母亲产后抑郁情绪问题对婴幼儿回应性养育的影响

The impact of postpartum depression on maternal responsiveness in infant care

  • 摘要:
    目的 分析母亲产后2个月抑郁情绪问题对2~24月龄婴幼儿养育照护的影响,为今后母婴保健工作提供科学依据。
    方法 基于上海市大规模前瞻性出生队列研究,选取全程参加产后2、6、12和24月龄随访的母婴共1 060对。通过标准化问卷和医院产科记录获取孕产相关信息;在母亲产后2个月使用《爱丁堡产后抑郁量表》评估母亲产后抑(PPD)郁情绪问题状况,在婴幼儿2、6、12和24月龄时使用问卷评价婴幼儿回应性照护和早期学习机会提供水平。婴幼儿2、6、12和24月龄回应性照护和早期学习机会提供得分均以总得分排序的第25百分位数(P25)为界值;运用混合效应模型分析母亲产后2个月抑郁情绪问题对2~24月龄婴幼儿养育照护的纵向影响。
    结果 混合效应模型分析的纵向结果尚未发现母亲PPD对婴幼儿12月龄内回应性养育和24月龄内早期学习机会提供水平有影响。单时点的分析发现,与母亲无PPD组相比,母亲有PPD组的婴幼儿2月龄回应性照护水平较低发生的风险增加93%(OR=1.931,95%CI:1.113~3.364,P=0.019),2月龄和24月龄早期学习机会提供水平较低发生的风险分别增加59%(OR=1.589,95%CI:1.082~2.324,P=0.017)和60%(OR=1.598,95%CI:1.120~2.279,P=0.010)。
    结论 母亲PPD会增加婴幼儿2月龄回应性养育水平较低发生的风险,但是否会产生长期效应,需持续关注。

     

    Abstract:
    Objective To analyze the impact of maternal postpartum depression (PPD) at 2 months postpartum on caregiving for infants aged 2 to 24 months, and to provide a scientific basis for future maternal and infant healthcare services.
    Methods Based on the Shanghai Maternal-Child Pairs Cohort, 1 060 mother-child pairs were selected from those fully participating in follow-up visits at 2, 6, 12, and 24 months postpartum. Pregnancy and childbirth-related information was collected using standardized questionnaire surveys and hospital obstetric and maternity records. The Edinburgh postpartum depression scale was used to assess the maternal postpartum depressive symptoms at 2 months postpartum. At 2, 6, 12, and 24 months postpartum, questionnaire survey was used to evaluate the maternal responsiveness in caregiving and the provision of early learning opportunities for infants. Scores for responsive caregiving and early learning opportunities at 2, 6, 12, and 24 months were grouped based on the 25th percentile (P25) of total scores. The mixed-effects model was used to analyze the longitudinal impact of maternal postpartum depression at 2 months on the caregiving of 2 to 24-month-old infants.
    Results The longitudinal results from the mixed-effects model did not show an impact of maternal PPD on infant responsive caregiving within 12 months and early learning opportunities within 24 months. However, cross-sectional analysis revealed that, compared to the non-PPD group, the risk of low responsive caregiving at 2 months in the PPD group was 93% higher (OR=1.931, 95%CI: 1.113‒3.364, P=0.019). The risks for low provision of early learning opportunities at 2 months and 24 months increased by 59% (OR=1.589, 95%CI: 1.082‒2.324, P=0.017) and 60% (OR=1.598, 95%CI:1.120‒2.279, P=0.010), respectively.
    Conclusion Maternal postpartum depression increases the risk of low responsive caregiving at 2 months, but its long-term effects warrant further research.

     

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