摘要
背景母亲产后分离焦虑是影响儿童社会情绪发展的重要因素,但母亲产后分离焦虑对儿童早期的影响和产生影响的关键节点尚不明确。目的探讨母亲在产后2年内4个时点的分离焦虑对学龄前期儿童社会情绪的影响。设计前瞻性队列研究。方法在上海睡眠出生队列中纳入年龄18~45岁、孕周≥28周、胎儿无已知畸形、长期定居在上海并在上海交通大学医学院附属仁济医院东区分院分娩、单胎妊娠的孕晚期产妇作为本文队列人群,子代纳入出生胎龄≥37周且出生体重2500~4000 g的健康新生儿,排除曾入住NICU或出生1、5 min Apgar评分中有1次≤7分者。采集孕晚期母亲受教育程度,家庭年收入,母亲生产年龄,抑郁、焦虑和整体应激水平,采集子代6月龄时婴儿气质类型。母亲于产后6、12、18和24个月行母亲分离焦虑量表(MSAS)评估,子代6岁时以长处和困难问卷(SDQ)评估儿童社会情绪发展情况。主要结局指标SDQ困难总分、内化问题和外化问题。结果2012年5月至2013年7月纳入符合本文孕晚期产妇和新生儿纳排标准的孕晚期产妇和子代新生儿均为262名,退出样本(n=80)和纳入样本(n=182)基线数据敏感性分析差异均无统计学意义。孕产妇生产时年龄(29.7±3.3)岁,最高学历以本科或大专学历占比最高(73.1%),基于抑郁量表评估抑郁,状态-特质焦虑问卷评估焦虑,孕妇生活事件量表评估应激水平,结果显示母亲孕晚期整体心理健康情况良好,家庭年收入14~29万元人民币者占48.6%,<14万元人民币者占38.1%;子代6月龄气质类型:易养型44.3%,中间偏易养型39.2%,中间型或难养型16.5%。母亲在子代6、12、18和24月龄的分离焦虑水平呈逐渐下降趋势,18和24月龄时母亲分离焦虑水平显著低于6月龄,差异有统计学意义。家庭年收入更高的母亲在儿童18月龄时分离焦虑水平更低,受教育程度更高的母亲在6月龄和18月龄时
Background Maternal separation anxiety is important for children's social-emotional development.However,the influence of postpartum separation anxiety on early childhood and the critical time points of its effect are still unclear.Objective To explore the impact of maternal separation anxiety at different time points within 2 years at 4 time points after delivery on social-emotional behavior problems of preschool children.Design Prospective cohort study.Methods In the Shanghai Sleep Birth Cohort,women during the third trimester,aged 18 to 45,gestational age≥28 weeks,without any known deformity,long-term resident in Shanghai,delivery in the eastern division of the Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,and single pregnancy were included as the cohort population.The offsprings were included if they were born at term and weighed 2500 to 4000g at birth,and excluded if they were admitted to the NICU after birth,or their Apgar score was≤7 at 1 or 5 minutes with asphyxia at birth.Maternal education level,family annual income,maternal age at delivery,maternal depression,anxiety,and overall stress level were assessed during late pregnancy,and the offspring were evaluated for temperament type when they were 6 months old.Maternal separation anxiety was assessed by the Maternal Separation Anxiety Scale(MSAS)at 6,12,18,and 24 months postpartum,and the offspring's social-emotional development was assessed with the Strengths and Difficulties Questionnaire(SDQ)at age 6.Main outcome measures Total difficulties score,internalizing problems,and externalizing problems.Results From May 2012 to July 2013,262 dyads of pregnant women and their offspring newborns were included according to the criteria for mothers and neonates.There was no statistical significance in the sensitivity analysis of baseline data between the withdrawn samples(n=80)and the final included samples in the current study(n=182).Maternal age at delivery was 29.7±3.3.Most of the mothers attained the highest education level
作者
苏茹昕
潘昊
林青敏
王广海
孙莞绮
姜艳蕊
朱绮
张云婷
江帆
SU Ruxin;PAN Hao;LIN Qingmin;WANG Guanghai;SUN Wanqi;JIANG Yanrui;ZHU Qi;ZHANG Yunting;JIANG Fan(Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Department of Developmental and Behavioral Pediatrics,National Children's Medical Center,Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Child Health Advocacy Institute,Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;MOE-Shanghai Key Laboratory of Children's Environmental Health,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Shanghai Center for Brain Science and Brain-Inspired Technology,Shanghai 201602,China)
出处
《中国循证儿科杂志》
CSCD
北大核心
2024年第5期392-399,共8页
Chinese Journal of Evidence Based Pediatrics
基金
国家自然科学基金委员会联合基金项目:U23A20170
上海交通大学“交大之星”计划医工交叉研究基金青年项目B:YG2023QNB21
上海市卫生健康委基金项目:2020CXJQ01。
关键词
母亲分离焦虑
学龄前儿童
情绪与行为问题
Maternal separation anxiety
preschool children
emotional and behavioral problems
