Department of Psychiatry and Human Behavior, Women and Children's Health and Well-Being Project, Orange, CA 92868, USA.
Neuroendocrinology. 2012;95(1):7-21. doi: 10.1159/000327017. Epub 2011 Apr 15.
BACKGROUND/AIMS: Accumulating evidence from a relatively small number of prospective studies indicates that exposure to prenatal stress profoundly influences the developing human fetus with consequences that persist into childhood and very likely forever.
Maternal/fetal dyads are assessed at ∼20, ∼25, ∼31 and ∼36 weeks of gestation. Infant assessments begin 24 h after delivery with the collection of cortisol and behavioral responses to the painful stress of the heel-stick procedure and measures of neonatal neuromuscular maturity. Infant cognitive, neuromotor development, stress and emotional regulation are evaluated at 3, 6 12 and 24 months of age. Maternal psychosocial stress and demographic information is collected in parallel with infant assessments. Child neurodevelopment is assessed with cognitive tests, measures of adjustment and brain imaging between 5 and 8 years of age.
Psychobiological markers of stress during pregnancy, especially early in gestation, result in delayed fetal maturation, disrupted emotional regulation and impaired cognitive performance during infancy and decreased brain volume in areas associated with learning and memory in 6- to 8-year-old children. We review findings from our projects that maternal endocrine alterations that accompany pregnancy and influence fetal/infant/child development are associated with decreased affective responses to stress, altered memory function and increased risk for postpartum depression.
Our findings indicate that the mother and her fetus both are influenced by exposure to psychosocial and biological stress. The findings that fetal and maternal programming occur in parallel may have important implications for long-term child development and mother/child interactions.
背景/目的：越来越多的前瞻性研究证据表明，产前应激会对发育中的人类胎儿产生深远影响，其后果会持续到儿童期甚至可能伴随终生。
在妊娠约 20 周、25 周、31 周和 36 周时对母婴对子进行评估。婴儿评估从出生后 24 小时开始，采集皮质醇，并对足跟采血这一疼痛应激过程中的行为反应以及新生儿神经肌肉成熟度进行测量。在婴儿 3、6、12 和 24 个月时对其认知、神经运动发育、应激和情绪调节进行评估。同时平行收集母亲的社会心理压力和人口统计学信息。在 5 至 8 岁时使用认知测试、适应度测量和脑成像对儿童神经发育进行评估。
怀孕期间的应激生物标志物，尤其是妊娠早期的应激生物标志物，会导致胎儿成熟延迟、情绪调节紊乱、婴儿期认知表现受损、6 至 8 岁儿童学习和记忆相关脑区体积减少。我们回顾了来自我们项目的发现，即伴随妊娠出现并影响胎儿/婴儿/儿童发育的母体内分泌变化与应激时的情感反应减少、记忆功能改变以及产后抑郁风险增加有关。
我们的研究结果表明，母亲及其胎儿都会受到社会心理和生物应激的影响。胎儿和母体编程同时发生的发现可能对儿童长期发育和母婴互动具有重要意义。
