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The Effects of Preeclampsia on Perinatal Risks and Infant Temperaments Among Mothers With Antenatal Depression

Psychology Research 2014年第6期4卷 451-461页

作者： Yoko Nomura Jackie Finik Jacquelyn Salzbank Jenny Ly Nancy Huynh taira davey Mariya Dineva AyeletAbelow Cindy Flores Rejina Daniel Holly Loudon Joanne Stone Patricia Pierre Gary Eglinton Jeffrey H. Newcorn Queens College (CUNY) & Icahn School of Medicine at Mount Sinai New York USA University of Maryland College Park Maryland USA Queens College (CUNY) &Icahn School of Medicine at Mount Sinai New York USA Icahn School of Medicineat Mount Sinai & CornellUniversity New YorkUSA Queens College (CUNY) New York USA Icahn School of Medicineat Mount Sinai New York USA New York Hospital Queens New York USA Icahn School of Medicineat Mount Sinai New York USA

Importance: Preeclampsia and depression are two of the most prevalent disorders known to affect pregnant women and unborn infants. However, few studies have prospectively examined the adverse influence of in-utero exposures to the two disorders on the optimal development in their offspring, including mortality, adverse birth outcomes, and infant temperament styles. Objectives: (1) To examine whether exposures to preeclampsia and antenatal depression were associated with developmental indices of offspring at birth and temperament at 3 months; and (2) To evaluate how preeclampsia and antenatal depression were associated with offspring temperamental style. Design: Prospective cohort study with regular assessment of mother"s blood pressure at each prenatal visit, offspring were followed till three months. Setting: Two prenatal clinics, New York City, USA. Participants: A cohort of 233 pregnant women were followed throughout pregnancy. Of those, 141 provided ratings of infant temperament at three months. Exposures: Diagnostic outcome of maternal depression by clinical interviewers blind to preeclampsia status were ascertained using the Structured Clinical Interview for DSM-IV Axis I Disorders. The development of preeclampsia, defined by the onset of hypertension (> 140/90 mm HG) after 20 weeks" gestation, accompanied by 300 mg of protein, monitored via electronic medical records. Main Outcome Measures: Birth outcomes were assessed via standardized ratings at delivery. Infant temperament was reported by the mother at six months, using the 91-item IBQ-R (Infant Behavioral Questionnaire-Revised). Results: Preeclampsia was associated with an over 5-fold increased risk for fetal/infant mortality, a 3- to 7-fold increased risk for poorer birth outcomes, and flatter affect and distress in infants. Furthermore, infants born to preeclamptic mothers with co-occurring depression displayed lower levels of smiling/laughter, high-intensity pleasure seeking behavior, perceptual sensiti

关键词：抑郁症气质子痫先兆产前婴儿围产期母亲

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