孕妇童年期不良经历与幼儿情绪行为发展轨迹的关系及产前抑郁症状的中介作用

Associiation of adverse childhood experiences of pregnant women with emotional and behavioral development trajectories of young children and the mediating role of prenatal depression symptom

摘要

目的 探讨孕妇产前抑郁症状在童年期不良经历(ACEs)与幼儿情绪行为发展轨迹关联中的中介作用,为儿童情绪行为问题的预防及干预提供科学的参考依据。方法 2020年4—7月建立母婴健康队列,通过问卷调查收集孕晚期孕妇的基本信息,采用爱丁堡产后抑郁量表、童年期不良经历问卷评估相关内容,子代12、18、24月龄和36月龄时评估情绪行为问题。采用中介效应检验研究变量间的关系。结果 共纳入125对母子,27.20%(34/125)的孕妇存在ACEs,产前抑郁症状检出率为28.8%(36/125)。ACEs可能通过孕妇产前抑郁症状影响子代失调发展轨迹,产前抑郁症状的间接效应值为0.12(95%CI: 0.02~0.27),中介效应占总效应的48.17%。结论 孕妇产前抑郁症状可能在ACEs对子代情绪行为发展轨迹影响中起中介作用。因此,在优生优育咨询以及产前检查时需关注女性早期成长环境,并注意孕期情绪状态。

Abstract

Objective To explore the mediating role of prenatal depression symptoms in the association of adverse childhood experiences (ACEs) with emotional and behavioral development trajectories in young children, so as to provide reference for the prevention and intervention of children′s mental problems. Methods A maternal-infant health cohort was established from April to July 2020.Basic information was collected from pregnant women in their third trimester using questionnaires.The Edinburgh Postnatal Depression Scale and the Adverse Childhood Experiences Questionnaire were used to assess relevant factors.Offspring emotional and behavioral problems were evaluated at 12, 18, 24, and 36 months of age.Mediating analysis was conducted to examine the relationships among variables. Results A total of 125 mother-child pairs were included.Among them, 27.20% (34/125) of the pregnant women had ACEs, and the rate of prenatal depression symptoms was 28.80% (36/125).ACEs may influence the developmental trajectory of dysregulation in offspring through maternal prenatal depressive symptoms.The indirect effect of prenatal depressive symptoms was 0.12 (95% CI: 0.02 - 0.27), accounting for 48.17% of the total effect. Conclusions Maternal prenatal depressive symptoms may mediate the association between ACEs and emotional-behavioral development trajectories in offspring.Preconception counseling and prenatal care should focus on women′s early-life environments and emotional status during pregnancy.

关键词

孕妇 / 童年期不良经历 / 产前抑郁症状 / 情绪行为问题 / 中介分析

Key words

pregnant women / adverse childhood experiences / prenatal depressive symptoms / emotional and behavioral problems / mediating analysis

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