La Marca-Ghaemmaghami Pearl, Dainese Sara M, Stalla Günter, Haller Marina, Zimmermann Roland, Ehlert Ulrike
a Department of Clinical Psychology and Psychotherapy , University of Zurich , Zurich , Switzerland.
b Max Planck Institute of Psychiatry , Munich , Germany.
Stress. 2017 May;20(3):231-240. doi: 10.1080/10253890.2017.1312336. Epub 2017 Apr 21.
This study explored the association between the acute psychobiological stress response, chronic social overload and amniotic fluid corticotropin-releasing hormone (CRH) and urocortin (UCN) in 34 healthy, second-trimester pregnant women undergoing amniocentesis. The study further examined the predictive value of second-trimester amniotic fluid CRH and UCN for fetal growth and neonatal birth outcome. The amniocentesis served as a naturalistic stressor, during which maternal state anxiety and salivary cortisol was measured repeatedly and an aliquot of amniotic fluid was collected. The pregnant women additionally completed a questionnaire on chronic social overload. Fetal growth parameters were obtained at amniocentesis using fetal ultrasound biometry and at birth from medical records. The statistical analyzes revealed that the acute maternal psychobiological stress response was unassociated with the amniotic fluid peptides, but that maternal chronic overload and amniotic CRH were positively correlated. Moreover, amniotic CRH was negatively associated with fetal size at amniocentesis and positively with growth in size from amniocentesis to birth. Hardly any studies have previously explored whether acute maternal psychological stress influences fetoplacental CRH or UCN levels significantly. Our findings suggest that (i) chronic, but not acute maternal stress may affect fetoplacental CRH secretion and that (ii) CRH is complexly involved in fetal growth processes as previously shown in animals.
本研究探讨了34名接受羊膜穿刺术的健康孕中期孕妇的急性心理生理应激反应、慢性社会负荷与羊水促肾上腺皮质激素释放激素（CRH）和尿皮质素（UCN）之间的关联。该研究进一步检验了孕中期羊水CRH和UCN对胎儿生长及新生儿出生结局的预测价值。羊膜穿刺术作为一种自然应激源，在此期间反复测量孕妇的状态焦虑和唾液皮质醇，并采集一份羊水样本。孕妇还完成了一份关于慢性社会负荷的问卷。在羊膜穿刺术时通过胎儿超声生物测量法获取胎儿生长参数，并在出生时从病历中获取相关数据。统计分析显示，孕妇急性心理生理应激反应与羊水肽无关联，但孕妇慢性负荷与羊水CRH呈正相关。此外，羊水CRH与羊膜穿刺术时的胎儿大小呈负相关，与从羊膜穿刺术到出生时的生长呈正相关。此前几乎没有研究探讨过孕妇急性心理应激是否会显著影响胎盘胎儿CRH或UCN水平。我们的研究结果表明：（i）孕妇慢性而非急性应激可能影响胎盘胎儿CRH分泌；（ii）如先前在动物研究中所示，CRH复杂地参与胎儿生长过程。
