Maternal depressive symptoms and infant health practices among low-income women
Maternal depressive symptoms and infant health practices among low-income women
复制标题
DOI：
10.1542/peds.113.6.e523
复制
发表时间：
2004-06-01
期刊：
影响因子：
8
通讯作者：
Culhane, JF
中科院分区：
文献类型：
--
作者：
Chung, EK;McCollum, KF;Culhane, JF
目标.确定母亲抑郁症状与婴儿保健服务的使用、父母教养方式和伤害预防措施之间的关系。对2000年2月至2001年11月期间在费城公共卫生中心就诊的妇女进行了一项前瞻性的、以社区为基础的调查。妇女在分娩前后3个时间点进行调查。在每个时间点用流行病学研究中心抑郁量表测定抑郁症状。我们研究了6个结果，分为3类：1）婴儿健康服务使用（充分的良好儿童护理和曾经住院）; 2）父母的做法（母乳喂养大于或等于1个月和使用体罚）; 3）伤害预防措施（有烟雾报警器和使用仰卧位）。样本包括774名单身（74%），无保险（63%），非裔美国人（65%）女性，平均年龄为24 +/- 6岁，平均年收入为8063美元。48%的女性在1或2个时间点有抑郁症状（曾经有症状），12%的女性在所有时间点都有抑郁症状（持续性症状）。与从未有过抑郁症状的女性相比（没有症状），有持续症状的妇女有近3倍的可能性有他们的孩子曾经住院治疗（调整后的比值比：2.89; 95%置信区间：1.61 - 5.07）和两倍的可能使用体罚（校正比值比：1.90; 95%置信区间：1.08 - 3.34）。与没有症状的女性相比，有持续抑郁症状的母亲家中安装烟雾报警器的可能性减少了近四分之三（调整后的比值比：0.28; 95%置信区间：0.11 - 0.70），使用背部睡姿的可能性减少了一半（调整后的比值比：0.56; 95%置信区间：0.35 - 0.91）。母亲抑郁症状与婴儿接受良好的儿童护理或母乳喂养大于或等于1个月的可能性之间没有关联。母亲抑郁症状持续从产前到产后期间与婴儿住院和使用体罚的风险增加，并与烟雾报警器和使用仰卧位的可能性较低有关。需要做出更多努力来识别和评估有抑郁症状的母亲，以改善幼儿的健康和安全。
Objectives. To determine the relationships between maternal depressive symptoms and the use of infant health services, parenting practices, and injury-prevention measures.Methods. A prospective, community-based survey of women attending Philadelphia public health centers between February 2000 and November 2001 was conducted. Women were surveyed at 3 time points before and after parturition. Depressive symptoms were determined with the Center for Epidemiologic Studies Depression Scale at each time point. We studied 6 outcomes, clustered into 3 categories: 1) infant health service use ( adequate well-child care and ever being hospitalized); 2) parenting practices (breastfeeding for greater than or equal to1 month and use of corporal punishment); and 3) injury-prevention measures ( having a smoke alarm and using the back sleep position).Results. The sample consisted of 774 largely single (74%), uninsured (63%), African American (65%) women, with a mean age of 24 +/- 6 years and a mean annual income of $ 8063. Forty-eight percent of women had depressive symptoms at 1 or 2 time points ( ever symptoms) and 12% had depressive symptoms at all points ( persistent symptoms). Compared with women who never had depressive symptoms ( without symptoms), women with persistent symptoms were nearly 3 times as likely to have their child ever hospitalized ( adjusted odds ratio: 2.89; 95% confidence interval: 1.61 - 5.07) and twice as likely to use corporal punishment ( adjusted odds ratio: 1.90; 95% confidence interval: 1.08 - 3.34). Mothers with persistent depressive symptoms were nearly three-quarters less likely to have smoke alarms in their homes ( adjusted odds ratio: 0.28; 95% confidence interval: 0.11 - 0.70) and one-half as likely to use the back sleep position ( adjusted odds ratio: 0.56; 95% confidence interval: 0.35 - 0.91), compared with women without symptoms. There was no association between maternal depressive symptoms and infant receipt of well-child care or the likelihood of breastfeeding for greater than or equal to 1 month.Conclusions. Maternal depressive symptoms persisting from the prepartum to postpartum periods were associated with increased risks of infant hospitalization and use of corporal punishment and with lower likelihood of having a smoke alarm and using the back sleep position. Additional efforts are needed to identify and evaluate mothers with depressive symptoms to improve the health and safety of young infants.