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探讨肥胖在儿童期创伤与孕期炎症之间关联中的作用。

Examination of the role of obesity in the association between childhood trauma and inflammation during pregnancy.

机构信息

Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center.

Center for Biostatistics, The Ohio State University.

出版信息

Health Psychol. 2018 Feb;37(2):114-124. doi: 10.1037/hea0000559. Epub 2017 Oct 2.

Abstract

OBJECTIVE

Childhood trauma is associated with negative perinatal health outcomes including mood disorders and shorter gestation. However, effects of early life exposures on maternal biology are poorly delineated. This study examined associations between childhood trauma and inflammation, as well as the mediating role of obesity in this relationship.

METHOD

This study examined a racially diverse sample of 77 pregnant women assessed in early, mid, and late pregnancy. Assessments included the Childhood Trauma Questionnaire, Center for Epidemiologic Studies-Depression Scale, serum CRP, IL-6, and TNF-α, and prepregnancy BMI.

RESULTS

Per linear mixed models, while no direct relationships were observed between childhood trauma with IL-6 or TNF-α, physical (95% CI: 0.007, 0.080) and emotional (95% CI: 0.005, 0.046) abuse as well as emotional neglect (95% CI: 0.010, 0.051) predicted elevated CRP. Effects remained after adjustment for race, income, education, smoking status, medical conditions, and depressive symptoms. PROCESS analyses showed BMI mediated the relationship between physical abuse and both serum CRP (95% CI: 0.014, 0.062) and IL-6 (95% CI: 0.009, 0.034).

CONCLUSIONS

Exposure to childhood trauma, particularly emotional abuse, physical abuse, and emotional neglect, is associated with inflammation in pregnant women. Obesity served as 1 pathway by which physical abuse contributed to elevations in serum CRP and IL-6. Interventions targeting maternal obesity prior to pregnancy may help mitigate the effects of childhood trauma on perinatal health. These findings have relevance for understanding biological and behavioral pathways by which early life exposures contribute to maternal health. (PsycINFO Database Record

摘要

目的

儿童期创伤与围产期负面健康结果有关,包括情绪障碍和早产。然而,早期生活暴露对母体生物学的影响还没有被很好地描述。本研究探讨了儿童期创伤与炎症之间的关系,以及肥胖在这种关系中的中介作用。

方法

本研究检查了 77 名孕妇的种族多样化样本,这些孕妇在孕早期、中期和晚期进行了评估。评估包括儿童期创伤问卷、流行病学研究中心抑郁量表、血清 CRP、IL-6 和 TNF-α以及孕前 BMI。

结果

通过线性混合模型,虽然儿童期创伤与 IL-6 或 TNF-α之间没有直接关系,但身体虐待(95%置信区间:0.007,0.080)和情感忽视(95%置信区间:0.005,0.046)以及情感忽视(95%置信区间:0.010,0.051)预测 CRP 升高。在调整种族、收入、教育、吸烟状况、医疗状况和抑郁症状后,效果仍然存在。PROCESS 分析表明,BMI 介导了身体虐待与血清 CRP(95%置信区间:0.014,0.062)和 IL-6(95%置信区间:0.009,0.034)之间的关系。

结论

暴露于儿童期创伤,特别是情感虐待、身体虐待和情感忽视,与孕妇的炎症有关。肥胖是身体虐待导致血清 CRP 和 IL-6 升高的 1 种途径。在怀孕前针对母体肥胖的干预措施可能有助于减轻儿童期创伤对围产期健康的影响。这些发现对于理解早期生活暴露对母体健康的生物学和行为途径具有重要意义。

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