母亲的实验室应激会影响胎儿神经行为：皮质醇并不能解释所有问题。

Maternal laboratory stress influences fetal neurobehavior: cortisol does not provide all answers.

作者信息

Fink Nadine Stephanie, Urech Corinne, Berger Christoph Tobias, Hoesli Irene, Holzgreve Wolfgang, Bitzer Johannes, Alder Judith

机构信息

Harvard Medical School, Children's Hospital, Child Development Unit, Boston, Massachusetts 02115, USA.

出版信息

J Matern Fetal Neonatal Med. 2010 Jun;23(6):488-500. doi: 10.3109/14767050903300985.

DOI:10.3109/14767050903300985

PMID:20298130

Abstract

OBJECTIVE

Maternal stress can have an impact on pregnancy. However, effects on fetal neurobehavior are not well understood. In this study, the effect of laboratory stress on maternal psychoneuroendocrinological response and on fetal neurobehavior was studied. Serum cortisol as a potential underlying mechanism was measured.

METHODS

Twenty-seven women made a single 1.5-h visit in their third trimester. The laboratory stressor involved an arithmetic task. Associations between maternal laboratory stress response and fetal neurobehavior were analyzed by studying 19 maternal-fetal dyads with high signal quality cardiotocograms.

RESULTS

Stress exposure changed participants stress perception (p < 0.0001). However, only half of the participants (responders) had an HPA-axis response. Fetuses responded to the stress exposure depending on their mothers' stress response: (i) there was a fetal heart rate (FHR) group effect at the level of trend (p = 0.06). Fetuses of responders had higher HR levels 20 min after the exposure (p = 0.043), (ii) there were interaction (p = 0.026) and group effects at the level of trend (p = 0.078) found for FHR short-term variation (STV). Fetuses of responders had lower FHR STV 20 min after stress exposure (p = 0.007). Cortisol as a potential underlying mechanism only seemed to be associated with short- and long-term variation of FHR.

CONCLUSIONS

An activation of the maternal stress-system could result in a child being born having a history of responding to maternal stress.

摘要

目的

母亲的压力会对妊娠产生影响。然而，其对胎儿神经行为的影响尚未得到充分了解。在本研究中，探讨了实验室压力对母亲心理神经内分泌反应及胎儿神经行为的影响。同时测量了血清皮质醇作为一种潜在的潜在机制。

方法

27名孕妇在孕晚期进行了一次为时1.5小时的就诊。实验室应激源包括一项算术任务。通过研究19对母婴二元组的高质量产时监护图，分析母亲实验室应激反应与胎儿神经行为之间的关联。

结果

应激暴露改变了参与者的应激感知（p<0.0001）。然而，只有一半的参与者（反应者）有下丘脑-垂体-肾上腺（HPA）轴反应。胎儿对应激暴露的反应取决于其母亲的应激反应：（i）在趋势水平上存在胎儿心率（FHR）组效应（p = 0.06）。暴露后20分钟，反应者的胎儿心率水平较高（p = 0.043），（ii）在FHR短期变异性（STV）方面发现了交互作用（p = 0.026）和趋势水平上的组效应（p = 0.078）。应激暴露后20分钟，反应者的胎儿FHR STV较低（p = 0.007）。皮质醇作为一种潜在的潜在机制，似乎仅与FHR的短期和长期变异性相关。