您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报 (医学版) ›› 2024, Vol. 62 ›› Issue (3): 87-91.doi: 10.6040/j.issn.1671-7554.0.2023.1051

• 医学心理学 • 上一篇    下一篇

儿童期不良经历对妊娠期抑郁症状的影响:母胎依恋的中介作用

曹丹凤,李慧   

  1. 山东第一医科大学第一附属医院(山东省千佛山医院)护理部, 山东 济南 250014
  • 发布日期:2024-05-06
  • 通讯作者: 李慧. E-mail:275769598@qq.com

Influence of adverse childhood experiences on depression in pregnancy: mediating effect of maternal-fetal attachment

CAO Danfeng, LI Hui   

  1. Department of Nursing, The First Affiliated Hospital of Shandong First Medical University &
    Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China
  • Published:2024-05-06

PDF (PC)

15

摘要： 目的 探讨母胎依恋在儿童期不良经历与妊娠期抑郁症状间的中介作用。 方法 选取2020年1-12月在山东省某三甲医院产科病房住院的900名孕妇为研究对象,采用一般信息调查表、爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale, EPDS)、儿童期不良经历问卷修订版量表(Revised Adverse Childhood Experience Questionnaire, ACEQ-R)和母胎依恋关系量表(Maternal Antenatal Attachment Scale, MAAS)进行问卷调查,探讨母胎依恋在儿童期不良经历与妊娠期抑郁症状间的中介作用。使用SPSS 21.0 PROCESS插件程序进行中介分析,Bootstrap程序进行中介效应检验。 结果 儿童期不良经历与母胎依恋(B=-0.73,P<0.001)、母胎依恋与妊娠期抑郁症状(B=-0.07,P<0.001)、儿童期不良经历与妊娠期抑郁症状(B=0.60,P<0.001)这三者之间的路径系数均达到显著水平。母胎依恋在儿童期不良经历与妊娠期抑郁症状之间存在中介效应,其间接效应为0.053,占总效应(0.597)的8.9%。 结论 儿童期不良经历可以通过母胎依恋对妊娠期抑郁产生影响。医护人员应积极学习母胎依恋及相关心理干预知识,在临床工作中为孕妇提供有针对性的指导。

关键词: 妊娠期, 抑郁症状, 儿童期不良经历, 母胎依恋, 中介作用

Abstract: Objective To investigate the mediating role of maternal attachment between adverse childhood experiences and depressive symptoms during pregnancy. Methods A total of 900 pregnant women hospitalized in the obstetric ward of a tertiary hospital in Shandong Province from January to December 2020 were selected as the research subjects. General Information Questionnaire, Edinburgh Postpartum Depression Scale(EPDS), Revised Adverse Childhood Experiences Questionnaire(ACEQ-R)and Maternal Antenatal Attachment Scale(MAAS)were used to explore mediating role of maternal attachment between adverse childhood experiences and depressive symptoms during pregnancy. The SPSS 21.0 PROCESS plug-in program was used for mediation analysis, and the Bootstrap program was used to test the mediation effect. Results The path coefficients between adverse childhood experiences and maternal fetal attachment(B=-0.73, P<0.001), maternal fetal attachment and depressive symptoms during pregnancy(B=-0.07, P<0.001), adverse childhood experiences and depressive symptoms during pregnancy(B=0.60, P<0.001)were all significant. Maternal-fetal attachment had a mediating effect between adverse childhood experiences and depressive symptoms during pregnancy. The indirect effect was 0.053, accounting for 8.9% of the total effect(0.597). Conclusion Adverse childhood experiences can influence prenatal depression through maternal-fetal attachment. Medical staff should actively learn about maternal fetal attachment and related psychological intervention knowledge, and provide targeted guidance for pregnant women in clinical work.

