Maternal Depressive Symptoms During and After Pregnancy and Psychiatric Problems in Children
Maternal Depressive Symptoms During and After Pregnancy and Psychiatric Problems in Children
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DOI：
10.1016/j.jaac.2016.10.007
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发表时间：
2017-01-01
影响因子：
13.3
通讯作者：
Raikkonen, Katri
中科院分区：
文献类型：
--
作者：
Lahti, Marius;Savolainen, Katri;Raikkonen, Katri
目的：母亲在怀孕期间的抑郁症状与儿童精神问题的风险增加有关。需要更精确地了解妊娠期症状出现的时间及其与其他产前和产后因素的独立性，以预测儿童精神病理学风险。我们研究了母亲在怀孕期间的抑郁症状是否能预测儿童的精神问题，这些关联是否是孕期或孕周特异性的和/或独立于妊娠障碍，以及母亲在怀孕后的抑郁症状是否会介导或增加产前效应。方法：研究样本包括2006年至2010年间在芬兰出生的2,296名妇女及其子女，参与前瞻性妊娠队列研究先兆子痫和宫内生长受限的预测和预防（PREDO）随访1.9 ~ 5.9岁。这些妇女在孕周+第12+0/13+6天和第38+0/39+6天或分娩期间每两周完成一次流行病学研究中心抑郁量表。在随访中，他们完成了Beck抑郁量表-II和儿童行为量表11/2- 5。结果：母亲抑郁症状在怀孕期间预测显着较高的内化（每SD单位增加0.28 SD单位[95% CI = 0.24-0.32]）、外化（0.26 [0.23-0.30]）和儿童总问题（0.31 [0.27-0.35]）。这些协会是非特异性的孕周，因此怀孕三个月，独立的妊娠障碍，独立的，虽然部分介导的，产妇抑郁症状怀孕后。精神问题是最大的儿童的母亲报告临床显着的抑郁症状，在整个怀孕期间和怀孕后。结论：母亲抑郁症状在怀孕期间预测增加精神问题的幼儿。从怀孕早期开始的预防性干预可能有益于后代的心理健康。
Objective: Maternal depressive symptoms during pregnancy are associated with increased risk of psychiatric problems in children. A more precise understanding of the timing of the symptoms during pregnancy and their independence of other prenatal and postnatal factors in predicting child psychopathology risk is needed. We examined whether maternal depressive symptoms during pregnancy predict child psychiatric problems, whether these associations are trimester- or gestational-week-specific and/or independent of pregnancy disorders, and whether maternal depressive symptoms after pregnancy mediate or add to the prenatal effects.Method: The study sample comprised 2,296 women and their children born in Finland between 2006-2010, participating in the prospective pregnancy cohort study Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) and followed up from 1.9 to 5.9 years of age. The women completed the Center for Epidemiologic Studies Depression Scale biweekly between gestational weeks+days 12+0/13+6 and 38+0/39+6 or delivery. In the follow-up, they completed the Beck Depression Inventory-II and Child Behavior Checklist 11/2-5.Results: Maternal depressive symptoms during pregnancy predicted significantly higher internalizing (0.28 SD unit per SD unit increase [95% CI = 0.24-0.32]), externalizing (0.26 [0.23-0.30]), and total problems (0.31 [0.27-0.35]) in children. These associations were nonspecific to gestational week and hence pregnancy trimester, independent of pregnancy disorders, and independent of, although partially mediated by, maternal depressive symptoms after pregnancy. Psychiatric problems were greatest in children whose mothers reported clinically significant depressive symptoms across pregnancy trimesters and during and after pregnancy.Conclusion: Maternal depressive symptoms during pregnancy predict increased psychiatric problems in young children. Preventive interventions from early pregnancy onward may benefit offspring mental health.