Lazinski Marysia J, Shea Alison K, Steiner Meir
Women's Health Concerns Clinic, St Joseph's Healthcare, Hamilton, ON, Canada.
Arch Womens Ment Health. 2008 Dec;11(5-6):363-75. doi: 10.1007/s00737-008-0035-4. Epub 2008 Oct 31.
Pregnancy is associated with major physiological changes and adaptation to these changes is crucial for normal fetal development. Heightened emotional stress during pregnancy may interfere with the necessary adaptation and lead to dysregulation of the two major stress response systems: the Hypothalamic-Pituitary-Adrenal (HPA) Axis and the Autonomic Nervous System (ANS). Negative effects on the fetus of such maladaptation have been documented in both animals and humans and range from poor birth outcomes to negative impacts on neurodevelopment, as well as long term emotional and behavioural disturbances. Conversely, it has been hypothesized that low levels of maternal prenatal stress may actually have an adaptive value for the offspring. Investigation of these associations employing physiological markers and repeated measures throughout pregnancy and postpartum of both the mother and the offspring, is required in order to understand the various effects of prenatal stress on the development of the offspring. It is also crucial to explore the possibility of variable periods of vulnerability throughout gestation. The aim of this commentary is to reexamine the current literature on the ill-effects of maternal stress during pregnancy on the offspring and to explore avenues for future treatment and prevention.
怀孕与重大生理变化相关,适应这些变化对胎儿正常发育至关重要。孕期情绪压力增加可能会干扰必要的适应过程,并导致两大应激反应系统失调:下丘脑-垂体-肾上腺(HPA)轴和自主神经系统(ANS)。动物和人类研究均已证明,这种适应不良对胎儿有负面影响,范围从不良出生结局到对神经发育的负面影响,以及长期的情绪和行为障碍。相反,有人推测母亲产前压力水平较低实际上可能对后代具有适应性价值。为了了解产前压力对后代发育的各种影响,需要使用生理指标并在整个孕期和产后对母亲和后代进行重复测量来研究这些关联。探索整个妊娠期不同易损期的可能性也至关重要。本评论的目的是重新审视当前关于孕期母亲压力对后代不良影响的文献,并探索未来治疗和预防的途径。