van Dijk Aimée E, Dawe Karen, Deanfield John, Stronks Karien, Gemke Reinoud J B J, Vrijkotte Tanja G M, Lawlor Debbie A
University of Amsterdam, Amsterdam, The Netherlands Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands
University of Bristol, Bristol, UK.
Eur J Prev Cardiol. 2014 Sep;21(9):1097-108. doi: 10.1177/2047487313486039. Epub 2013 Apr 4.
To investigate whether (1) maternal psychosocial stress (depression/anxiety) during pregnancy is associated with offspring vascular function and (2) whether any association differs depending on the gestational timing of exposure to stress. We also investigated whether any association is likely to be due to intrauterine mechanisms by (3) comparing with the association of paternal stress with offspring vascular function and (4) examining whether any prenatal association is explained by maternal postnatal stress.
Associations were examined in a UK birth cohort, with offspring outcomes (systolic and diastolic blood pressure, SBP and DBP, endothelial function assessed by brachial artery flow-mediated dilatation (FMD); arterial stiffness assessed by carotid to radial pulse wave velocity (PWV), brachial artery distensibility (DC), and brachial artery diameter (BD) assessed at age 10-11 years (n = 4,318). Maternal depressive symptoms and anxiety were assessed at 18 and 32 weeks gestation and 8 months postnatally. Paternal symptoms were assessed at week 19. With the exception of DBP and BD, there were no associations of maternal depressive symptoms with any of the vascular outcomes. Maternal depressive and anxiety symptoms were associated with lower offspring DBP and wider BD, though the latter attenuated to the null with adjustment for confounding factors. Paternal symptoms were not associated with offspring outcomes. Maternal postnatal depressive symptoms were associated with lower offspring SBP.
We found no evidence to support the hypothesis that maternal stress during pregnancy adversely affects offspring vascular function at age 10-12 years via intrauterine mechanisms.
研究(1)孕期母亲心理社会压力(抑郁/焦虑)是否与后代血管功能相关,以及(2)这种关联是否因孕期暴露于压力的时间不同而有所差异。我们还通过(3)将父亲压力与后代血管功能的关联进行比较,以及(4)检查产前关联是否由母亲产后压力来解释,研究这种关联是否可能归因于宫内机制。
在一个英国出生队列中研究这些关联,后代的结局包括收缩压和舒张压(SBP和DBP)、通过肱动脉血流介导的扩张(FMD)评估的内皮功能;在10至11岁时评估的动脉僵硬度,通过颈动脉至桡动脉脉搏波速度(PWV)、肱动脉扩张性(DC)和肱动脉直径(BD)来评估(n = 4318)。在妊娠18周和32周以及产后8个月评估母亲的抑郁症状和焦虑。在第19周评估父亲的症状。除了DBP和BD外,母亲的抑郁症状与任何血管结局均无关联。母亲的抑郁和焦虑症状与后代较低的DBP和较宽的BD相关,不过在对混杂因素进行调整后,后者减弱至无关联。父亲的症状与后代结局无关。母亲产后抑郁症状与后代较低的SBP相关。
我们没有发现证据支持以下假设,即孕期母亲压力通过宫内机制对10至12岁后代的血管功能产生不利影响。