Research Department of Clinical, Educational and Health Psychology, University College London, London, UK; Scientific Institute, IRCCS Eugenio Medea, Child Psychopathology Unit, Bosisio Parini, Lecco, Italy.
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Psychoneuroendocrinology. 2019 Mar;101:253-262. doi: 10.1016/j.psyneuen.2018.11.018. Epub 2018 Nov 14.
Accumulating evidence suggests that antenatal maternal stress is associated with altered behavioral and physiological outcomes in the offspring, however, whether this association is causal and the underlying biological mechanisms remain largely unknown. While the most studied mediator of maternal stress influences on the fetus has generally been cortisol, alternative novel markers of stress or inflammation warrant further consideration. The current investigation explored the influence of variations in self-reported symptoms of distress, stress hormones and inflammatory markers on infant birth outcomes and early stress regulation. The sample consisted of 104 pregnant women (mean gestational age = 34.76; SD = 1.12) and their healthy newborns. Maternal self-reported symptoms of depression and anxiety were evaluated through the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory and levels of serum Interleukine-6 (IL-6), C-Reactive Protein (CRP), salivary cortisol and alpha amylase (sAA) were measured in late pregnancy. Newborns' cortisol and behavioral response to the heel-stick was assessed 48-72 hours after birth. The associations between maternal stress measures and infant birth outcomes and stress reactivity, adjusted for potential confounders, were examined through hierarchical linear regressions and hierarchical linear models. Higher maternal IL-6 levels were associated with smaller head circumference at birth, while diurnal sAA levels were positively associated with birthweight. Maternal diurnal cortisol was related to newborn's stress reactivity: a flatter infant cortisol response to the heel-stick was associated with greater maternal cortisol increases after awakening during pregnancy, while greater infant behavioural reactivity was related to a flatter maternal diurnal cortisol profile. The observational nature of these data does not allow for causal inferences but the current findings illustrate that antenatal factors related to alterations in maternal stress and immune response systems are associated with fetal growth and neonatal stress reactivity. This may have implications for later health and psychological outcomes.
越来越多的证据表明，产前母体应激与后代行为和生理结果的改变有关，然而，这种关联是否具有因果关系以及潜在的生物学机制在很大程度上仍不清楚。虽然母体应激对胎儿影响的最研究中介物通常是皮质醇，但替代的新型应激或炎症标志物值得进一步考虑。目前的研究探讨了母体应激的变化对婴儿出生结局和早期应激调节的影响。样本包括 104 名孕妇（平均妊娠年龄=34.76；SD=1.12）及其健康新生儿。通过爱丁堡产后抑郁量表和状态-特质焦虑量表评估产妇抑郁和焦虑的自我报告症状，在妊娠晚期测量血清白细胞介素-6（IL-6）、C-反应蛋白（CRP）、唾液皮质醇和α淀粉酶（sAA）的水平。在出生后 48-72 小时评估新生儿的皮质醇和对足跟采血的行为反应。通过分层线性回归和分层线性模型，在调整潜在混杂因素后，检查母体应激测量值与婴儿出生结局和应激反应之间的关联。母体 IL-6 水平较高与出生时头围较小有关，而日间 sAA 水平与出生体重呈正相关。母体日间皮质醇与新生儿应激反应有关：足跟采血时新生儿皮质醇反应较平缓与妊娠期间觉醒后母体皮质醇增加有关，而新生儿行为反应较大与母体日间皮质醇曲线较平缓有关。这些数据的观察性质不允许进行因果推断，但目前的研究结果表明，与母体应激和免疫反应系统改变相关的产前因素与胎儿生长和新生儿应激反应有关。这可能对以后的健康和心理结果产生影响。
