Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China 200032.
Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China 200032.
J Affect Disord. 2020 Mar 1;264:150-156. doi: 10.1016/j.jad.2019.12.019. Epub 2019 Dec 14.
Recent research suggested that oxytocin might be associated with prenatal anxiety or depression. Also, our previous study indicated that resilience could buffer the effect of stress on prenatal anxiety and depression, which is a kind of psychological adjustment ability to stress in life. The effects of oxytocin and resilience are supposed to be similar but no study was carried out to find the association between them. Current evidence on the effect of oxytocin on prenatal mental health were with small sample size and equivocal results, especially with a lack of studies in Chinese pregnant women.
To investigate the relationship between oxytocin and resilience, and its role in regulating prenatal anxiety and depression among Chinese women.
The study was based on a sub-sample of the Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC) by stratified random sampling. A total of 632 participants completed blood collection for serum oxytocin measurement and questionnaires pertaining to early pregnancy stress and resilience in the second trimester, which were assessed by the Life Event Scale for Pregnancy Women (LESPW) and the revised Resilience Scale for Adults (RSA), respectively. Prenatal anxiety and depression were assessed by Self-Rating Anxiety Scale (SAS) and the Center for Epidemiological Survey, Depression Scale (CES-D), respectively, at the third trimester. Correlation analysis and stratified linear regression analyses were conducted to understand the role of oxytocin in regulating prenatal anxiety and depression.
The concentration of serum oxytocin in the second trimester ranged from 98.14 pg⋅ml to 197.28 pg⋅ml, and there was no significant difference between different gestational age (r = 0.024, P = 0.579). The association between stress and prenatal anxiety was stronger in high oxytocin group than that in low oxytocin group, with B value of 3.338 and 2.638, respectively, after adjusting for residence, educational level, family income and parity. The same effect was found in the association between stress and prenatal depression, with B value of 2.360 and 2.060, respectively. However, it was not significantly associated with early pregnancy stress (Z = 1.933, P = 0.630), prenatal anxiety (Z = 1.387, P = 0.165), prenatal depression (Z = -0.027, P = 0.978), nor resilience (F = 1.282, P = 0.280).
The existence of recall bias and restricted residential areas of the participants may limit the extrapolation of the study. Also, unsynchronized sampling timing of the oxytocin and psychological resilience measures is another limitation.
Serum oxytocin levels in the second trimester had an effect of modification between early pregnancy stress and prenatal anxiety and depression. Pregnant women with high oxytocin in the second trimester should receive more attention and further study is needed on the mechanism of oxytocin for the mental health of pregnant women.
最近的研究表明，催产素可能与产前焦虑或抑郁有关。此外，我们之前的研究表明，韧性可以缓冲压力对产前焦虑和抑郁的影响，这是一种生活中应对压力的心理调节能力。催产素和韧性的作用应该是相似的，但没有研究发现它们之间的关联。目前关于催产素对产前心理健康影响的证据样本量较小，结果也存在争议，特别是缺乏对中国孕妇的研究。
探讨催产素与韧性的关系及其在调节中国妇女产前焦虑和抑郁中的作用。
本研究基于上海母婴对子队列（Shanghai MCPC）的子样本，采用分层随机抽样。共有 632 名参与者完成了血液采集，以测量血清催产素，并在妊娠中期完成了与早期妊娠压力和韧性相关的问卷，分别采用妊娠妇女生活事件量表（LESPW）和成人韧性量表（RSA）进行评估。妊娠晚期采用焦虑自评量表（SAS）和流行病学研究中心抑郁量表（CES-D）评估产前焦虑和抑郁。采用相关分析和分层线性回归分析了解催产素在调节产前焦虑和抑郁中的作用。
妊娠中期血清催产素浓度范围为 98.14 pg/ml 至 197.28 pg/ml，不同孕龄之间无显著差异（r=0.024，P=0.579）。在调整居住地、教育水平、家庭收入和产次后，应激与产前焦虑的关联在高催产素组中强于低催产素组，B 值分别为 3.338 和 2.638。在应激与产前抑郁的关联中也发现了同样的效果，B 值分别为 2.360 和 2.060。然而，它与早期妊娠应激（Z=1.933，P=0.630）、产前焦虑（Z=1.387，P=0.165）、产前抑郁（Z=0.027，P=0.978）和早期妊娠应激（F=1.282，P=0.280）均无显著相关性。
参与者存在回忆偏倚和受限的居住区域，这可能限制了研究的推广。此外，催产素和心理韧性测量的采样时间不同也是另一个限制。
妊娠中期血清催产素水平对早期妊娠应激与产前焦虑和抑郁之间具有修饰作用。妊娠中期催产素水平较高的孕妇应受到更多关注，需要进一步研究催产素对孕妇心理健康的作用机制。
