Bhat Sunil K, Beilin Lawrence J, Robinson Monique, Burrows Sally, Mori Trevor A
aSchool of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth bTelethon Kids Institute, University of Western Australia, Subiaco, Western Australia, Australia.
J Hypertens. 2015 Apr;33(4):711-9; discussion 719. doi: 10.1097/HJH.0000000000000476.
Various environmental stressors in pregnancy have been reported to affect high blood pressure (BP) in adult offspring. However, few studies have examined the effect of prenatal maternal psychological stress on offspring BP and BMI in early adulthood.
In 957 Raine cohort participants, regression analyses were used to examine the association between the count of maternal life stress events experienced during pregnancy and offspring BP and BMI at age 20.
Prenatal life stress associated positively with offspring BMI but inversely with SBP. After adjustment for confounders each additional prenatal life stress event reduced offspring SBP by 0.66 mmHg (P = 0.013) in those with an average BMI and lowered the odds of systolic (pre)hypertension by 17% (odds ratio = 0.83; P = 0.008). The inverse relationship between prenatal life stress and adult SBP was stronger in offspring with higher BMI. On the contrary, each unit increase in prenatal life stress score predicted a BMI increase of 0.37 kg/m (P = 0.022). Longitudinal analysis showed similar effects of prenatal life stress for offspring BMI from age 8 and SBP from age 14.
This study has shown that maternal stress in pregnancy significantly associated with BMI from early childhood, but contrary to our hypothesis predicted lower resting SBP and lower odds of systolic (pre)hypertension in young adult offspring. The effect of prenatal life stress on BP was accentuated by a higher BMI. Fetal programming events as a result of prenatal stress may underpin some of these relationships.
据报道,孕期的各种环境应激源会影响成年后代的高血压(BP)。然而,很少有研究探讨产前母亲心理压力对成年早期后代血压和体重指数(BMI)的影响。
在957名雷恩队列参与者中,采用回归分析来研究孕期母亲经历的生活应激事件数量与20岁后代血压和BMI之间的关联。
产前生活应激与后代BMI呈正相关,但与收缩压呈负相关。在调整混杂因素后,对于平均BMI的个体,每增加一次产前生活应激事件,后代收缩压降低0.66 mmHg(P = 0.013),收缩期(预)高血压的几率降低17%(优势比 = 0.83;P = 0.008)。产前生活应激与成年收缩压之间的负相关在BMI较高的后代中更强。相反,产前生活应激评分每增加一个单位,预测BMI增加0.37 kg/m²(P = 0.022)。纵向分析显示,产前生活应激对8岁起的后代BMI和14岁起的收缩压有类似影响。
本研究表明,孕期母亲压力与儿童早期BMI显著相关,但与我们的假设相反,预测成年后代静息收缩压较低且收缩期(预)高血压几率较低。产前生活应激对血压的影响在BMI较高时更为明显。产前应激导致的胎儿编程事件可能是这些关系的部分基础。