Department of Psychiatry/Behavioral Medicine, Columbia University, 1150 St Nicholas Ave, New York, NY 10032.
Dev Psychobiol. 2013 Nov;55(7):707-18. doi: 10.1002/dev.21066. Epub 2012 Jul 6.
Distress-linked activation of the maternal hypothalamic-pituitary-adrenal (HPA)-axis is considered a pathway by which affect regulation impacts the fetal milieu and neurodevelopment. There is little direct evidence for this conceptual model. In 103 women [mean age 27.45 (±5.65) years] at 36-38 weeks gestation, salivary cortisol was measured before/after stress tasks; distress questionnaires were completed. At 18.49 (±1.83) weeks, infants underwent the Harvard Infant Behavioral Reactivity Protocol assessing cry/motor responses to novelty; women reported on infant behavior and postnatal distress. Prenatal cortisol and distress were not significantly correlated (all ps > .10). Proportional odds logistic regressions showed that neither prenatal nor postnatal distress was associated with infant responses to the Harvard Protocol yet pre-stress cortisol and maternal age were: The odds of being classified as High Reactive were 1.60 times higher [95% CI: 1.04, 2.46] for each unit of added cortisol and .90 times lower [95% CI: .82, .99] for every additional year in maternal age. No associations were found between cortisol or prenatal distress and mother-rated infant behavior; postnatal distress was positively associated with mother-rated infant negative behavior (p = .03). Observer and mother-rated infant behavior were not associated (all ps > .05). Based on independent observations of infants in contrast to maternal perceptions, these results lend support to the hypothesis that pregnant women's HPA-axis activity influences infant behavior. The impact of maternal distress was not supported, except in so far as postnatal distress may increase the likelihood of making negative judgments about infant behavior.
压力相关的母体下丘脑-垂体-肾上腺（HPA）轴激活被认为是影响调节对胎儿环境和神经发育产生影响的途径。目前几乎没有直接证据支持这一概念模型。在 103 名 36-38 孕周的孕妇（平均年龄 27.45 ± 5.65 岁）中，在应激任务前后测量唾液皮质醇；完成应激问卷。在 18.49 ± 1.83 孕周时，婴儿接受哈佛婴儿行为反应性方案评估对新奇事物的哭声/运动反应；妇女报告婴儿行为和产后压力。产前皮质醇和压力无显著相关性（所有 ps > .10）。比例优势逻辑回归显示，产前或产后压力均与婴儿对哈佛方案的反应无关，但应激前皮质醇和产妇年龄相关：皮质醇每增加一个单位，被归类为高反应的几率增加 1.60 倍[95%置信区间：1.04，2.46]；产妇年龄每增加 1 岁，几率降低 0.90 倍[95%置信区间：0.82，0.99]。皮质醇或产前压力与母亲评定的婴儿行为之间没有关联；产后压力与母亲评定的婴儿消极行为呈正相关（p = .03）。观察者和母亲评定的婴儿行为没有相关性（所有 ps > .05）。与母亲的看法相反，这些结果基于对婴儿的独立观察，支持了孕妇 HPA 轴活动影响婴儿行为的假设。产妇压力的影响没有得到支持，除非产后压力可能增加对婴儿行为做出负面判断的可能性。
