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胎儿心率反应因女性的精神状态而异:发育风险的早期指标?

Fetal heart rate reactivity differs by women's psychiatric status: an early marker for developmental risk?

作者信息

Monk Catherine, Sloan Richard P, Myers Michael M, Ellman Lauren, Werner Elizabeth, Jeon Jiyeon, Tager Felice, Fifer William P

机构信息

Department of Psychiatry, Columbia University, New York, NY 10032, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 2004 Mar;43(3):283-90. doi: 10.1097/00004583-200403000-00009.

Abstract

OBJECTIVE

To determine whether there are differences in fetal heart rate (FHR) reactivity associated with women's psychiatric status.

METHOD

In 57 women in their 36th to 38th week of pregnancy (mean age 27 +/- 6 years), electrocardiogram, blood pressure (BP), respiration (RSP), and FHR were measured during baseline and a psychological challenge (a Stroop color-word matching task). Subjects underwent the Structured Clinical Interview for DSM-IV (SCID) and completed the Spielberger State-Trait Anxiety Inventory prior to testing.

RESULTS

There was a significant main effect of maternal diagnostic group on FHR reactivity during the Stroop task even after controlling for birth weight and women's BP reactivity (F4,44 = 2.68, p =.04). Fetuses of depressed women had greater heart rate increases compared to fetuses of women with anxiety disorders and those of healthy, low-anxiety women (post hoc comparisons using the Fisher protected least significant difference test; t = 4.12, p <.05; t = 4.72, p <.01, respectively). There was a similar pattern comparing fetuses of healthy, high-anxiety women to the same two groups (t = 3.29, p <.05; t = 3.99, p <.05, respectively). There were no group differences in FHR during a resting baseline period (F4,52 = 1.2, p =.35).

CONCLUSIONS

Maternal mood disturbance is associated with alterations in children's physiological reactivity prior to birth.

摘要

目的

确定与女性精神状态相关的胎儿心率(FHR)反应性是否存在差异。

方法

对57名怀孕36至38周的女性(平均年龄27±6岁),在基线期和心理挑战(一项Stroop颜色-文字匹配任务)期间测量心电图、血压(BP)、呼吸(RSP)和FHR。受试者在测试前接受了DSM-IV结构化临床访谈(SCID),并完成了斯皮尔伯格状态-特质焦虑量表。

结果

即使在控制出生体重和女性血压反应性之后,母亲诊断组在Stroop任务期间对FHR反应性仍有显著的主效应(F4,44 = 2.68,p =.04)。与患有焦虑症的女性和健康、低焦虑女性的胎儿相比,抑郁症女性的胎儿心率增加更大(使用Fisher保护最小显著差异检验进行事后比较;t = 4.12,p <.05;t = 4.72,p <.01)。将健康、高焦虑女性的胎儿与相同的两组进行比较时也有类似模式(分别为t = 3.29,p <.05;t = 3.99,p <.05)。在静息基线期,FHR无组间差异(F4,52 = 1.2,p =.35)。

结论

母亲情绪障碍与出生前儿童生理反应性的改变有关。

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