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产前母体应激是否会损害健康出生结局的幼儿的认知发育,并改变其气质特征?

Does prenatal maternal stress impair cognitive development and alter temperament characteristics in toddlers with healthy birth outcomes?

机构信息

Anhui Medical University, Hefei, China.

出版信息

Dev Med Child Neurol. 2014 Mar;56(3):283-9. doi: 10.1111/dmcn.12378. Epub 2014 Jan 20.

DOI:10.1111/dmcn.12378
PMID:24512346
Abstract

AIM

The aim of this study was to assess the cognitive and behavioural development of children with healthy birth outcomes whose mothers were exposed to prenatal stress but did not experience pregnancy complications.

METHOD

In this prospective study, self-reported data, including the Prenatal Life Events Checklist about stressful life events (SLEs) during different stages of pregnancy, were collected at 32 to 34 weeks' gestation. Thirty-eight healthy females (mean age 27 y 8 mo, SD 2 y 4 mo) who were exposed to severe SLEs in the first trimester were defined as the exposed infant group, and 114 matched comparison participants were defined as the unexposed infant group (1:3). Maternal postnatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale. The Bayley Scales of Infant Development and the Toddler Temperament Scale were used to evaluate the cognitive development and temperament characteristics of the infants with healthy birth outcomes when they were 16 to 18 months old.

RESULTS

A randomized block multivariate analysis of covariance showed that the mental development index scores of the infants of mothers with prenatal exposure to SLEs in the first trimester averaged seven points (95% confidence interval 3.23-10.73 points) lower than those of the unexposed infants. Moreover, the infants in the exposed group achieved higher scores for regularity (adjusted mean [SD] 2.77 [0.65] vs. 2.52 [0.78], F(5,146) =5.27, p=0.023) and for persistence and attention span (adjusted mean 3.61 [0.72] vs. 3.35 [0.52], F(5,146) =5.51, p=0.020).

INTERPRETATION

This study provides evidence that lower cognitive ability and less optimal worse behavioural response in infants might independently result from prenatal maternal stress.

摘要

目的

本研究旨在评估出生结局健康的儿童的认知和行为发育情况,这些儿童的母亲在孕期经历了产前应激,但未发生妊娠并发症。

方法

在这项前瞻性研究中,于妊娠 32 至 34 周时采集自我报告数据,包括产前生活事件检查表,以了解孕期不同阶段的应激性生活事件(SLEs)。将在孕早期接触到严重 SLEs 的 38 名健康女性(平均年龄 27 岁 8 个月,标准差 2 岁 4 个月)定义为暴露组婴儿,将 114 名匹配的对照组参与者定义为未暴露组婴儿(1:3)。采用爱丁堡产后抑郁量表评估产后母亲的抑郁症状。采用贝利婴幼儿发展量表和幼儿气质量表评估出生结局健康的婴儿在 16 至 18 个月时的认知发育和气质特征。

结果

随机区组多元方差分析显示,母亲在孕早期接触 SLEs 的婴儿的精神发育指数得分平均低 7 分(95%置信区间 3.23-10.73 分)。此外,暴露组婴儿的规律性得分更高(调整后的平均[SD]为 2.77[0.65]比 2.52[0.78],F(5,146)=5.27,p=0.023),坚持性和注意力跨度得分更高(调整后的平均 3.61[0.72]比 3.35[0.52],F(5,146)=5.51,p=0.020)。

结论

本研究提供了证据表明,产前母亲应激可能导致婴儿的认知能力降低和行为反应不佳。

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