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产前心理社会压力与 5-7 岁儿童血压的关系。

The association between prenatal psychosocial stress and blood pressure in the child at age 5-7 years.

机构信息

Department of Public Health, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands.

出版信息

PLoS One. 2012;7(8):e43548. doi: 10.1371/journal.pone.0043548. Epub 2012 Aug 21.

Abstract

OBJECTIVE

Prenatal maternal stress could have permanent effects on the offspring's tissue structure and function, which may predispose to cardiovascular diseases. We investigated whether maternal psychosocial stress is a prenatal factor affecting the blood pressure (BP) of offspring.

STUDY DESIGN

In the Amsterdam Born Children and their Development (ABCD) study, around gestational week 16, depressive symptoms, state-anxiety, pregnancy-related anxiety, parenting daily hassles and job strain were recorded by questionnaire. A cumulative stress score was also calculated (based on 80(th) percentiles). Systolic and diastolic BP and mean arterial pressure (MAP) were measured in the offspring at age 5-7 years. Inclusion criteria were: no use of antihypertensive medication during pregnancy; singleton birth; no reported cardiovascular problems in the child (N = 2968 included).

RESULTS

After adjustment for confounders, the single stress scales were not associated with systolic and diastolic BP, MAP and hypertension (p>0.05). The presence of 3-4 psychosocial stressors prenatally (4%) was associated with 1.5 mmHg higher systolic and diastolic BP (p = 0.046; p = 0.04) and 1.5 mmHg higher MAP in the offspring (p = 0.02) compared to no stressors (46%). The presence of 3-4 stressors did not significantly increase the risk for hypertension (OR 1.8; 95% CI 0.93.4). Associations did not differ between sexes. Bonferroni correction for multiple testing rendered all associations non-significant.

CONCLUSIONS

The presence of multiple psychosocial stressors during pregnancy was associated with higher systolic and diastolic BP and MAP in the child at age 5-7. Further investigation of maternal prenatal stress may be valuable for later life cardiovascular health.

摘要

目的

产前母体应激可能对后代的组织结构和功能产生永久性影响,从而导致心血管疾病。我们研究了母体心理社会应激是否是影响后代血压(BP)的产前因素。

研究设计

在阿姆斯特丹出生的儿童及其发育(ABCD)研究中,在妊娠第 16 周左右,通过问卷调查记录了抑郁症状、状态焦虑、与妊娠相关的焦虑、日常育儿琐事和工作压力。还计算了累积应激评分(基于第 80 个百分位数)。在子女 5-7 岁时测量收缩压、舒张压和平均动脉压(MAP)。纳入标准为:妊娠期间未使用抗高血压药物;单胎分娩;儿童无心血管问题报告(包括 2968 名儿童)。

结果

调整混杂因素后,单一应激量表与收缩压、舒张压、MAP 和高血压均无相关性(p>0.05)。产前存在 3-4 种心理社会应激源(4%)与收缩压和舒张压升高 1.5mmHg(p=0.046;p=0.04)和 MAP 升高 1.5mmHg(p=0.02)相关与无应激源(46%)相比。存在 3-4 种应激源并不会显著增加高血压的风险(OR 1.8;95%CI 0.93.4)。这些关联在性别之间没有差异。对多次测试的 Bonferroni 校正使所有关联均不显著。

结论

妊娠期间存在多种心理社会应激源与儿童 5-7 岁时的收缩压、舒张压和 MAP 升高相关。进一步研究母体产前应激可能对后代的心血管健康有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e68/3424234/c03eb00ec88c/pone.0043548.g001.jpg

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