School of Health & Human Sciences, Southern Cross University, Lismore, New South Wales, Australia.
Women Birth. 2011 Mar;24(1):40-6. doi: 10.1016/j.wombi.2010.08.001. Epub 2010 Sep 15.
The aetiology of non-syndromic cleft lip and palate has as yet not been clearly defined. Familial relationships, environmental toxins and nutritional status have all been considered without conclusive results, although in some studies a potential link between non-syndromic cleft lip and palate and any one or more of these factors has been proposed. Elevated stress, particularly an extended term of traumatic stress, can lead to oxidative damage at the cellular level via hypothalamus-pituitary-adrenal (HPA) axis dysregulation, high cortisol and cytokine production. The effect of this hormonal shift is to re-direct the blood supply to the mother's muscles, thereby reducing the supply to the placenta, causing a potential nutritional deficiency which may then result in a genetic alteration in the foetus. Mothers with a child aged two years or younger who had been born with a cleft, who were members of CleftPals, a family support group, volunteered to be participants in this qualitative study. The research first called for a survey to be completed by the mother and this was then followed by an interview conducted by the researcher. The study involved families living in the three eastern States of Australia. The results suggest that physical and/or emotional stress may well be implicated in clefting. While little work has been done in considering stress as a causal factor, the existing literature suggests, as does this study, that elevated stress levels at, or soon after, conception appear to affect foetal development.
非综合征性唇腭裂的病因尚未明确。家族关系、环境毒素和营养状况都被考虑在内，但没有得出明确的结果，尽管在一些研究中，非综合征性唇腭裂与这些因素中的一个或多个因素之间存在潜在联系。高水平的压力，特别是长期创伤性压力，可通过下丘脑-垂体-肾上腺（HPA）轴失调、皮质醇和细胞因子产生增加，导致细胞水平的氧化损伤。这种激素变化的影响是将血液供应重新引导到母亲的肌肉，从而减少胎盘的供应，导致潜在的营养缺乏，从而可能导致胎儿的基因改变。有一个两岁或两岁以下的孩子患有唇裂的母亲，是一个家庭支持组织 CleftPals 的成员，自愿成为这项定性研究的参与者。研究首先要求母亲完成一项调查，然后由研究人员进行访谈。该研究涉及居住在澳大利亚东部三个州的家庭。结果表明，身体和/或情绪压力很可能与唇裂有关。虽然很少有研究考虑压力作为一个因果因素，但现有文献表明，正如这项研究一样，受孕时或受孕后不久的高压力水平似乎会影响胎儿的发育。
