母亲中、晚孕期焦虑/抑郁心理状况对婴儿早期气质的影响

Effects of maternal anxiety and depression in second or third trimester on early infantile temperament

目的评估母亲中、晚孕期的焦虑/抑郁症状对婴儿早期气质各个维度的影响。方法回顾性纳入2018年9月至2019年9月在北京市大兴区妇幼保健院儿童保健科进行气质测评的1~2月龄婴儿,查阅病历记录其母亲产前在本院孕妇心理门诊的焦虑/抑郁测评结果。共864对母婴纳入分析。气质测评采用婴儿早期气质问卷,由母亲进行填写。母亲中孕期或晚孕期焦虑/抑郁状况的评估采用宗氏焦虑自评量表和抑郁自评量表。采用多重线性回归分析产前焦虑/抑郁对婴儿早期气质的影响。结果263例母亲完成了中孕期焦虑/抑郁的评估,6.5%(17/263)有焦虑症状,21.7%(57/263)有抑郁症状;601例母亲完成了晚孕期的心理评估,5.0%(30/601)有焦虑症状,有抑郁症状的占16.1%(97/601)。在校正了母亲年龄、文化程度、是否计划妊娠、是否工作及婴儿性别等混杂因素后,中孕期母亲的焦虑症状使婴儿活动水平(B=0.325)、节律性(B=0.386)、适应性(B=0.463)、反应强度(B=0.448)和注意分散度(B=0.398)得分升高(P值均<0.05);中孕期母亲的抑郁症状使婴儿活动水平(B=0.282)、节律性(B=0.226)、适应性(B=0.319)和注意分散度(B=0.247)得分升高(P值均<0.05)。母亲晚孕期焦虑的婴儿活动水平(B=0.276)、趋避性(B=0.270)、反应强度(B=0.401)、情绪本质(B=0.512)和注意分散度(B=0.353)得分升高(P值均<0.05);母亲晚孕期抑郁的婴儿活动水平(B=0.282)、趋避性(B=0.227)、适应性(B=0.356)、情绪本质(B=0.336)、坚持性(B=0.354)和注意分散度(B=0.343)方面的得分均较高(P值均<0.05)。结论母亲中孕期和晚孕期抑郁/焦虑对婴儿早期的气质维度不良影响的范围不同,婴儿早期的活动水平增高和注意力不易分散与母亲中、晚孕期焦虑和抑郁均相关。

Objective To evaluate the association between maternal anxiety and depression in the second or third trimester and early infantile temperament.Methods This was a retrospective study involving infants aged 1-2 months who received temperament assessment in Beijing Daxing Maternal and Child Care Hospital from September 2018 to September 2019.A total of 864 mother-infant dyads were enrolled and medical records and psychological assessment results of the mothers were collected.Early Infancy Temperament Questionnaire(EITQ)was filled in by the mothers to assess infant temperament.Maternal anxiety and depression in the second or third trimester were measured by Zung Self-rating Anxiety Scale(SAS)and Zung Self-rating Depression Scale(SDS),respectively.Effects of maternal depression and anxiety on infant temperament were analyzed using multiple linear regression model.Results There were 263 mothers completing the assessment of anxiety and depression in the second trimester.Seventeen(6.5%)of them had anxiety symptoms and 57(21.7%)had depression symptoms.While 601 mothers completed the same psychological assessment scales in the third trimester,including 30(5.0%)with anxiety symptoms and 97(16.1%)with depression symptoms.After adjustment for confounders including maternal age,education background,planned or unplanned conception,employment status and infant gender,maternal anxiety in the second trimester was associated with significantly higher EITQ scores in activity(B=0.325),rhythmicity(B=0.386),adaptability(B=0.463),intensity(B=0.448)and distractibility(B=0.398)(all P<0.05);maternal depression in the second trimester was associated with significantly higher EITQ scores in activity(B=0.282),rhythmicity(B=0.226),adaptability(B=0.319)and distractibility(B=0.247)(all P<0.05).Similarly,maternal anxiety in the third trimester was related to significantly higher EITQ scores in activity(B=0.276),approach(B=0.270),intensity(B=0.401),mood(B=0.512)and distractibility(B=0.353)(all P<0.05);maternal depression in the third trimester was related to significantly higher EITQ scores in activity(B=0.282),approach(B=0.227),adaptability(B=0.356),mood(B=0.336),persistence(B=0.354)and distractibility(B=0.343)(all P<0.05).Conclusions Maternal anxiety and depression in the second or third trimester have negative influences on different dimensions of infant temperament.Higher activity level and poorer attentional regulation at early infantile stage were both associated with maternal depression and anxiety during pregnancy.