Jones Alexander, Godfrey Keith M, Wood Peter, Osmond Clive, Goulden Peter, Phillips David I W
Medical Research Council, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, United Kingdom.
J Clin Endocrinol Metab. 2006 May;91(5):1868-71. doi: 10.1210/jc.2005-2077. Epub 2006 Feb 7.
Experimental studies in animals show that adverse prenatal environments lead to lifelong alterations in the activity of the hypothalamic-pituitary-adrenal axis, which mediates the stress response through secretion of glucocorticoid hormones. The extent to which such prenatal hypothalamic-pituitary-adrenal axis adaptations occur in humans is unknown.
The objective of the study was to determine whether smaller but otherwise healthy term babies are more likely to demonstrate increased glucocorticoid responses to psychological stress in childhood.
This was a cross-sectional study of 68 boys and 72 girls (aged 7-9 yr) who have been followed up since 12 wk gestation when their mothers took part in a study of healthy children born in Southampton, United Kingdom.
Salivary cortisol responses to psychological stress were measured.
In boys, birth weight was inversely related to salivary cortisol responses to stress (r = -0.56, P < 0.001) but not morning cortisol levels, whereas in girls, morning peak cortisol was inversely related to birth weight (r = -0.36, P < 0.05). These associations were independent of gestational age and potential confounding factors including obesity, social class, and educational achievement.
This study suggests that processes occurring during fetal life, resulting in smaller newborns, have a lasting effect on adrenocortical responses to stress in boys and on basal adrenocortical activity in girls. Given the known associations between small alterations in adrenocortical activity and features of the metabolic syndrome such as raised blood pressure and glucose intolerance, these effects warrant further investigation of their potential impact on the future health of prepubertal children.
动物实验研究表明，不良的产前环境会导致下丘脑 - 垂体 - 肾上腺轴的活动发生终身改变，该轴通过分泌糖皮质激素来介导应激反应。目前尚不清楚这种产前下丘脑 - 垂体 - 肾上腺轴的适应性变化在人类中出现的程度。
本研究的目的是确定体型较小但其他方面健康的足月儿在童年时期是否更有可能表现出对心理应激的糖皮质激素反应增强。
这是一项横断面研究，研究对象为68名男孩和72名女孩（年龄7 - 9岁），自妊娠12周起对他们进行随访，当时他们的母亲参与了一项关于在英国南安普敦出生的健康儿童的研究。
测量唾液皮质醇对心理应激的反应。
在男孩中，出生体重与唾液皮质醇对应激的反应呈负相关（r = -0.56，P < 0.001），但与早晨皮质醇水平无关；而在女孩中，早晨皮质醇峰值与出生体重呈负相关（r = -0.36，P < 0.05）。这些关联独立于胎龄以及包括肥胖、社会阶层和教育程度在内的潜在混杂因素。
本研究表明，胎儿期发生的导致新生儿体型较小的过程，对男孩肾上腺皮质对应激的反应以及女孩肾上腺皮质基础活动有持久影响。鉴于肾上腺皮质活动的微小变化与代谢综合征特征（如血压升高和葡萄糖不耐受）之间已知的关联，这些影响值得进一步研究它们对青春期前儿童未来健康的潜在影响。
