The emotional-behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: a prospective Australian pregnancy cohort study
The emotional-behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: a prospective Australian pregnancy cohort study
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DOI：
10.1007/s00787-014-0672-2
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发表时间：
2015-10-01
影响因子：
6.4
通讯作者：
Brown, Stephanie
中科院分区：
文献类型：
--
作者：
Giallo, Rebecca;Woolhouse, Hannah;Brown, Stephanie
在孕期和产后期间暴露于母亲抑郁的儿童患一系列健康、福祉和发育问题的风险增加。然而，很少有研究研究围产期及以后的母亲抑郁症状对儿童健康的影响。本研究旨在探讨幼儿时期母亲抑郁症状的严重程度和慢性程度与儿童4岁时情绪行为困难之间的关系。数据来自1085多名母亲和儿童，参与了澳大利亚一项大规模的预期怀孕队列。潜伏级分析发现，从怀孕到产后4年，母亲抑郁症状有三种不同的轨迹：(1)没有或几乎没有症状(61%)，(2)持续的亚临床症状(30%)，(3)增加和持续的高症状(9%)。回归分析表明，即使在考虑了导致儿童结局不佳的已知风险因素后，经历亚临床症状、不断增加和持续高度症状的母亲的孩子出现情绪行为困难的可能性至少是报告症状轻微的母亲的孩子的两倍。这些发现要求政策制定者和卫生专业人员考虑如何为在整个幼儿期经历更广泛抑郁症状的母亲量身定做护理和支持，以最大限度地增加改善短期和长期孕产妇和儿童健康结果的机会。
Children exposed to maternal depression during pregnancy and in the postnatal period are at increased risk of a range of health, wellbeing and development problems. However, few studies have examined the course of maternal depressive symptoms in the perinatal period and beyond on children's wellbeing. The present study aimed to explore the relationship between both the severity and chronicity of maternal depressive symptoms across the early childhood period and children's emotional-behavioural difficulties at 4 years of age. Data from over 1,085 mothers and children participating in a large Australian prospective pregnancy cohort were used. Latent class analysis identified three distinct trajectories of maternal depressive symptoms from pregnancy to 4 years postpartum: (1) no or few symptoms (61 %), (2) persistent subclinical symptoms (30 %), and (3) increasing and persistently high symptoms (9 %). Regression analyses revealed that children of mothers experiencing subclinical and increasing and persistently high symptoms were at least two times more likely to have emotional-behavioural difficulties than children of mothers reporting minimal symptoms, even after accounting for known risk factors for poor outcomes for children. These findings challenge policy makers and health professionals to consider how they can tailor care and support to mothers experiencing a broader spectrum of depressive symptoms across the early childhood period, to maximize opportunities to improve both short-and long-term maternal and child health outcomes.