母亲产后抑郁与婴儿早期发育关系队列研究

Association between maternal postpartum depression and infant's early development: a cohort study

目的探讨产后抑郁与婴儿发育的关系。方法于2015年1月—2016年12月采用方便抽样法在湖南省怀化市鹤城区妇幼保健中心招募产后42 d初次建卡的母婴队列1 251对,产后42 d及产后6个月采用爱丁堡产后抑郁量表(EPDS)评定母亲抑郁症状,婴儿6个月采用年龄与发育进程问卷中文版(ASQ-C)评定婴儿发育情况,并测定体格发育指标。结果母亲产后42 d抑郁检出率为17.03%,产后6月抑郁检出率为4.32%;母亲产后42 d抑郁组的婴儿ASQ-C总分及沟通、解决问题、个人–社会3个能区得分低于非抑郁组,差异有统计学意义(P<0.01),母亲当前抑郁组的婴儿粗大运动能区得分低于非抑郁组,差异有统计学意义(P<0.05),母亲产后42 d及当前抑郁的2组婴儿体格发育差异均无统计学意义(P>0.05),logistic回归分析显示,产后42 d母亲抑郁是6个月婴儿发育迟缓的危险因素(OR=2.655,95%CI=1.843~3.825),母亲当前抑郁症状与婴儿发育迟缓的关联无统计学意义(OR=1.776,95%CI=0.859~3.671)。结论母亲产后抑郁症状对婴儿发育有负面影响,应在孕期及产后积极开展健康指导,降低母亲抑郁症状发生。

Objective To explore the association between maternal postpartum depression and infant＇s early development.Methods Totally 1 251 mother-child pairs were recruited in Maternal and Child Health Care Center of Hecheng district of Huaihua municipality between January 2015 and December 2016. Maternal depression was assessed using the Edinburgh Postnatal Depression Scale （EPDS） at 42-day and 6-month after delivery; infant development was assessed with the Ages and Stages Questionnaire （ASQ-C） at 6-month; and physical development indicators were also measured.Results Of the mothers, 17.03% reported depressive symptoms at 42-day after delivery, as did 4.32% at 6-month. The domain scores of communication, problem solving, and personal-social and total score of ASQ-C of the infants with mothers reporting depression symptoms at 42-day postpartum were all lower than those of the infants with mothers not reporting depression symptoms （P 〈 0.01 for all）; the score of gross motor of the infants with mothers reporting depression symptoms at 6-month was lower than that of the infants with mothers not reporting depression symptoms （P 〈 0.05）. But there were no differences in physical development indicators between the infants with and without mothers reporting depression symptoms at 42-day and 6-month （P 〉 0.05 for all）. Logistic regression analyses revealed that maternal postnatal depression at 42-day was a significant risk factor for developmental retardation of infants at 6-month （odds ratio[OR]=2.655, 95% confidence interval[95% CI]：1.843-3.825）, but maternal postnatal depression at 6-month was not significantly associated with infants＇ development （OR=1.776, 95% CI：0.859-3.671）.Conclusion Maternal postnatal depression has adverse impacts on infants＇ development; postnatal health education should be conducted among pregnant women during pregnancy and postpartum to prevent postpartum depression.