Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany; Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Landau, Germany.
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Psychoneuroendocrinology. 2019 Mar;101:223-231. doi: 10.1016/j.psyneuen.2018.11.002. Epub 2018 Nov 5.
Prenatal maternal stress is an established risk factor for somatic and psychological health of the offspring. A dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in offspring has been suggested as an important mechanism. However, the impact of prenatal stress on stress reactivity in preschool-aged children is not yet well understood. This is partly due to the fact that for this age group there is no stress test as well established as for older children and adults. In the present work a previously published stress test (Kryski et al., 2011) was evaluated in a large sample of 45-month-old children (n = 339). Furthermore, the relation between measures of prenatal maternal stress and cortisol reactivity was investigated. Prenatal stress was defined as psychopathology (self-report available for n = 339; expert-rating available for a subsample of n = 246) and perceived stress (n = 244) during pregnancy. The stress paradigm elicited significant increases in salivary cortisol 30 and 40 min after the test, and 60.8% of the children were classified as responders. Lower cortisol levels after the stress test were observed in the group of children with prenatal stress defined as maternal psychopathology (both self-reported and expert-rated). Maternal perceived stress as a continuous measure was not significantly associated with cortisol levels. However, when comparing children in the highest quartile of maternal perceived stress to all other children, significantly lower cortisol values were observed in the prenatally stressed group. The present study confirms the paradigm by Kryski et al. as an effective stress test for preschool-aged children. Moreover, it provides further evidence that prenatal stress impacts HPA axis reactivity. Future studies should target the timing, nature, and intensity of prenatal stressors and their effect on the stress response in offspring at different developmental stages.
产前母体应激是后代躯体和心理健康的既定风险因素。已有研究提出，后代下丘脑-垂体-肾上腺（HPA）轴失调是一个重要的机制。然而，产前应激对学龄前儿童应激反应的影响尚不清楚。这在一定程度上是因为对于这个年龄段，还没有像对年龄较大的儿童和成人那样成熟的应激测试。在本研究中，我们评估了 Kryski 等人先前发表的应激测试（2011）在 45 个月大的儿童（n=339）的大样本中的应用。此外，我们还研究了产前母体应激与皮质醇反应性之间的关系。产前应激被定义为妊娠期间的精神病理学（n=339 可提供自我报告；n=246 可提供专家评定）和感知压力（n=244）。应激范式引发唾液皮质醇在测试后 30 和 40 分钟显著增加，60.8%的儿童被归类为反应者。在定义为母体精神病理学的（自我报告和专家评定）产前应激组中，应激测试后皮质醇水平较低。作为连续测量的母体感知压力与皮质醇水平无显著相关性。然而，当将母亲感知压力最高四分位数的儿童与所有其他儿童进行比较时，在产前应激组中观察到皮质醇值显著降低。本研究证实了 Kryski 等人的范式作为一种有效的学龄前儿童应激测试。此外，它提供了进一步的证据表明产前应激会影响 HPA 轴反应性。未来的研究应该针对产前应激源的时间、性质和强度及其对不同发育阶段后代应激反应的影响。
