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产前应激与婴儿五个月时的情感反应。

Prenatal stress and infant affective reactivity at five months of age.

机构信息

Department of Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Blumenstr. 8, 69115 Heidelberg, Germany.

出版信息

Early Hum Dev. 2011 Feb;87(2):129-36. doi: 10.1016/j.earlhumdev.2010.11.014. Epub 2010 Dec 30.

Abstract

BACKGROUND

prospective studies concerning prenatal stress and its outcome on children's emotional development postulated a potential influence of prenatal hormonal levels or emotional stressors on child development [1-3]. In a retrospective study, an influence of maternal emotional stress on infant affective reactivity was found [4].

AIMS

this study was conducted in order to confirm these findings in a prospective study design.

STUDY DESIGN

a prospective longitudinal study design was conducted with three study waves during pregnancy and one time point five months postnatally.

SUBJECTS

the final sample consisted of n=104 mother-infant dyads.

OUTCOME MEASURES

Maternal baseline cortisol levels and emotional stress were assessed in each trimester of pregnancy. Children were examined with the infant reactivity battery according to Kagan & Snidman [5] at the age of five months.

RESULTS

mothers of children with high affective reactivity (cry score≥7) were significantly less depressed (p<.10) and perceived less stress (p<.05) in mid-pregnancy and were confronted with less external stress factors (p<.10) at the end of pregnancy. Cortisol levels did not differ in both groups in any pregnancy trimenon (p>.05).

CONCLUSIONS

these data add a new specific aspect to the 'fetal programming hypothesis' and are the first to confirm the speculative data from retrospective studies. Baseline cortisol does not seem to be the 'hormonal mediator' of this association. Therefore, cortisol stress reactivity or other neuroendocrine mechanisms should be assessed in future studies.

摘要

背景

前瞻性研究表明,产前应激及其对儿童情绪发展的影响,可能与产前激素水平或情绪应激源对儿童发育的潜在影响有关[1-3]。在一项回顾性研究中,发现了母亲情绪应激对婴儿情感反应的影响[4]。

目的

本研究旨在通过前瞻性研究设计来证实这些发现。

设计

采用前瞻性纵向研究设计,在妊娠期间进行了三次研究,产后五个月进行了一次。

研究对象

最终样本包括 n=104 例母婴对子。

结果测量

在每个妊娠 trimester 评估母体基线皮质醇水平和情绪应激。在五个月大时,根据 Kagan & Snidman[5],使用婴儿反应性电池对儿童进行检查。

结果

高情感反应(哭闹评分≥7)儿童的母亲在妊娠中期抑郁程度显著降低(p<.10),压力感知降低(p<.05),妊娠晚期面临的外部应激因素减少(p<.10)。在任何妊娠 trimester 中,两组的皮质醇水平均无差异(p>.05)。

结论

这些数据为“胎儿编程假说”增添了一个新的特定方面,并且首次证实了回顾性研究的推测数据。基线皮质醇似乎不是这种关联的“激素中介物”。因此,在未来的研究中应评估皮质醇应激反应或其他神经内分泌机制。

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