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贫困儿童产前和围产期因素与学龄前儿童皮质醇昼夜节律及应激反应性的关联

Associations of Prenatal and Perinatal Factors with Cortisol Diurnal Pattern and Reactivity to Stress at Preschool Age Among Children Living in Poverty.

作者信息

Elhassan Maha E, Miller Alison L, Vazquez Delia M, Lumeng Julie C

机构信息

Michigan University Faculty of Medicine, Center for Human Growth and Development, Michigan, USA Phone: +1 7346471102 E-mail:

出版信息

J Clin Res Pediatr Endocrinol. 2015 Jun;7(2):114-20. doi: 10.4274/jcrpe.1685.

Abstract

OBJECTIVE

To examine the association of pre- and perinatal factors with diurnal cortisol pattern and reactivity to a stressor at preschool age among children living in poverty.

METHODS

Preschool aged children (n=275) provided saliva samples 3 times per day for 3 days to assess circadian rhythmicity (intercept and slope reflected diurnal pattern) and during a behavioral stress elicitation protocol to measure reactivity (5 samples before, during and after the stressor). Pre- and perinatal predictors were pregnancy weight gain, pre-pregnancy body mass index (BMI), infant birth weight z-score and gestational age. We ran 7 linear regression models predicting each of the cortisol outcomes including all pre- and perinatal predictors and covariates simultaneously.

RESULTS

Greater pregnancy weight gain predicted higher morning cortisol [b=0.020 (SE 0.007), p=0.003]. Greater pregnancy weight gain also predicted higher cortisol at recovery from the stressor in girls only [β=0.002 (SE 0.001), p=0.036]. There was no association of pre-pregnancy BMI with any cortisol outcome. Higher birth weight z-score predicted higher morning cortisol in the total sample [β=0.134 (SE 0.066, p=0.043]. Greater gestational age predicted lower cortisol during peak stress in the sample who underwent cortisol reactivity testing [β=-0.015 (SE 0.007), p=0.032] and in boys [β=-0.032 (SE 0.014), p=0.027].

CONCLUSION

Pre- and perinatal factors are associated with cortisol patterning in offspring at preschool age. The implications for child health require additional studies.

摘要

目的

探讨贫困地区儿童出生前及围产期因素与学龄前儿童日间皮质醇模式及对应激源反应性之间的关联。

方法

学龄前儿童(n = 275)连续3天每天提供3次唾液样本,以评估昼夜节律(截距和斜率反映日间模式),并在行为应激诱发方案期间测量反应性(应激源前、应激期间和应激后5个样本)。出生前及围产期预测因素包括孕期体重增加、孕前体重指数(BMI)、婴儿出生体重z评分和胎龄。我们进行了7个线性回归模型,同时预测每个皮质醇结果,包括所有出生前及围产期预测因素和协变量。

结果

孕期体重增加较多预示着早晨皮质醇水平较高[b = 0.020(标准误0.007),p = 0.003]。孕期体重增加较多还仅在女孩中预示着应激源恢复时皮质醇水平较高[β = 0.002(标准误0.001),p = 0.036]。孕前BMI与任何皮质醇结果均无关联。较高的出生体重z评分在总样本中预示着早晨皮质醇水平较高[β = 0.134(标准误0.066,p = 0.043]。胎龄较大预示着接受皮质醇反应性测试的样本在应激高峰时皮质醇水平较低[β = -0.015(标准误0.007),p = 0.032],在男孩中也是如此[β = -0.032(标准误0.014),p = 0.027]。

结论

出生前及围产期因素与学龄前子代的皮质醇模式有关。对儿童健康的影响需要更多研究。

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