Guardino Christine M, Dunkel Schetter Christine, Hobel Calvin J, Gaines Lanzi Robin, Schafer Peter, Thorp John M, Shalowitz Madeleine U
From the Department of Psychology (Guardino, Dunkel Schetter), University of California, Los Angeles; Department of Obstetrics and Gynecology (Hobel), Division of Maternal-Fetal Medicine, The Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, California; Department of Health Behavior (Lanzi), University of Alabama at Birmingham; Health Policy (Schafer), New York Academy of Medicine; Obstetrics and Gynecology (Thorp), University of North Carolina, Chapel Hill; North Shore University Health System Research Institute and Department of Pediatrics (Shalowitz), University of Chicago, Illinois; and Eunice Kennedy Shriver National Institute of Child Health and Human Development (CHNN).
Psychosom Med. 2017 May;79(4):450-460. doi: 10.1097/PSY.0000000000000424.
Elevated levels of C-reactive protein (CRP) are associated with increased risk of cardiovascular and metabolic disease. The current study tested associations between psychosocial stress and CRP in a large sample of women during the first postpartum year.
We analyzed data collected by the five-site Community Child Health Network study, which studied a predominately poor population. Participants (n = 1206 women; 54% African American, 23% white, 23% Hispanic/Latina) were recruited shortly after the birth of a child. Multiple linear regression analyses tested associations of psychosocial stress in several life domains (financial, neighborhood, family, coparenting, partner relationship, discrimination, and interpersonal violence) with log-transformed CRP concentrations at 6-month and 1-year postpartum.
Forty-eight percent of participants showed evidence of elevated CRP (≥3 mg/L) at 6-month postpartum, and 46% had elevated CRP at 12-month postpartum. Chronic financial stress at 1-month postpartum predicted higher levels of CRP at 6- (b = .15, SE = .05, p = .006) and 12-month postpartum (b = .15, SE = .06, p = .007) adjusting for race/ethnicity, income, education, parity, health behaviors, and chronic health conditions, though associations became nonsignificant when adjusted for body mass index.
In this low-income and ethnic/racially diverse sample of women, higher financial stress at 1-month postbirth predicted higher CRP. Study findings suggest that perceived financial stress stemming from socioeconomic disadvantage may be a particular deleterious form of stress affecting maternal biology during the year after the birth of a child.
C反应蛋白（CRP）水平升高与心血管疾病和代谢性疾病风险增加相关。本研究在一大群产后第一年的女性样本中测试了心理社会压力与CRP之间的关联。
我们分析了由五站点社区儿童健康网络研究收集的数据，该研究主要针对贫困人口。参与者（n = 1206名女性；54%为非裔美国人，23%为白人，23%为西班牙裔/拉丁裔）在孩子出生后不久被招募。多元线性回归分析测试了几个生活领域（经济、邻里、家庭、共同养育、伴侣关系、歧视和人际暴力）中的心理社会压力与产后6个月和1年时经对数转换的CRP浓度之间的关联。
48%的参与者在产后6个月时有CRP升高（≥3mg/L）的证据，46%在产后12个月时CRP升高。在调整了种族/民族、收入、教育、产次、健康行为和慢性健康状况后，产后1个月时的慢性经济压力预示着产后6个月（b = 0.15，SE = 0.05，p = 0.006）和12个月时（b = 0.15，SE = 0.06，p = 0.007）的CRP水平更高，不过在调整体重指数后，这些关联变得不显著。
在这个低收入且种族/民族多样的女性样本中，产后1个月时较高的经济压力预示着更高的CRP。研究结果表明，社会经济劣势导致的感知经济压力可能是孩子出生后一年内影响母亲生理的一种特别有害的压力形式。
