O'Connor Thomas G, Ben-Shlomo Yoav, Heron Jon, Golding Jean, Adams Diana, Glover Vivette
Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Boulevard, Rochester, NY 14642, USA.
Biol Psychiatry. 2005 Aug 1;58(3):211-7. doi: 10.1016/j.biopsych.2005.03.032.
Animal studies suggest that prenatal stress is associated with long-term disturbance in hypothalamic-pituitary-adrenal (HPA) axis function, but evidence in humans is lacking. This study examined the long-term association between prenatal anxiety and measures of diurnal cortisol at age 10 years.
Measures of cortisol were collected at awakening, 30 min after awakening, and at 4 pm and 9 pm on 3 consecutive days in a sample of 10-year-olds (n = 74) from the Avon Longitudinal Study of Parents and Children, a prospective longitudinal cohort study of mothers and children on whom measures of anxiety and depression were collected in pregnancy and the postpartum period. Analyses examined the links between symptoms of prenatal anxiety and multiple indicators of cortisol, an index of HPA axis functioning.
Prenatal anxiety was significantly associated with individual differences in awakening and afternoon cortisol after accounting for obstetric and sociodemographic risk (partial correlations were .32 and .25, p < .05). The effect for awakening cortisol remained significant after controlling for multiple postnatal assessments of maternal anxiety and depression.
This study provides the first human evidence that prenatal anxiety might have lasting effects on HPA axis functioning in the child and that prenatal anxiety might constitute a mechanism for an increased vulnerability to psychopathology in children and adolescents.
动物研究表明，产前应激与下丘脑-垂体-肾上腺（HPA）轴功能的长期紊乱有关，但人类研究证据不足。本研究探讨了产前焦虑与10岁儿童日间皮质醇测量值之间的长期关联。
在“埃文亲子纵向研究”中，对10岁儿童样本（n = 74）连续3天在觉醒时、觉醒后30分钟、下午4点和晚上9点收集皮质醇测量值。该研究是一项关于母亲和儿童的前瞻性纵向队列研究，在孕期和产后收集了焦虑和抑郁测量值。分析探讨了产前焦虑症状与皮质醇多个指标（HPA轴功能指标）之间的联系。
在考虑产科和社会人口学风险后，产前焦虑与觉醒时和下午皮质醇的个体差异显著相关（偏相关系数分别为0.32和0.25，p < 0.05）。在控制了产后多次对母亲焦虑和抑郁的评估后，觉醒时皮质醇的影响仍然显著。
本研究提供了首个关于人类的证据，表明产前焦虑可能对儿童的HPA轴功能产生持久影响，且产前焦虑可能是儿童和青少年心理病理学易感性增加的一种机制。