Key words: Pregnancy, Depressive symptoms, Adverse childhood experiences, Maternal-fetal attachment, Mediation

中图分类号: 

  • R47
[1] World Health Organization. World mental health report: Transforming mental health for all[EB/OL].[2023-11-10]. https://www.who.int/publications/i/item/9789240049338.
[2] 新华社.中共中央 国务院印发《“健康中国2030”规划纲要》[EB/OL] ( 2016-10-25)[2023-10-16]. http://www.xinhuanet.com//politics/2016-10/25/c_1119785867.htm
[3] 王葳,尹晓辉,王晓霞,等. 孕妇心理压力状况及影响因素分析[J].中国妇幼健康研究, 2017, 28(3): 252-255. WANG Wei, YIN Xiaohui, WANG Xiaoxia, et al. Psychological pressure status and its risk factors of pregnant women[J]. Chinese Journal of Woman and Child Health Research, 2017, 28(3): 252-255.
[4] 王玉琼, 王颖, 郭秀静. 妊娠早期和中期孕妇发生抑郁状况的调查及分析[J].解放军护理杂志, 2015, 32(18): 5-8.
[5] 胡娟, 王玉琼. 成都市孕产妇产前抑郁与产后抑郁关系的研究[J].中华护理杂志, 2009, 44(11): 984-987. HU Juan, WANG Yuqiong. The relationship between antenatal depression and postnatal depression of women in Chengdu City[J]. Chinese Journal of Nursing, 2009, 44(11): 984-987.
[6] Kingston D, Tough S, Whitfield H, et al. Prenatal and postpartum maternal psychological distress and infant development: a systematic review[J]. Child Psychiatry Hum Dev, 2012, 43(5): 683-714.
[7] 吴散散. 妊娠期抑郁及影响因素分析[D].北京:北京协和医学院, 2020.
[8] Rifkin-Graboi A, Bai J, Chen H, et al. Prenatal maternal depression associates with microstructure of right amygdala in neonates at birth[J]. Biological Psychiatry, 2013, 74(11): 837-844.
[9] 曹丹凤, 刘宗花, 王君芝, 等. 女性儿童期家庭功能障碍对成年后妊娠期抑郁症状的独立和累积作用[J].山东大学学报(医学版), 2022, 60(6): 97-101, 106. CAO Danfeng, LIU Zonghua, WANG Junzhi, et al. The independent and cumulative associations of childhood household dysfunction with depressive symptoms during pregnancy[J]. Journal of Shandong University(Health Sciences), 2022, 60(6): 97-101, 106.
[10] 王智强, 汪蕾蕾, 韩娟, 等. 儿童期不良经历与成年后抑郁症的相关性研究[J]. 华中科技大学学报(医学版), 2016, 45(2): 216-223. WANG Zhiqiang, WANG Leilei, HAN Juan, et al. Association of adverse childhood experiences with depression in adults[J]. Acta Med Univ Sci Technol Huazhong, 2016, 45(2): 216-223.
[11] Chapman DP, Whitfield CL, Felitti VJ, et al. Adverse childhood experiences and the risk of depressive disorders in adulthood[J]. J Affect Disord, 2004, 82(2): 217-225.
[12] Bielawska-Batorowicz E, Siddiqui A. A study of prenatal attachment with Swedish and Polish expectant mothers[J]. J Reprod Infant Psychol,2008, 26(4): 373-384.
[13] 李亚芳, 孙垚, 潘丽, 等. 领悟社会支持对孕晚期妇女焦虑抑郁与母胎依恋的调节作用[J]. 中国实用护理杂志, 2019, 35(14): 1079-1083. LI Yafang, SUN Yao, PAN Li, et al. Moderating effect of perceived social support on relationship between negative emotion and maternal-fetal attachment[J]. Chinese Journal of Practical Nursing, 2019, 35(14): 1079-1083.
