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母亲焦虑和抑郁对胎儿神经发育的影响。

Effects of maternal anxiety and depression on fetal neuro-development.

机构信息

Department of Psychology, Durham University, Science Site, South Road, Durham DH1 3LE, United Kingdom.

Department of Psychology, Durham University, Science Site, South Road, Durham DH1 3LE, United Kingdom.

出版信息

J Affect Disord. 2018 Dec 1;241:469-474. doi: 10.1016/j.jad.2018.08.047. Epub 2018 Aug 13.

Abstract

BACKGROUND

Fetal development is affected by maternal mental health with research indicating that maternal anxiety and depression are co-morbid; nevertheless differential effects on the fetus have been found. This study examines, prenatally, effects of maternal stress, anxiety and depression on fetal eye-blink reactions to experimental sound and light stimulation.

METHODS

Two groups of singleton fetuses (mean 32-weeks gestation) were examined using 4D ultrasound: a control group (N = 14, 7 female) with no stimulation and an experimental group (N = 21, 13 female) exposed to experimental sound, light and cross-modal stimulation. For both groups ultrasound scans were performed and fetal eye-blink was assessed. Mothers completed the Hospital-Anxiety-and-Depression Scale and the Perceived-Stress Scale. Analysis was carried out using Poisson mixed effects modelling.

RESULTS

Fetal eye-blink rate during experimental stimulation was significantly and differentially associated with maternal mental health with a 20% increase of fetal eye-blink rate for each unit increase in anxiety score (p = 0.02) and a decrease of 21% of eye blink rate for each unit of increase in depression score (p = 0.02). Sound stimulation but not light stimulation significantly affected blink-rate with fetuses habituating to the stimuli (p < 0.001).

LIMITATIONS

Limitations are the relatively small number of fetuses and that a follow up after birth is essential to establish potential long-term effects.

CONCLUSIONS

Of clinical importance is the finding that although fetuses are affected by maternal mental health in general here we demonstrate, using eye-blink-rate during stimulation as measure of neuro-development, that fetuses are differentially affected by maternal anxiety and depression with anxiety increasing and depression decreasing fetal reactivity significantly.

摘要

背景

胎儿发育受到产妇心理健康的影响,研究表明,产妇焦虑和抑郁并存;然而,对胎儿的影响却不同。本研究在产前检查了母亲的应激、焦虑和抑郁对胎儿对实验性声音和光刺激的眨眼反应的影响。

方法

使用 4D 超声检查了两组单胎胎儿(平均 32 周妊娠):对照组(N=14,7 名女性)无刺激,实验组(N=21,13 名女性)暴露于实验性声音、光和跨模态刺激。对两组胎儿进行超声扫描并评估胎儿眨眼。母亲完成了医院焦虑和抑郁量表和感知压力量表。使用泊松混合效应模型进行分析。

结果

实验性刺激期间胎儿眨眼率与产妇心理健康显著相关且存在差异,焦虑评分每增加一个单位,胎儿眨眼率增加 20%(p=0.02),抑郁评分每增加一个单位,眨眼率下降 21%(p=0.02)。声音刺激而不是光刺激显著影响眨眼率,胎儿对刺激产生习惯(p<0.001)。

局限性

局限性在于胎儿数量相对较少,并且在出生后进行随访对于确定潜在的长期影响至关重要。

结论

虽然胎儿普遍受到产妇心理健康的影响,但我们在这里通过刺激期间的眨眼率作为神经发育的测量指标表明,焦虑增加和抑郁显著降低胎儿反应性,因此胎儿受到母亲焦虑和抑郁的影响存在差异。这具有重要的临床意义。

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