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孕妇心理困扰与儿童心血管代谢危险因素。

Maternal psychological distress during pregnancy and childhood cardio-metabolic risk factors.

机构信息

Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands.

Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, the Netherlands.

出版信息

Nutr Metab Cardiovasc Dis. 2019 Jun;29(6):572-579. doi: 10.1016/j.numecd.2019.02.008. Epub 2019 Mar 6.

Abstract

BACKGROUND AND AIMS

Previous studies suggest that psychological distress during pregnancy may lead to fetal developmental adaptations, which programme cardio-metabolic disease of the offspring. We examined the associations of maternal overall psychological distress, depression and anxiety during pregnancy with cardio-metabolic risk factors in 10-year-old children and explore potential sex-specific differences.

METHODS AND RESULTS

In a population-based prospective cohort study among 4,088 mothers and their children, information about overall psychological distress, including depression and anxiety was obtained through the Brief Symptom Inventory during pregnancy. We measured child blood pressure and heart rate and insulin, glucose, serum lipids and C-reactive protein blood concentrations at 10 years. Analyses were performed in the total group and in boys and girls separately. Psychological distress during pregnancy was associated with higher childhood heart rate among boys only (differences 0.34 (95% Confidence Interval (CI) 0.18, 0.50) standard deviation scores (SDS), 0.22 (95% CI 0.06, 0.38) SDS, 0.33 (95% CI 0.19, 0.48) SDS, for overall psychological distress, depression and anxiety, respectively). Maternal anxiety during pregnancy was associated with higher childhood triglycerides among girls (difference 0.35 (95% CI 0.17, 0.53) SDS). Maternal psychological distress was not associated with childhood blood pressure, cholesterol, insulin, glucose and C-reactive protein concentrations.

CONCLUSIONS

Maternal psychological distress may influence their offspring heart rate and triglycerides concentrations. Further studies are needed to replicate these findings and assess the long-term cardio-metabolic consequences of maternal psychological distress.

摘要

背景与目的

既往研究提示孕期心理困扰可能导致胎儿发育适应,从而为后代心血管代谢疾病奠定基础。我们旨在探讨孕期整体心理困扰、抑郁和焦虑与 10 岁儿童心血管代谢风险因素的相关性,并探究潜在的性别特异性差异。

方法和结果

在一项基于人群的前瞻性队列研究中,我们纳入了 4088 名母亲及其子女,孕期通过 Brief Symptom Inventory 量表评估母亲的整体心理困扰(包括抑郁和焦虑)。我们于儿童 10 岁时测量其血压、心率和胰岛素、血糖、血脂及 C 反应蛋白浓度。我们在总人群中以及男孩和女孩中分别进行分析。孕期心理困扰与男孩的儿童期心率升高相关(差异分别为 0.34(95%置信区间:0.18,0.50)标准差评分、0.22(95%置信区间:0.06,0.38)标准差评分、0.33(95%置信区间:0.19,0.48)标准差评分,分别对应整体心理困扰、抑郁和焦虑)。孕期焦虑与女孩的儿童期甘油三酯升高相关(差异为 0.35(95%置信区间:0.17,0.53)标准差评分)。孕期母亲的心理困扰与儿童期血压、胆固醇、胰岛素、血糖及 C 反应蛋白浓度无相关性。

结论

母亲的心理困扰可能影响其后代的心率和甘油三酯浓度。需要进一步研究来复制这些发现,并评估孕期母亲心理困扰对后代心血管代谢的长期影响。

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