Perinatal depression prevention through the mother-infant dyad: The role of maternal childhood maltreatment.
Perinatal depression prevention through the mother-infant dyad: The role of maternal childhood maltreatment.
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DOI：
10.1016/j.jad.2021.04.068
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发表时间：
2021-07-01
影响因子：
6.6
通讯作者：
Monk C
中科院分区：
文献类型：
--
作者：
Berry OO;Babineau V;Lee S;Feng T;Scorza P;Werner EA;Monk C
围产期抑郁症的预防研究很少关注母婴二分体或考虑母亲儿童虐待（CM）的影响。对两项联合随机对照试验的二次分析有效产后育儿实践资源（PREPP）研究了CM对预防围产期抑郁症的疗效和对6周婴儿行为的影响的调节作用。109名孕妇中有32%的人赞成CM（CM+）。在产后6周，与常规强化治疗（ETAU）相比，接受PREPP治疗的妇女的抑郁和焦虑程度显著降低，这是基于汉密尔顿评定的汉密尔顿抑郁量表（HRSD）和汉密尔顿焦虑量表（HRSA）。（平均差异分别为M=-3.84（SD= 0.14，p<0.01）和M=-4.31（SD= 0.32，p <0.001））。当将CM添加到模型中时，在CM+女性中，PREPP与ETAU治疗对HRSD和HRSA结局的影响不再显著，尽管对CM−女性的影响仍然存在。然而，接受PREPP与ETAU的CM+妇女报告婴儿白天睡眠平均增加189.8分钟（SE= 50.48，p=0.001）。婴儿行为的自我报告措施。CM+女性与CM-女性对预防围产期抑郁症的干预反应有限，但仍报告婴儿白天睡眠增加。这项研究增加了越来越多的文献，预防研究可能需要纳入适合女性儿童创伤史的方法，同时考虑婴儿功能，因为两者都可能是与母亲情绪相关的治疗目标。
Prevention studies for perinatal depression rarely focus on the mother–infant dyad or consider the impact of maternal childhood maltreatment (CM). A secondary analysis of two combined randomized controlled trials of Practical Resources for Effective Postpartum Parenting (PREPP) examined the moderating role of CM on the efficacy of preventing perinatal depression and effects on infant behavior at six weeks. 32% of 109 pregnant women endorsed CM (CM+). At six weeks postpartum, women who received PREPP compared to enhanced treatment as usual (ETAU) had significant reductions in depression and anxiety based on the observer-rated Hamilton Rating Scale for Depression (HRSD) and Hamilton Rating Scale for Anxiety (HRSA) (mean difference of M=−3.84 (SD= 0.14, p<0.01) and M=−4.31 (SD= 0.32, p <0.001) respectively). When CM was added to the models, there no longer was a significant PREPP versus ETAU treatment effect on HRSD and HRSA outcomes in CM+ women though effects remained for CM− women. However, CM+ women who received PREPP vs ETAU reported a mean increase in infant daytime sleep of 189.8 minutes (SE= 50.48, p=0.001). Self-report measures of infant behavior were used. CM+ women versus CM− had limited response to an intervention to prevent perinatal depression yet still reported an increase in infant daytime sleep. This study adds to the growing literature that prevention studies may need to incorporate approaches tailored to fit women with childhood trauma histories while also considering infant functioning as both may be treatment targets relevant to maternal mood.
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