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中国上海围生期心理变化对婴儿神经发育的影响:基于群组的纵向轨迹分析。

The Influence of Perinatal Psychological Changes on Infant Neurodevelopment in Shanghai, China: A Longitudinal Group-based Trajectory Analysis.

机构信息

Fenglin Community Health Service Center in Xuhui District, Shanghai, China.

Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.

出版信息

J Affect Disord. 2024 Sep 15;361:291-298. doi: 10.1016/j.jad.2024.06.029. Epub 2024 Jun 12.

Abstract

OBJECTIVE

This prospective cohort study, conducted at the Fenglin Community Health Service Center (FCHC) in Xuhui District, Shanghai, aimed to investigate the impact of maternal psychological status on offspring neurodevelopment.

METHODS

A total of 430 mother-child pairs were included, with pregnant women enrolled between February 18, 2020, and April 19, 2021. Face-to-face interviews and electronic data collection on demographic characteristics, health conditions and medical history were employed at various stages of pregnancy and postpartum. Maternal depression and anxiety were assessed using the PHQ-9 and GAD-7 scales, while offspring neurodevelopment was measured at six months using the Ages and Stages Questionnaire 3rd Edition (ASQ-3). In statistical analyses, group-based trajectory modeling (GBTM) was employed to identify the latent groups for maternal psychological trajectories, including depression and anxiety, and logistic regression was used to explore associations between maternal psychological trajectories and offspring neurodevelopment, adjusting for potential confounders.

RESULTS

Five latent trajectory groups were identified for both depression and anxiety, exhibiting distinct patterns over time. Results indicated that maternal psychological trajectories were associated with various domains of offspring neurodevelopment, including communication, problem-solving, personal-social, and gross motor skills. Specifically, mothers in trajectory groups characterized by the highest level of depression or anxiety showed increased odds of offspring neurodevelopmental delays compared to reference groups.

CONCLUSION

Our findings underscore the importance of maternal mental health during the perinatal period and highlight the potential implications for offspring neurodevelopment. Further research is warranted to elucidate underlying mechanisms and inform targeted interventions to support maternal mental well-being and optimize offspring outcomes.

摘要

目的

本前瞻性队列研究在上海市徐汇区枫林社区卫生服务中心(FCHC)进行,旨在探讨产妇心理状况对后代神经发育的影响。

方法

共纳入 430 对母婴对,孕妇于 2020 年 2 月 18 日至 2021 年 4 月 19 日入组。在妊娠和产后的各个阶段,采用面对面访谈和电子数据采集的方法收集人口统计学特征、健康状况和病史。使用 PHQ-9 和 GAD-7 量表评估产妇抑郁和焦虑,使用第 3 版年龄与阶段问卷(ASQ-3)在 6 个月时评估后代神经发育。在统计分析中,采用基于群组的轨迹建模(GBTM)识别产妇心理轨迹的潜在群组,包括抑郁和焦虑,并采用逻辑回归探讨产妇心理轨迹与后代神经发育之间的关联,调整潜在混杂因素。

结果

确定了抑郁和焦虑的五个潜在轨迹组,随时间呈现出不同的模式。结果表明,产妇心理轨迹与后代神经发育的各个领域相关,包括沟通、解决问题、个人-社会和粗大运动技能。具体而言,与参考组相比,处于抑郁或焦虑程度最高轨迹组的母亲,其后代神经发育迟缓的几率增加。

结论

本研究结果强调了围产期产妇心理健康的重要性,并突出了其对后代神经发育的潜在影响。需要进一步研究阐明潜在机制,并为支持产妇心理健康和优化后代结局提供有针对性的干预措施提供信息。

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