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原发性巨细胞病毒感染孕妇的创伤后应激与新生儿先天性感染风险

Post-traumatic stress in pregnant women with primary cytomegalovirus infection and risk of congenital infection in newborns.

作者信息

Vadini Francesco, Tracanna Elisa, Polilli Ennio, Tontodonati Monica, Ricci Elena, Santilli Francesca, Parruti Giustino

机构信息

, LPsy, PhD, Psychoinfectivology Service, Unit of Infectious Diseases, Pescara General Hospital, Pescara, Italy.

, LPsy, Psychoinfectivology Service, Unit of Infectious Diseases, Pescara General Hospital, Pescara, Italy.

出版信息

BJPsych Open. 2016 Nov 24;2(6):373-376. doi: 10.1192/bjpo.bp.116.003152. eCollection 2016 Nov.

DOI:10.1192/bjpo.bp.116.003152
PMID:28507767
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5422111/
Abstract

BACKGROUND

Substantial evidence indicates that perinatal mental disturbances are associated with the risk for negative maternal-newborn outcomes. A neuroendocrine brain-placenta interaction has been described to explain the association between prenatal stress-related disorders and placental abnormalities. Whether these mechanisms may affect the likelihood of mother-to-child transmission (MTCT) of infections has never been investigated.

AIMS

To evaluate the role of psychological factors in cytomegalovirus (CMV) MTCT in pregnant women with primary CMV infection.

METHOD

A cohort of 276 pregnant women with primary CMV infection underwent assessment of (a) reactive psychopathological symptoms, such as current depressive symptoms and ongoing symptoms of post-traumatic stress disorder; and (b) stable personality traits, such as alexithymia and Type D (distressed) personality. Congenital infection was diagnosed by CMV DNA amplification from blood and/or urine and saliva from newborn at birth.

RESULTS

The occurrence of congenital CMV disease in the newborn was independently predicted by post-traumatic stress symptoms during pregnancy.

CONCLUSIONS

Our findings suggest that psychological stress-related disturbances may weaken the physical and immunological barrier against the mother-to-fetus transmission of viruses.

DECLARATION OF INTEREST

We declare that we have no conflicting interests to disclose.

COPYRIGHT AND USAGE

© The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

摘要

背景

大量证据表明,围产期精神障碍与母婴不良结局风险相关。一种神经内分泌脑 - 胎盘相互作用已被描述,以解释产前应激相关障碍与胎盘异常之间的关联。这些机制是否可能影响母婴感染传播(MTCT)的可能性从未被研究过。

目的

评估心理因素在原发性巨细胞病毒(CMV)感染孕妇的CMV母婴传播中的作用。

方法

对276例原发性CMV感染孕妇进行队列研究,评估(a)反应性精神病理症状,如当前的抑郁症状和创伤后应激障碍的持续症状;以及(b)稳定的人格特质,如述情障碍和D型(苦恼型)人格。通过出生时从新生儿的血液和/或尿液及唾液中进行CMV DNA扩增来诊断先天性感染。

结果

新生儿先天性CMV疾病的发生可由孕期创伤后应激症状独立预测。

结论

我们的研究结果表明,心理应激相关障碍可能会削弱针对病毒母婴传播的生理和免疫屏障。

利益声明

我们声明我们没有利益冲突需要披露。

版权与使用

©皇家精神科医学院2016年。这是一篇开放获取文章,根据知识共享非商业性、无衍生作品(CC BY - NC - ND)许可条款分发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7838/5422111/8d4a1c5e698d/bjporcpsych003152-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7838/5422111/8d4a1c5e698d/bjporcpsych003152-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7838/5422111/8d4a1c5e698d/bjporcpsych003152-g001.jpg

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