Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA.
J Adolesc Health. 2012 Aug;51(2 Suppl):S3-8. doi: 10.1016/j.jadohealth.2012.04.008.
There is significant current interest in the degree to which prenatal exposures, including maternal psychological factors, influence child outcomes. Studies that detect an association between prenatal maternal psychological distress and child developmental outcomes are subject to a number of interpretative challenges in the inference of causality. Some of these are common to many types of prenatal exposures that must necessarily rely on observational designs. Such challenges include the correlation between prenatal and postnatal exposures and the potential role of other sources of shared influence, such as genetic factors. Others are more specific to this area of research. These include confounding between maternal report of child outcomes and the maternal psychological attributes under study, difficulties in distinguishing maternal stress from more ubiquitous aspects of maternal personality, and the lack of association between cortisol and measures of maternal psychological stress. This article considers these methodological issues and offers an additional methodology focused on fetal neurobehavior for discerning potential mechanisms that may mediate associations between maternal psychological functioning and the developing fetal nervous system.
目前，人们对产前暴露（包括产妇心理因素）对儿童发育结果的影响程度非常感兴趣。在推断因果关系时，检测产前产妇心理困扰与儿童发育结果之间存在关联的研究受到许多解释性挑战的影响。其中一些挑战与许多类型的产前暴露都有关系，这些暴露必然依赖于观察性设计。这些挑战包括产前和产后暴露之间的相关性，以及其他来源的共同影响（如遗传因素）的潜在作用。其他挑战则更为具体。这些挑战包括儿童发育结果的母亲报告与正在研究的产妇心理特征之间的混杂，区分母亲压力与更普遍的母亲个性方面的困难，以及皮质醇与产妇心理压力测量之间缺乏关联。本文考虑了这些方法学问题，并提出了一种额外的关注胎儿神经行为的方法，以辨别可能在产妇心理功能与发育中的胎儿神经系统之间的关联中起中介作用的潜在机制。
