Sandman Curt A, Buss Claudia, Head Kevin, Davis Elysia Poggi
Department of Psychiatry and Human Behavior, University of California, Irvine, Orange, California.
Department of Pediatrics, University of California, Irvine, Orange, California; Institut für Medizinische Psychologie, Charité Centrum für Human-und Gesundheitswissenschaften, Charité Universitätsmedizin, Berlin, Germany.
Biol Psychiatry. 2015 Feb 15;77(4):324-34. doi: 10.1016/j.biopsych.2014.06.025. Epub 2014 Jul 10.
Maternal depression is one of the most common prenatal complications. The consequences of fetal exposure to maternal depression are poorly understood. The aim of this study is to examine the association between fetal exposure to maternal depressive symptoms and cortical thickness in children 6-9 years old.
A prospective, longitudinal study of maternal depressive symptoms at 19, 25, and 31 weeks' gestation was followed by acquisition of a structural magnetic resonance imaging scan in 81 children (age, 86.1 ± 9.9 months).
Significant (p < .01) cortical thinning in children primarily in the right frontal lobes was associated with exposure to prenatal maternal depression. The strongest association was at 25 weeks' gestation; exposure to maternal depression at 25 gestational weeks was associated with cortical thinning in 19% of the whole cortex and 24% of the frontal lobes, primarily in the right superior, medial orbital, and frontal pole regions of the prefrontal cortex (p < .01). The significant association between prenatal maternal depression and child externalizing behavior (p < .05) was mediated by cortical thinning in prefrontal areas of the right hemisphere.
The pattern of cortical thinning in children exposed to prenatal maternal depression is similar to patterns in depressed patients and in individuals with risk for depression. Exposure to prenatal depression coupled with subsequent cortical thinning was associated with presence of externalizing behavior in preadolescent children and may be prodromal markers of risk for dysphoria. Vulnerability to prenatal influences at 25 gestational weeks may result from the enormous growth and dramatic structural changes in the nervous system.
孕期母亲抑郁是最常见的产前并发症之一。胎儿暴露于母亲抑郁环境下所产生的后果尚不清楚。本研究旨在探讨胎儿暴露于母亲抑郁症状与6至9岁儿童皮质厚度之间的关联。
对19周、25周和31周孕期的母亲抑郁症状进行前瞻性纵向研究,随后对81名儿童(年龄86.1±9.9个月)进行结构磁共振成像扫描。
儿童主要在右侧额叶出现显著(p<.01)的皮质变薄,这与产前母亲抑郁的暴露有关。最强的关联出现在孕25周;孕25周时暴露于母亲抑郁与整个皮质的19%以及额叶的24%的皮质变薄有关,主要位于前额叶皮质的右侧上、内侧眶部和额极区域(p<.01)。产前母亲抑郁与儿童外化行为之间的显著关联(p<.05)由右半球前额叶区域的皮质变薄介导。
暴露于产前母亲抑郁的儿童的皮质变薄模式与抑郁症患者及有抑郁风险个体的模式相似。产前抑郁暴露加上随后的皮质变薄与青春期前儿童外化行为的存在有关,可能是烦躁不安风险的前驱标志物。孕25周时对产前影响的易感性可能源于神经系统的巨大生长和显著的结构变化。