不良童年经历：对后代端粒长度和精神病理学的影响。
Adverse Childhood Experiences: Implications for Offspring Telomere Length and Psychopathology.
机构信息
The Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans (Esteves, Drury); the Department of Neuroscience, Tulane Brain Institute, Tulane University, New Orleans (Jones, Drury); the Department of Applied Psychology and Human Development, University of Toronto (Wade); the Department of Cell and Molecular Biology, Tulane University, New Orleans (Callerame); the Department of Obstetrics and Gynecology, Emory University, Atlanta (Smith); and the Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, Tulane University, New Orleans (Theall).
出版信息
Am J Psychiatry. 2020 Jan 1;177(1):47-57. doi: 10.1176/appi.ajp.2019.18030335. Epub 2019 Sep 6.
OBJECTIVE
Adverse childhood experiences (ACEs) are associated with mental and physical health risks that, through biological and psychosocial pathways, likely span generations. Within an individual, telomere length (TL), an established marker of cellular stress and aging, is associated with both ACE exposure and psychopathology, providing the basis for an emerging literature suggesting that TL is a biomarker of the health risks linked to early-life adversity both within and across generations. The authors tested the effect of maternal ACEs on both the trajectory of infant TL and infant social-emotional problems at 18 months of age.
METHODS
Pregnant women were recruited, and maternal scores on the Adverse Childhood Experience questionnaire were obtained, along with demographic and prenatal stress measures. Postnatal visits with 155 mother-infant dyads occurred when infants were 4, 12, and 18 months of age. At each visit, infant buccal swabs were collected for TL measurement, and mothers completed measures of maternal depression. Mothers also completed the Child Behavior Checklist at the 18-month visit. Mixed-effects modeling was used to test how maternal ACEs influenced infant TL trajectory. Linear regression was used to test the association between maternal ACEs and infant internalizing and externalizing behaviors. Finally, the interaction between telomere attrition from 4 to 18 months and maternal ACEs was examined as a predictor of infant scores on the Child Behavior Checklist.
RESULTS
Higher maternal ACEs were associated with shorter infant TL across infancy and higher infant externalizing behavioral problems at 18 months. No associations were found with internalizing behavioral problems. Telomere attrition from 4 to 18 months interacted with maternal ACEs to predict externalizing behaviors. In infants whose mothers reported higher scores on the Adverse Childhood Experience questionnaire, greater telomere attrition predicted higher externalizing problems, even when accounting for maternal postnatal depression and prenatal stress.
CONCLUSIONS
These data demonstrate an interactive pathway between maternal early-life adversity and infant TL that predicts emerging behavioral problems in the next generations.
目的
不良的童年经历（ACEs）与精神和身体健康风险相关，这些风险通过生物和心理社会途径，可能会跨越几代人。在个体内部，端粒长度（TL）是细胞应激和衰老的既定标志物，与 ACE 暴露和精神病理学都有关联，这为一个新兴的文献提供了基础，该文献表明 TL 是与个体和跨代的早期生活逆境相关的健康风险的生物标志物。作者检验了母亲 ACEs 对婴儿 TL 轨迹和 18 个月大婴儿社会情感问题的影响。
方法
招募了孕妇，并获得了他们的 ACE 问卷得分，以及人口统计学和产前压力指标。在婴儿 4、12 和 18 个月时，对 155 对母婴进行了产后访视。每次访视时，都从婴儿的口腔中采集 TL 测量用的拭子，母亲完成了抑郁测量。母亲还在 18 个月时完成了儿童行为检查表。混合效应模型用于检验母亲 ACEs 如何影响婴儿 TL 轨迹。线性回归用于检验母亲 ACEs 与婴儿内化和外化行为之间的关系。最后，检验了从 4 个月到 18 个月期间端粒耗损与母亲 ACEs 的相互作用，作为儿童行为检查表上婴儿得分的预测指标。
结果
母亲 ACEs 得分越高，婴儿在整个婴儿期的 TL 越短，18 个月时的婴儿外化行为问题越高。与内化行为问题无关。从 4 个月到 18 个月期间的端粒耗损与母亲 ACEs 相互作用，预测了外化行为。在母亲 ACEs 问卷得分较高的婴儿中，端粒损耗越大，预测外化问题的能力越强，即使考虑到母亲产后抑郁和产前压力也是如此。
结论
这些数据表明，母亲早期生活逆境与婴儿 TL 之间存在一种交互途径，这种途径可以预测下一代出现行为问题。
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