Miller Gregory E, Borders Ann E, Crockett Amy H, Ross Kharah M, Qadir Sameen, Keenan-Devlin Lauren, Leigh Adam K, Ham Paula, Ma Jeffrey, Arevalo Jesusa M G, Ernst Linda M, Cole Steve W
Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, United States.
Department of Obstetrics & Gynecology, NorthShore University Health System, University of Chicago Pritzker School of Medicine, Evanston, IL, United States.
Brain Behav Immun. 2017 Aug;64:276-284. doi: 10.1016/j.bbi.2017.04.014. Epub 2017 Apr 21.
Children from economically disadvantaged families experience worse cognitive, psychiatric, and medical outcomes compared to more affluent youth. Preclinical models suggest some of the adverse influence of disadvantage could be transmitted during gestation via maternal immune activation, but this hypothesis has not been tested in humans. It also remains unclear whether prenatal interventions can mitigate such effects. To fill these gaps, we conducted two studies. Study 1 characterized the socioeconomic conditions of 79 women during pregnancy. At delivery, placenta biopsies and umbilical blood were collected for transcriptional profiling. Maternal disadvantage was associated with a transcriptional profile indicative of higher immune activation and slower fetal maturation, particularly in pathways related to brain, heart, and immune development. Cord blood cells of disadvantaged newborns also showed indications of immaturity, as reflected in down-regulation of pathways that coordinate myeloid cell development. These associations were independent of fetal sex, and characteristics of mothers (age, race, adiposity, diabetes, pre-eclampsia) and babies (delivery method, gestational age). Study 2 performed the same transcriptional analyses in specimens from 20 women participating in CenteringPregnancy, a group-based psychosocial intervention, and 20 women in traditional prenatal care. In both placenta biopsies and cord blood, women in CenteringPregnancy showed up-regulation of transcripts found in Study 1 to be most down-regulated in conjunction with disadvantage. Collectively, these results suggest socioeconomic disparities in placental biology are evident at birth, and provide clues about the mechanistic origins of health disparities. They also suggest the possibility that psychosocial interventions could have mitigating influences.
与家境较为富裕的青少年相比,来自经济弱势家庭的儿童在认知、精神和医疗方面的表现更差。临床前模型表明,弱势的一些不利影响可能在孕期通过母体免疫激活传递,但这一假设尚未在人类中得到验证。产前干预能否减轻此类影响也仍不清楚。为填补这些空白,我们开展了两项研究。研究1对79名女性孕期的社会经济状况进行了特征描述。分娩时,采集胎盘活检样本和脐带血进行转录谱分析。母体弱势与一种转录谱相关,该转录谱表明免疫激活水平较高且胎儿成熟较慢,尤其是在与大脑、心脏和免疫发育相关的通路中。弱势新生儿的脐带血细胞也显示出不成熟的迹象,这在协调髓系细胞发育的通路下调中有所体现。这些关联独立于胎儿性别以及母亲(年龄、种族、肥胖、糖尿病、先兆子痫)和婴儿(分娩方式、孕周)的特征。研究2对参与“孕期中心”(一种基于群体的社会心理干预项目)的20名女性和接受传统产前护理的20名女性的样本进行了相同的转录分析。在胎盘活检样本和脐带血中,参与“孕期中心”的女性均表现出研究1中发现的与弱势相关的下调程度最大的转录本上调。总体而言,这些结果表明胎盘生物学中的社会经济差异在出生时就很明显,并为健康差异的机制起源提供了线索。它们还表明社会心理干预可能具有减轻影响的可能性。