Rich-Edwards Janet W, Grizzard Tarayn A
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass 02215, USA.
Am J Obstet Gynecol. 2005 May;192(5 Suppl):S30-5. doi: 10.1016/j.ajog.2005.01.072.
This review focuses on the contribution of psychosocial stress to the racial/ethnic disparities in preterm delivery in the United States and addresses the subset of psychosocial stressors that are disproportionately prevalent among minority women. We argue that chronic exposure to poverty, racism, and insecure neighborhoods may condition stress responses and physiologic changes in ways that increase the risk of preterm delivery. Cumulative stressors may impact pregnancy outcomes through several intersecting pathways, which include neuroendocrine, behavioral, immune, and vascular mechanisms. Many of these pathways also lead to chronic disease. It may be useful to consider preterm delivery as a chronic disease with roots in childhood, adolescence, and early adulthood. Like other physiologic systems, the female reproductive axis may be vulnerable to the physiologic "wear and tear" of cumulative stress, which results in preterm delivery.
本综述聚焦于心理社会压力对美国早产方面种族/族裔差异的影响，并探讨在少数族裔女性中普遍存在的心理社会压力源子集。我们认为，长期暴露于贫困、种族主义和不安全社区环境中，可能会以增加早产风险的方式影响应激反应和生理变化。累积的压力源可能通过多种相互交织的途径影响妊娠结局，这些途径包括神经内分泌、行为、免疫和血管机制。其中许多途径还会导致慢性病。将早产视为一种起源于儿童期、青少年期和成年早期的慢性病可能会有所帮助。与其他生理系统一样，女性生殖轴可能易受累积压力导致的生理“磨损”影响，进而引发早产。
