as low birth weight and 2.7% as macrosomia.The mediation-moderation analysis revealed that depressive symptoms partially mediated the relationship between neglect and birth weight (β=-0.051, 95%CI:-0.082 to -0.023).Additionally, family support positively moderated both the effect of neglect on birth weight and the effect of depressive symptoms on birth weight (β=0.189, 95% CI:0.100 to 0.277; β=0.132, 95%CI:0.048 to 0.216). Conclusions Prenatal depressive symptoms and family support play mediating and moderating roles in the relationship between maternal childhood neglect experiences and offspring birth weight.Early identification of pregnant women with childhood neglect histories and targeted interventions addressing prenatal depression and family support may help reduce the occurrence of adverse birth weight.
关键词
孕妇 /
忽视 /
抑郁症状 /
出生体重 /
家庭支持
Key words
pregnant women /
neglect /
depressive symptoms /
birth weight /
family support
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