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白细胞介素-17A 与妊娠 24-28 周孕妇的慢性应激。

Interleukin-17A and Chronic Stress in Pregnant Women at 24-28 Weeks Gestation.

机构信息

Tiffany A. Moore, PhD, RN, is Assistant Professor, College of Nursing-Omaha Division, University of Nebraska Medical Center. Adam J. Case, PhD, is Assistant Professor, Department of Cellular and Integrative Physiology, College of Medicine, University of Nebraska Medical Center, Omaha. Therese L. Mathews, PhD, APRN-NP, BCBA-D, is Associate Professor, College of Nursing-Omaha Division, University of Nebraska Medical Center. Katherine Laux Kaiser, PhD, PHCNS, BC, is Professor Emeritus, College of Nursing-Omaha Division, University of Nebraska Medical Center. Matthew C. Zimmerman, PhD, is Associate Professor, Department of Cellular and Integrative Physiology, College of Medicine, University of Nebraska Medical Center, Omaha, and Director, Free Radicals in Medicine Program, Omaha, Nebraska. Crystal Modde Epstein, PhD, APRN-NP, is a Post-Doctoral Scholar, School of Nursing, University of California, San Francisco.

出版信息

Nurs Res. 2019 Mar/Apr;68(2):167-173. doi: 10.1097/NNR.0000000000000334.

Abstract

BACKGROUND

Allostatic load (AL) is a biopsychosocial model that suggests chronic psychosocial stress leads to physiological dysregulation and poor outcomes. The purpose of this study was to examine AL in pregnant women operationalized using proinflammatory cytokines and psychosocial indicators and perinatal outcomes.

OBJECTIVES

The aim of the study was to identify relationships between circulating cytokines/chemokines and the Prenatal Distress Questionnaire, the Maternal Antenatal Attachment Scale, the Emotional Quotient Inventory, the Life Experiences Scale, and demographics in pregnant women.

METHODS

A cross-sectional design was used to recruit pregnant women between 24 and 28 weeks of gestation. Blood and stress/emotional indicators were obtained after informed consent. Plasma was abstracted to simultaneously measure 29 cytokines/chemokines using a multiplex array. Cytokine/chemokine levels were compared with continuous variables using Spearman's rho and with categorical variables using Mann-Whitney U.

RESULTS

Twenty-five women with medically high-risk (n = 16) and low-risk (n = 9) pregnancies consented. Most women were White (68%) with a mean age of 29 years (SD = 5.9). Although several cytokines and chemokines showed significant correlations with the stress/emotional indicators, only interleukin-17A (IL-17A) was significantly associated with all of the indicators (Prenatal Distress Questionnaire: rs = .528, p = .012; Maternal Antenatal Attachment Scale: rs = -.439, p = .036; Emotional Quotient Inventory total: rs = -.545, p = .007), Life Experiences Scale (rs = .458, p = .032), birth weight (rs = -.499, p = .013), and race (p = .01).

DISCUSSION

Increased levels of IL-17A, a known cytokine associated with chronic stress and with poor perinatal outcomes, were associated with high prenatal distress, low maternal attachment, and lower emotional intelligence in pregnant women. Increased levels of IL-17A also were associated with lower birth weight and non-White race. Results support the model of AL in pregnant women and highlight IL-17A as a potential biomarker of AL during pregnancy.

摘要

背景

适应负荷(AL)是一个生物心理社会模型,表明慢性心理社会压力会导致生理失调和不良后果。本研究的目的是检查使用促炎细胞因子和心理社会指标以及围产期结局来操作的孕妇中的 AL。

目的

本研究的目的是确定循环细胞因子/趋化因子与产前焦虑问卷、产妇产前依恋量表、情绪商数量表、生活经历量表和孕妇人口统计学之间的关系。

方法

采用横断面设计招募妊娠 24 至 28 周的孕妇。获得知情同意后,获取血液和应激/情绪指标。使用多重分析从血浆中提取 29 种细胞因子/趋化因子以进行同步测量。使用 Spearman rho 比较细胞因子/趋化因子水平与连续变量,使用 Mann-Whitney U 比较细胞因子/趋化因子水平与分类变量。

结果

25 名患有医学高危(n = 16)和低危(n = 9)妊娠的孕妇同意参与。大多数女性为白人(68%),平均年龄为 29 岁(SD = 5.9)。尽管几种细胞因子和趋化因子与应激/情绪指标有显著相关性,但只有白细胞介素 17A(IL-17A)与所有指标均显著相关(产前焦虑问卷:rs =.528,p =.012;产妇产前依恋量表:rs = -.439,p =.036;情绪商数量表总分:rs = -.545,p =.007)、生活经历量表(rs =.458,p =.032)、出生体重(rs = -.499,p =.013)和种族(p =.01)。

讨论

已知与慢性应激和不良围产期结局相关的促炎细胞因子 IL-17A 水平升高与孕妇产前焦虑、低产妇依恋和较低的情绪智力相关。IL-17A 水平升高也与出生体重较低和非白人种族相关。结果支持了孕妇中 AL 的模型,并强调了 IL-17A 作为妊娠期间 AL 的潜在生物标志物。

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