Objective

To examine whether maternal depressed mood at birth moderated the protective effect of a home-visiting intervention on the quality of caregiving for children growing up in a low- and middle-income country.

Method

Almost all pregnant mothers in 24 Cape Town neighborhoods were recruited into a cluster randomized controlled trial matched by neighborhoods to the Philani home-visiting condition (HVC) or the standard care condition (SC). At 3 years after birth, the quality of mother–child interactions between HVC and SC mothers with and without antenatal depressed mood was assessed in a representative subset by rating videotaped observations of mother–child interactions on 10 dimensions of caregiving.

Results

As predicted, maternal depressed mood at birth moderated the effect of the HVC on the quality of mother–child interactions. Among nondepressed mothers, mothers and their children in the HVC scored significantly higher on 5 of the 10 dimensions of the maternal–child interaction scale than mothers in the SC: mothers exhibited more maternal sensitivity, talked more, had more harmonious interactions, and had children who paid more attention and exhibited more positive affect. However, being in the HVC did not significantly affect the mother–child interaction scores among mothers with depressed mood. Among HVC children, those with mothers with depressed mood showed significantly less positive affect and talked less with their mothers than children with nondepressed mothers. SC children with mothers with depressed mood were more responsive and paid attention to their mothers than children with nondepressed mothers.

Conclusion

Home visiting resulted in a better quality of caregiving for mothers without depressive symptoms. Future interventions need to specifically target maternal depression and positive mother–child interactions.

Clinical trial registration information

Mentor Mothers: A Sustainable Family Intervention in South African Townships; https://clinicaltrials.gov; NCT00972699; Philani Home-based Nutrition Intervention Program; https://clinicaltrials.gov; NCT00995592.

中文翻译：

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家访和产前抑郁症影响南非母婴互动的质量。

客观的

为了检验母亲在出生时的情绪低落是否减轻了家庭访问干预对在中低收入国家中成长的儿童的照料质量的保护作用。

方法

开普敦24个社区中几乎所有怀孕的母亲都被纳入一项随机分组的随机对照试验中，该社区与邻里相匹配的费拉尼家庭就诊条件（HVC）或标准护理条件（SC）相匹配。出生后3年，通过评估10个照护过程中母婴互动的录像观察结果，评估了有代表性和无产前抑郁情绪的HVC和SC母亲之间母婴互动的质量。

结果

如预料的那样，母亲在出生时情绪低落减轻了HVC对母婴互动质量的影响。在非抑郁母亲中，HVC中的母亲及其子女在母婴互动量表的10个维度中的5个得分均显着高于SC中的母亲：母亲表现出更高的母体敏感性，更多的交谈，更和谐的互动以及有孩子给予更多关注并表现出更多积极影响。但是，进入HVC并不会显着影响情绪低落的母亲之间的母子互动得分。在HVC儿童中，那些情绪低落的母亲比没有抑郁的母亲表现出明显更少的积极影响，与母亲的交谈也较少。

结论

上门探访可为没有抑郁症状的母亲提供更好的护理质量。未来的干预措施需要专门针对孕产妇抑郁症和积极的母婴互动。

临床试验注册信息

导师母亲：南非乡镇的可持续家庭干预；https://clinicaltrials.gov; NCT00972699；菲拉尼家庭营养干预计划；https://clinicaltrials.gov; NCT00995592。