Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Mol Psychiatry. 2019 Aug;24(8):1157-1177. doi: 10.1038/s41380-018-0265-4. Epub 2018 Oct 3.
Maternal mental illness can have a devastating effect during the perinatal period, and has a profound impact on the care that the baby receives and on the relationships that the baby forms. This review summarises clinical evidence showing the effects of perinatal depression on offspring physical and behavioural development, and on the transmission of psychopathology between generations. We then evaluate a number of factors which influence this relationship, such as genetic factors, the use of psychotropic medications during pregnancy, the timing within the perinatal period, the sex of the foetus, and exposure to maltreatment in childhood. Finally, we examine recent findings regarding the molecular mechanisms underpinning these clinical observations, and identify relevant epigenetic and biomarker changes in the glucocorticoid, oxytocin, oestrogen and immune systems, as key biological mediators of these clinical findings. By understanding these molecular mechanisms in more detail, we will be able to improve outcomes for both mothers and their offspring for generations.
产妇精神疾病在围产期可能会产生毁灭性影响，并对婴儿所接受的护理以及其建立的人际关系产生深远影响。本综述总结了临床证据，表明围产期抑郁症对后代身体和行为发育以及代际间精神病理学传播的影响。然后，我们评估了影响这种关系的一些因素，如遗传因素、怀孕期间使用精神药物、围产期的时间、胎儿性别以及儿童期受虐待的情况。最后，我们研究了最近关于这些临床观察结果的分子机制的发现，并确定了糖皮质激素、催产素、雌激素和免疫系统中相关的表观遗传和生物标志物变化，这些都是这些临床发现的关键生物学介质。通过更详细地了解这些分子机制，我们将能够改善母亲及其后代几代人的结局。
