Smith Alicia K, Newport D Jeffrey, Ashe Morgan P, Brennan Patricia A, Laprairie Jamie L, Calamaras Martha, Nemeroff Charles B, Ritchie James C, Cubells Joseph F, Stowe Zachary N
Departments of Psychiatry & Behavioral SciencesPsychology, Emory University, Atlanta, GADepartment of Psychiatry & Behavioral Sciences, University of Miami, Miami, FLDepartments of PathologyHuman GeneticsGynecology & Obstetrics, Emory University, Atlanta, GA, USA.
Clin Endocrinol (Oxf). 2011 Jul;75(1):90-5. doi: 10.1111/j.1365-2265.2011.03998.x.
Clinical and preclinical studies indicate that maternal stress during pregnancy may exert long-lasting adverse effects on offspring. This investigation sought to identify factors mediating the relationship between maternal and neonatal hypothalamic-pituitary-adrenal (HPA) axes in pregnant women with past or family psychiatric history.
Two hundred and five pairs of maternal and umbilical cord blood samples from a clinical population were collected at delivery.
Maternal and neonatal HPA axis activity measures were plasma adrenocorticotrophic hormone (ACTH), total cortisol, free cortisol and cortisol-binding globulin concentrations. The effects of maternal race, age, body mass index, psychiatric diagnosis (DSM-IV), birth weight, delivery method and estimated gestational age (EGA) at delivery on both maternal and neonatal HPA axis measures were also examined. Incorporating these independent predictors as covariates where necessary, we evaluated whether neonatal HPA axis activity measures could be predicted by the same maternal measure using linear regression.
Delivery method was associated with umbilical cord plasma ACTH and both total and free cord cortisol concentrations (T = 10·53-4·21; P < 0·0001-0·010). After accounting for method of delivery and EGA, we found that maternal plasma ACTH concentrations predicted 23·9% of the variance in foetal plasma ACTH concentrations (T = 6·76; P < 0·0001), and maternal free and total plasma cortisol concentrations predicted 39·8% and 32·3% of the variance in foetal plasma free and total cortisol concentrations (T = 5·37-6·90; P < 0·0001), respectively.
These data suggest that neonatal response is coupled with maternal HPA axis activity at delivery. Future investigations will scrutinize the potential long-term sequelae for the offspring.
临床和临床前研究表明，孕期母亲压力可能会对后代产生长期不良影响。本研究旨在确定在有既往或家族精神病史的孕妇中，介导母亲与新生儿下丘脑-垂体-肾上腺（HPA）轴之间关系的因素。
从临床人群中收集了205对母婴的分娩时母体和脐带血样本。
母体和新生儿HPA轴活性指标为血浆促肾上腺皮质激素（ACTH）、总皮质醇、游离皮质醇和皮质醇结合球蛋白浓度。还研究了母亲的种族、年龄、体重指数、精神诊断（DSM-IV）、出生体重、分娩方式和分娩时的估计孕周（EGA）对母体和新生儿HPA轴指标的影响。必要时将这些独立预测因素作为协变量纳入，我们使用线性回归评估新生儿HPA轴活性指标是否可以由相同的母体指标预测。
分娩方式与脐带血浆ACTH以及脐带总皮质醇和游离皮质醇浓度相关（T = 10·53 - 4·21；P < 0·0001 - 0·010）。在考虑分娩方式和EGA后，我们发现母体血浆ACTH浓度可预测胎儿血浆ACTH浓度方差的23·9%（T = 6·76；P < 0·0001），母体游离和总血浆皮质醇浓度分别可预测胎儿血浆游离和总皮质醇浓度方差的39·8%和32·3%（T = 5·37 - 6·90；P < 0·0001）。
这些数据表明，分娩时新生儿反应与母体HPA轴活性相关。未来的研究将仔细检查后代潜在的长期后遗症。