[14] Szegda K, Bertone-Johnson ER, Pekow P, et al. Physical activity and depressive symptoms during pregnancy among Latina women: a prospective cohort study[J]. BMC Pregnancy Childbirth, 2018, 18(1): 252.
[15] Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale[J]. Br J Psychiatry, 1987, 150:782-786. doi: 10.1192/bjp.150.6.782.
[16] Gibson J, Mckenzie-McHarg K, Shakespeare J, et al. A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepatum and postpartum women[J]. Acta Psychiatr Scand, 2009, 119(5):350-364.
[17] Finkelhor D, Shattuck A, Turner H, et al. A revised inventory of Adverse Childhood Experiences[J]. Child Abuse Negl, 2015, 48: 13-21. doi: 10. 1016 /j. chiabu. 2015. 07. 011.
[18] 王艳荣, 林萍珍, 曹枫林. 中文儿童期不良经历问卷修订版的效度与信度[J]. 中国心理卫生杂志, 2018, 32(9): 760-764. WANG Yanrong, LIN Pingzhen, CAO Fenglin. Validity and Reliability of the Chinese Version of the Revised Adverse Childhood Experience Questionnaire[J]. Chinese Mental Health Journal, 2018, 32(9): 760-764.
[19] Golbasi Z, Ucar T, Tugut N. Validity and Reliability of the Turkish Version of the Maternal Antenatal Attachment Scale[J]. Jpn J Nurs Sci, 2015, 12(2): 154-161.
[20] 聂戈, 范红霞. 母胎依恋关系量表的修订及信效度检验[J].中国临床心理学杂志, 2017, 25(4): 675-677. NIE Ge, FAN Hongxia. Validity and Reliability of the Chinese Version Maternal Antenatal Attachment Scale[J]. Chinese Journal of Clinical Psychology, 2017, 25(4): 675-677.
[21] 黄海涛, 丁月明, 万晓, 等. 母胎依恋与围产期抑郁关系的研究进展[J].解放军护理杂志, 2022, 39(4): 71-73.
[22] 张烜, 李佳欢, 王颖, 等. 情绪调节在实习护生正念水平与临床沟通能力之间的中介作用[J].山东大学学报(医学版), 2018, 56(12): 86-91. ZHANG Xuan, LI Jiahuan, WANG Ying, etal. Mediating effect of emotion regulation on relationship between mindfulness and clinical communication ability of nursing students[J]. Journal of Shandong University(Health Sciences), 2018, 56(12): 86-91.
[23] Kelly AE. The psychology of secrets[M]. New York: Kluwer Academic/Plenum, 2002: 1-12.
[24] Stockl H, Gardner F. Womens perceptions of how pregnancy influences the context of intimate partner violence in Germany[J]. Cult Health Sex, 2013, 15(10): 1206-1220.
[25] Narayan AJ, Lieberman AF, Masten AS. Intergenerational transmission and prevention of adverse childhood experiences(ACEs)[J]. Clin Psychol Rev, 2021, 85:101997. doi: 10.1016/j.cpr.2021.101997.
[26] Lotto CR, Altafim ERP, Linhares MBM. Maternal history of childhood adversities and later negative parenting: a systematic review[J]. Trauma Violence Abuse, 2023, 24(2): 662-683.
