Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210 United States; Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210 United States; Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States; Department of Psychology, The Ohio State University, Columbus, OH 43210, United States; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
Brain Behav Immun. 2018 Nov;74:231-240. doi: 10.1016/j.bbi.2018.09.012. Epub 2018 Sep 11.
Women who have experienced significant adversities during childhood and adulthood are at risk for excessive inflammation during pregnancy, but the mechanisms are unclear. Using structural equation modeling, we examined pathways from childhood abuse history and current socioeconomic status (SES) to inflammatory markers through indicators of health risk, recent stressors, and psychological distress in 214 women assessed at mid-pregnancy (5-31 weeks gestation). Self-reported data on socioeconomic indicators, childhood trauma history, pre-pregnancy body mass index (BMI), smoking, sleep quality, interpersonal conflict, recent life events, perceived stress, and depressive symptoms were collected, and serum levels of C-reactive protein (CRP) and interleukin (IL)-6 were determined. In separate models, pre-pregnancy BMI, sleep quality, and interpersonal conflict statistically explained the relationship between adversity and inflammation. These three intermediate variables were then entered into a multiple mediation analysis to examine unique effects. Childhood abuse history and current SES both demonstrated significant indirect effects on CRP through pre-pregnancy BMI, and current SES showed a significant indirect effect on IL-6 through all intermediate variables. When examining each indirect pathway individually, pre-pregnancy BMI and interpersonal conflict emerged as parallel pathways by which low current SES leads to elevated IL-6; the indirect pathway through sleep quality was no longer significant. Pre-pregnancy BMI and interpersonal conflict are two independent mechanisms by which adversity is associated with increased inflammation during pregnancy. Women who have been exposed to significant adversity may be at particular risk for obesity, sleep disruption, and interpersonal conflict, with implications for immune dysregulation during pregnancy.
在妊娠期间，经历过童年和成年期重大逆境的女性存在过度炎症的风险，但具体机制尚不清楚。本研究采用结构方程模型，在 214 名妊娠中期（妊娠 5-31 周）女性中，通过健康风险指标、近期压力源和心理困扰，评估了童年虐待史和当前社会经济状况（SES）与炎症标志物之间的途径。评估了社会经济指标、童年创伤史、孕前体重指数（BMI）、吸烟、睡眠质量、人际冲突、近期生活事件、感知压力和抑郁症状的自我报告数据，并测定了 C 反应蛋白（CRP）和白细胞介素（IL）-6 的血清水平。在单独的模型中，孕前 BMI、睡眠质量和人际冲突在逆境与炎症之间的关系中具有统计学意义。然后，将这三个中间变量纳入多重中介分析，以检验独特的影响。童年虐待史和当前 SES 均通过孕前 BMI 对 CRP 具有显著的间接影响，当前 SES 通过所有中间变量对 IL-6 具有显著的间接影响。当分别检查每个间接途径时，孕前 BMI 和人际冲突作为低 SES 导致 IL-6 升高的平行途径出现；通过睡眠质量的间接途径不再显著。孕前 BMI 和人际冲突是逆境与妊娠期间炎症增加相关的两种独立机制。经历过重大逆境的女性可能特别容易肥胖、睡眠中断和人际冲突，这对妊娠期间免疫失调有影响。
