Braithwaite Elizabeth C, Murphy Susannah E, Ramchandani Paul G
Department of Experimental Psychology, University of Oxford, 9 South Parks Road, Oxford, OX1 3UD, UK.
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
Arch Womens Ment Health. 2016 Aug;19(4):581-90. doi: 10.1007/s00737-016-0611-y. Epub 2016 Mar 4.
Prenatal depression is associated with adverse offspring outcomes, and the prevailing mechanistic theory to account for mood-associated effects implicates alterations of the maternal and foetal hypothalamic-pituitary adrenal (HPA) axes. Recent research suggests that depression may be associated with a failure to attenuate cortisol reactivity during early pregnancy. The aim of the current study is to investigate whether this effect continues into mid and late gestation. A further aim is to test whether maternal prenatal cortisol reactivity directly predicts infant cortisol reactivity. One hundred three pregnant women were recruited during either the second or third trimester. Depressive symptoms were assessed by self-report, and maternal salivary cortisol responses to a stressor (infant distress film) were measured. Approximately 2 months after birth, mothers (n = 88) reported postnatal depression and infant salivary cortisol responses to inoculation were measured. Prenatal depression was not associated with cortisol reactivity to acute stress in mid and late pregnancy. Similarly, neither prenatal depression nor maternal prenatal cortisol reactivity predicted infant cortisol reactivity to inoculation at 2 months. If the effects of prenatal depression on foetal and infant development are mediated by alterations of the maternal and foetal HPA axes, then early pregnancy may be a particularly vulnerable period. Alternatively, changes to HPA reactivity may not be as central to this association as previously thought.
产前抑郁与不良的子代结局相关,而解释情绪相关影响的主流机制理论涉及母体和胎儿下丘脑-垂体-肾上腺(HPA)轴的改变。近期研究表明,抑郁可能与孕早期未能减弱皮质醇反应性有关。本研究的目的是调查这种效应是否会持续到妊娠中期和晚期。另一个目的是测试母体产前皮质醇反应性是否能直接预测婴儿的皮质醇反应性。在孕中期或孕晚期招募了103名孕妇。通过自我报告评估抑郁症状,并测量母体唾液皮质醇对应激源(婴儿窘迫影片)的反应。出生后约2个月,母亲(n = 88)报告产后抑郁情况,并测量婴儿唾液皮质醇对接种的反应。产前抑郁与妊娠中期和晚期对急性应激的皮质醇反应性无关。同样,产前抑郁和母体产前皮质醇反应性均不能预测婴儿在2个月时对接种的皮质醇反应性。如果产前抑郁对胎儿和婴儿发育的影响是由母体和胎儿HPA轴的改变介导的,那么孕早期可能是一个特别脆弱的时期。或者,HPA反应性的变化可能不像之前认为的那样是这种关联的核心因素。