Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Rennes, Université de Rennes 1 et Centre Hospitalier Guillaume Régnier, Rennes, France.
Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Rennes, Université de Rennes 1 et Centre Hospitalier Guillaume Régnier, Rennes, France.
Neurosci Biobehav Rev. 2014 Jun;43:137-62. doi: 10.1016/j.neubiorev.2014.03.022. Epub 2014 Apr 18.
Many studies have examined effects of prenatal stress on pregnancy and fetal development, especially on prematurity and birthweight, and more recently long-term effects on child behavioral and emotional development. These studies are reviewed and their limitations are discussed with regard to definitions (including the concepts of stress and anxiety), stress measurements, samples, and control for confounds such as depression. It appears necessary to assess individual stress reactivity prospectively and separately at each trimester of pregnancy, to discriminate chronic from acute stress, and to take into consideration moderator variables such as past life events, sociocultural factors, predictability, social support and coping strategies. Furthermore, it might be useful to examine simultaneously, during but also after pregnancy, stress, anxiety and depression in order to understand better their relationships and to evaluate their specific effects on pregnancy and child development. Finally, further research could benefit from an integrated psychological and biological approach studying together subjective perceived stress and objective physiological stress responses in pregnant women, and their effects on fetal and child development as well as on mother-infant interactions.
许多研究都探讨了产前压力对妊娠和胎儿发育的影响，尤其是对早产和出生体重的影响，以及最近对儿童行为和情绪发展的长期影响。本文对这些研究进行了回顾，并讨论了它们在定义（包括压力和焦虑的概念）、压力测量、样本以及针对抑郁等混杂因素的控制方面的局限性。看来有必要前瞻性地评估个体的应激反应，并在妊娠的每个阶段分别进行评估，区分慢性应激和急性应激，并考虑到调节变量，如过去的生活事件、社会文化因素、可预测性、社会支持和应对策略。此外，同时在怀孕期间和之后检查压力、焦虑和抑郁可能有助于更好地理解它们之间的关系，并评估它们对妊娠和儿童发育的具体影响。最后，进一步的研究可以从一个综合的心理和生物学方法中受益，该方法同时研究孕妇的主观感知压力和客观生理应激反应，以及它们对胎儿和儿童发育以及母婴互动的影响。
