Department of Paediatrics, Faculty of Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8.
Psychosom Med. 2013 Nov-Dec;75(9):856-62. doi: 10.1097/PSY.0000000000000004. Epub 2013 Oct 25.
Recent studies suggest that effective social support during pregnancy may buffer adverse effects of maternal psychological distress on fetal development. The mechanisms whereby social support confers this protective advantage, however, remain to be clarified. The aim of this study was to assess whether individual differences in social support alter the covariation of psychological distress and cortisol during pregnancy.
Eighty-two pregnant women's psychological distress and cortisol were prospectively assessed in all three trimesters using an ecological momentary assessment strategy. Appraisal of partner social support was assessed in each trimester via the Social Support Effectiveness questionnaire.
In multilevel analysis, ambulatory assessments of psychological distress during pregnancy were associated with elevated cortisol levels (unstandardized β = .023, p < .001). Consistent with the stress-buffering hypothesis, social support moderated the association between psychological distress and cortisol (unstandardized β = -.001, p = .039), such that the covariation of psychological distress and cortisol increased with decreases in effective social support. The effect of social support for women with the most effective social support was a 50.4% reduction in the mean effect of distress on cortisol and a 2.3-fold increase in this effect for women with the least effective social support scores.
Pregnant women receiving inadequate social support secrete higher levels of cortisol in response to psychological distress as compared with women receiving effective social support. Social support during pregnancy may be beneficial because it decreases biological sensitivity to psychological distress, potentially shielding the fetus from the harmful effects of stress-related increases in cortisol.
最近的研究表明，妊娠期间有效的社会支持可以缓冲产妇心理困扰对胎儿发育的不利影响。然而，社会支持发挥这种保护优势的机制仍需阐明。本研究旨在评估社会支持的个体差异是否改变妊娠期间心理困扰和皮质醇的共变。
采用生态瞬时评估策略，前瞻性评估 82 名孕妇在所有三个孕期的心理困扰和皮质醇。在每个孕期，通过社会支持有效性问卷评估伴侣社会支持的评价。
在多层次分析中，妊娠期间的动态评估心理困扰与皮质醇水平升高相关（未标准化β=0.023，p<0.001）。与应激缓冲假说一致，社会支持调节了心理困扰和皮质醇之间的关系（未标准化β=-0.001，p=0.039），即心理困扰和皮质醇的共变随着有效社会支持的减少而增加。对于社会支持最有效的女性，社会支持的影响是减轻皮质醇对困扰的平均影响的 50.4%，而对于社会支持评分最低的女性，这种影响增加了 2.3 倍。
与接受有效社会支持的女性相比，接受支持不足的女性在心理困扰时会分泌更高水平的皮质醇。妊娠期间的社会支持可能有益，因为它降低了对心理困扰的生物学敏感性，可能使胎儿免受与压力相关的皮质醇增加的有害影响。
