摘要
目的 研究母亲产后2个月内的抑郁症状与1.5~2月龄婴儿发育水平之间的关联.方法 基于"上海亲子队列",于2016年4月至2018年4月在上海市松江区和浦东新区2个接产医院招募孕妇共6714人,截至2019年1月15日,完成婴儿1.5~2月龄随访的母子共3548对,使用爱丁堡产后抑郁量表评定母亲产后2个月内的抑郁症状,使用年龄-发育进程问卷中文版的2月龄问卷评估婴儿各能区发育.结果 母亲产后2个月内出现产后抑郁症状的人数占比20.18%,母亲有产后抑郁症状组婴儿的沟通、粗大动作、精细动作、解决问题、个人-社会5个能区发育可疑延迟或延迟检出率(分别为23.04% 、16.48% 、26.26% 、21.09% 、22.21%)显著高于母亲无产后抑郁症状组(分别为18.82% 、11.30% 、18.57% 、16.81% 、18.40%),χ2值分别为6.45、14.18、20.99、7.20、5.35,均P<0.05.在控制多种重要混杂因素后,发现母亲产后2个月内抑郁症状是婴儿1.5~2月龄粗大动作、精细动作发育的独立危险因素,调整OR值(95%CI)分别为1.40(1.01~2.02)、1.58(1.19~2.10);对于沟通能区的危害作用也接近统计显著性,调整OR值(95%CI)为1.32(0.98~1.78).结论 母亲产后抑郁症状会增加1.5~2月龄婴儿粗大动作和精细动作及沟通能区出现发育可疑延迟或延迟的可能性,应在孕期和产后积极采取干预措施促进母婴健康.
Objective To study the relationship between maternal depression symptoms in 2 months postpartum and infant development at 1.5-2 months of age.Methods Based on the Shanghai Maternal-Child Pairs Cohort,6714 pregnant women were recruited in two hospitals located in Songjiang distinct and Pudong new area of Shanghai since April 2016 to April 2018.Finally,3548 mother-child pairs have been followed-up of infants aged 1.5 to 2 months until January 15,2019.Edinburgh Postnatal Depression Scale was used to assess the depressive symptoms of the mother within 2 months postpartum,and two-month old Age and Stage Questionnaire(ASQ)-Third Edition was used to evaluate the development of each functional area of children at 1.5~2 months of age.Results 20.18%of mothers developed depression symptoms in 2 months postpartum.The detection rates of suspicious delay or delay in five ASQ attributes including communication,gross motor,fine motor,problem solving and personal-social in the group of mothers with postpartum depressive symptoms(23.04%,16.48%,26.33%,21.09%and 22.21%,respectively)were significantly higher than the rates in the group of mothers without postpartum depressive symptoms(18.82%,11.30%,18.57%,16.81%and 18.40%,respectively),and the differences were statistically significant(χ~2=6.45,14.18,20.99,7.20 and 5.35,respectively,all P<0.05).After adjusting multiple important confounders,maternal depression symptoms in 2 months postpartum was an independent risk factor of infant gross motor(OR=1.40,95%CI:1.01-2.02)and fine motor development(OR=1.58,95%CI:1.19-2.10),and its effect on infants’communication development was close to statistical significance(OR=1.32,95%CI:0.98-1.78).Conclusion Maternal postpartum depressive symptoms can increase the likelihood of developmental delays or suspicious developmental delays in gross motor and fine motor and communication of infants aged 1.5 to 2 months.It is of great significance to adopt active interventions to promote maternal and child health during and after pregnancy.
作者
张羽頔
祁月
马雪梅
蒋子晗
檀丽薇
史慧静
ZHANG Yudi;QI Yue;MA Xuemei;JIANG Zihan;TAN Liwei;SHI Huijing(Marernal,Child&Adolescent Healrh Depariment,School of Public Health,Fudan Universily,Shanghai 200032,Chima)
出处
《中国妇幼健康研究》
2020年第7期889-894,共6页
Chinese Journal of Woman and Child Health Research
基金
上海市“高峰高原”计划Ⅰ类高峰学科“公共卫生与预防医学”建设计划,上海市第四轮公共卫生三年行动重点学科建设计划资助项目(编号:15GWZK0402)。
