Department of Public Health, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands.
PLoS One. 2012;7(1):e30413. doi: 10.1371/journal.pone.0030413. Epub 2012 Jan 17.
Autonomic nervous system (ANS) misbalance is a potential causal factor in the development of cardiovascular disease. The ANS may be programmed during pregnancy due to various maternal factors. Our aim is to study maternal prenatal psychosocial stress as a potential disruptor of cardiac ANS balance in the child.
Mothers from a prospective birth cohort (ABCD study) filled out a questionnaire at gestational week 16 [IQR 12-20], that included validated instruments for state anxiety, depressive symptoms, pregnancy-related anxiety, parenting daily hassles and job strain. A cumulative stress score was also calculated (based on 80(th) percentiles). Indicators of cardiac ANS in the offspring at age 5-6 years are: pre-ejection period (PEP), heart rate (HR), respiratory sinus arrhythmia (RSA) and cardiac autonomic balance (CAB), measured with electrocardiography and impedance cardiography in resting supine and sitting positions.
2,624 mother-child pairs, only single births, were available for analysis. The stress scales were not significantly associated with HR, PEP, RSA and CAB (p≥0.17). Accumulation of maternal stress was also not associated with HR, PEP, RSA and CAB (p≥0.07).
Results did not support the hypothesis that prenatal maternal psychosocial stress deregulates cardiac ANS balance in the offspring, at least in rest, and at the age of five-six years.
自主神经系统（ANS）失衡是心血管疾病发展的潜在因果因素。由于各种母体因素，ANS 可能在怀孕期间被编程。我们的目的是研究母体产前心理社会应激作为儿童心脏自主神经平衡潜在破坏因素。
来自前瞻性出生队列（ABCD 研究）的母亲在妊娠第 16 周（IQR 12-20）填写了一份问卷，其中包括用于评估状态焦虑、抑郁症状、妊娠相关焦虑、日常育儿烦恼和工作压力的验证工具。还计算了累积应激评分（基于第 80 个百分位数）。后代 5-6 岁时心脏自主神经系统的指标包括：射血前期（PEP）、心率（HR）、呼吸窦性心律失常（RSA）和心脏自主平衡（CAB），通过心电图和阻抗心动图在休息仰卧位和坐姿下进行测量。
2624 对母婴对，仅单胎出生，可用于分析。应激量表与 HR、PEP、RSA 和 CAB 无显著相关性（p≥0.17）。累积的母体应激也与 HR、PEP、RSA 和 CAB 无相关性（p≥0.07）。
结果不支持产前母体心理社会应激会使后代心脏自主神经系统平衡失调的假设，至少在休息时和 5-6 岁时是如此。