[27] Jussila H, Pelto J, Korja R, et al. The association of maternal-fetal attachment with smoking and smoking cessation during pregnancy in The FinnBrain Birth Cohort Study[J]. BMC Pregnancy Childbirth, 2020, 20(1): 741.
[1] 宋敏,曹鲁泉,吴利龙,吴淑霞,刘静,张娟,刘翠英. 9例产科A族链球菌感染临床分析[J]. 山东大学学报 (医学版), 2023, 61(11): 89-95.
[2] 曹丹凤,刘宗花,王君芝,张国翔. 女性儿童期家庭功能障碍对成年后妊娠期抑郁症状的独立和累积作用[J]. 山东大学学报 (医学版), 2022, 60(6): 97-101.
[3] 孙富云,王维鹏,张会会,耿艳,安小霞,李双双,张彬彬. 结直肠癌术后患者人格特质与抑郁、焦虑症状的关联性[J]. 山东大学学报 (医学版), 2021, 59(7): 91-96.
[4] 龙宇晗,罗霞,姜洁. 妊娠期异常高脂血症2例报告并文献复习[J]. 山东大学学报 (医学版), 2021, 59(3): 103-106.
[5] 萧阳,陶宇,王方怡,梁俞秀,张晋,季晓康,王志萍. 山东省部分地区PM2.5和PM10暴露与妊娠期糖尿病的关联性分析[J]. 山东大学学报 (医学版), 2021, 59(12): 101-109.
[6] 路翠艳,潘芳,方方. 大学生主动、被动拖延与正念、自我效能感的关系[J]. 山东大学学报 (医学版), 2021, 59(10): 110-115.
[7] 陈擎仪,张烜,王娟,孙继伟,曹丹凤, 曹枫林. 妊娠期女性自杀意念的危险因素及其累积效应[J]. 山东大学学报 (医学版), 2021, 59(1): 91-94.
[8] 吕岩,于潇,蔺新英,赵琦,王保珍. 聊城市老年女性膳食模式与抑郁症状的关系[J]. 山东大学学报 (医学版), 2020, 58(11): 103-108.
[9] 景翔,王亚丽,卢露,夏宇,焦安安,李耀祖,徐凌忠. 农村老年人日常活动能力、社会支持与孤独感的关系:一般自我效能的中介作用[J]. 山东大学学报 (医学版), 2020, 58(1): 94-99.
[10] 黄凤艳,许俐,刘平,王志萍. 会阴裂伤在孕前BMI与产后盆底肌功能障碍关联性中的中介作用[J]. 山东大学学报 (医学版), 2019, 57(2): 99-104.
[11] 王颖,杨蓓,王娟,李艳艳,曹枫林. 累积儿童期逆境对护士抑郁症状的影响[J]. 山东大学学报 (医学版), 2019, 57(11): 83-89.
[12] 于娜,郭情情,孙梅,盛燕,马增香,秦莹莹. 甲状腺癌术后行IVF/ICSI-ET助孕临床结局[J]. 山东大学学报 (医学版), 2018, 56(9): 54-58.
[13] 张烜,李佳欢,王颖,柴榕,杨蓓,曹枫林. 情绪调节在实习护生正念水平与临床沟通能力之间的中介作用[J]. 山东大学学报 (医学版), 2018, 56(12): 86-91.
[14] 李长瑾,洪炜,赵佳,甘伟. 老年人生活质量与心理弹性的关系及领悟社会支持的中介作用[J]. 山东大学学报（医学版）, 2017, 55(9): 6-10.
[15] 刘春琴, 李华芳, 田晓红, 邹桂元, 厉萍. 精神科护士人格特征与心理困扰的关系:心理弹性的中介作用[J]. 山东大学学报（医学版）, 2015, 53(9): 90-94.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 孟朝暾,李钦, 孙卉,邬信芳,孙文凯,高伟. 白细胞介素18单核苷酸多态性与73例喉鳞状细胞癌易感性的关联性[J]. 山东大学学报 (医学版), 2020, 1(9): 58 -63 .
[2] 安迪,汪心婷,刘珍珍,贾存显. 青少年不宁腿综合征与自杀行为的关系[J]. 山东大学学报 (医学版), 2020, 1(9): 77 -82 .
[3] 李良,薛冰,谢红强,赵强. 小肠侵袭性蔓状血管瘤1例[J]. 山东大学学报 (医学版), 2020, 1(9): 122 -124 .
[4] 王东盛,刘倩,寇妍. PDGF及其受体在大鼠胰腺纤维化中的作用[J]. 山东大学学报(医学版), 2006, 44(4): 360 -363 .
[5] 张旭华,刘师莲,秦延江,靖永胜,徐广润. 多发性硬化患者脑脊液蛋白质组学的研究[J]. 山东大学学报(医学版), 2006, 44(5): 438 -442 .
[6] 王敏. 雌激素减少与代谢综合征关系的实验研究[J]. 山东大学学报(医学版), 2006, 44(5): 492 -495 .
[7] 许艺怀1，孙书珍1，甄军晖2，李倩1，王聪1. CXCL16和ox-LDL在阿霉素肾病小鼠中的变化及意义[J]. 山东大学学报（医学版）, 2014, 52(5): 68 -72 .
[8] 韩波1，2，王建春2，张涛2，朱小龙2，李丛2，王正军2，赵勇2，邹承伟2. 风湿性心房颤动患者左心房组织中钙蛋白酶-2的表达[J]. 山东大学学报（医学版）, 2014, 52(4): 93 -96 .
[9] 岳庆伟，朱德晓，吴金涛，刘海莉，张静，李贵宝，丁兆习，孙晋浩. 甲基苯丙胺对中脑边缘投射多巴胺神经元自发动作电位频率和Ih电流的影响[J]. 山东大学学报（医学版）, 2014, 52(5): 10 -14 .
[10] 张慧,张明华,李勤,陈廷顺,赵琦,汪慧,于书彦. 家兔疑核内P2X受体在急性低氧中的作用[J]. 山东大学学报(医学版), 2008, 46(2): 136 -139 .
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发