The association between pregnancy-related anxiety and behavioral development in 18-month-old children: The mediating effects of parenting styles and breastfeeding methods

Authors：Yu-Wei Liu , Hui Liu , Kun Huang , Bei-Bei Zhu , Shuang-Qin Yan , Jia-Hu Hao , Peng Zhu , Fang-Biao Tao , Shan-Shan Shao

Source：J Affect Disord. 2023 Jul 15;333:392-402.

DOI: 10.1016/j.jad.2023.04.014

Abstract：

Background: Pregnancy-related anxiety (PRA) is a distinct type of anxiety from general anxiety, affects many pregnant women, and is correlated with poor behavioral development in children. However, the mediation paths were unclear.

Methods: A total of 2032 mother-infant pairs from the Ma'anshan Birth Cohort were included in the current study. Maternal PRA was assessed in the second and third trimesters. Children's behavioral development was evaluated at the age of 18 months. In addition, information on parenting styles and breastfeeding methods was obtained at postpartum. Multivariate regression and structural equation modeling were used to examine the associations between maternal PRA and children's behavioral development.

Results: Significant intercorrelations were found between maternal PRA, the potential mediators (parenting styles and breastfeeding methods), and 18-month-old children's ASQ scores. Parenting styles played an intermediary role in the relationship between maternal PRA and children's behavioral development (β = 0.030, 95 % confidence interval: 0.017-0.051), and the mediating effect accounted for 29.1 % of the total effect. However, breastfeeding methods did not mediate the link between PRA and children's behavior.

Limitations: Depression and postpartum anxiety were not controlled for in our analysis, which left us unable to estimate the independent impact of PRA on children's behavior.

Conclusions: Parenting rather than breastfeeding is the mediating factor of behavioral problems in children caused by PRA.

摘要：

背景：妊娠相关焦虑（PRA）是一种不同于一般焦虑的焦虑类型，影响着许多孕妇，并与儿童的不良行为发展相关。然而，其中介路径尚不清楚。

方法：本研究纳入了马鞍山出生队列中的 2032 对母婴。在孕中期和孕晚期对母亲的PRA进行评估。儿童的行为发育在 18 个月大时进行评估。此外，还在产后获得了有关养育方式和母乳喂养方法的信息。研究采用多元回归和结构方程模型来检验产妇PRA与儿童行为发育之间的关系。

结果：研究发现，母亲PRA、潜在中介因素（养育方式和母乳喂养方法）与18个月大儿童的ASQ得分之间存在显著的相互关系。养育方式在母亲PRA与儿童行为发展之间的关系中起中介作用（β = 0.030，95 % 置信区间：0.017-0.051），中介效应占总效应的29.1%。然而，母乳喂养方法并没有在PRA与儿童行为之间起到中介作用。

局限性：我们的分析没有控制抑郁和产后焦虑，因此无法估计PRA对儿童行为的独立影响。

结论：PRA导致的儿童行为问题的中介因素是养育而非母乳喂养。