Department of Psychological and Brain Sciences, Neuroscience and Behavior Program, University of Massachusetts, Amherst, MA, USA.
Dev Psychobiol. 2021 Apr;63(3):409-436. doi: 10.1002/dev.22021. Epub 2020 Aug 11.
Prenatal stress adversely affects offspring development. Although cortisol is hypothesized to be a key mediator of stress-induced developmental deficits, determining the amount of fetal cortisol exposure produced by maternal stress has proved challenging. Current approaches, such as measuring cortisol concentrations in maternal plasma, saliva, or urine, amniotic fluid, fetal plasma, or cord blood, all have significant limitations for assessing cumulative fetal cortisol exposure over time. A recently emerging approach is to measure cortisol concentrations in maternal hair and/or newborn hair or nail samples. Maternal hair cortisol potentially shows long-term production across each trimester of pregnancy, whereas neonatal hair or nail cortisol is thought to reflect mainly third trimester hormone accumulation. This review first describes fetal adrenocortical development, placental cortisol metabolism, and the various sources of fetal cortisol exposure across pregnancy. We then summarize the results obtained from "classical" methods of assessing prenatal cortisol exposure prior to the advent of hair and nail cortisol measurement. Lastly, we discuss the initial development and validation of the hair cortisol methodology, its subsequent application to studies of chronic stress, and recent findings regarding maternal and neonatal hair or nail cortisol concentrations in relation to prenatal stress and other variables of interest.
产前应激会对后代的发育产生不利影响。虽然皮质醇被假设为应激引起的发育缺陷的关键介质，但确定母体应激产生的胎儿皮质醇暴露量一直具有挑战性。目前的方法，如测量母体血浆、唾液或尿液、羊水、胎儿血浆或脐血中的皮质醇浓度，在评估随时间推移的累积胎儿皮质醇暴露方面都存在显著的局限性。最近出现的一种方法是测量母体头发和/或新生儿头发或指甲样本中的皮质醇浓度。母体头发皮质醇在整个妊娠期间都有可能长期产生，而新生儿头发或指甲皮质醇则被认为主要反映了第三个孕期的激素积累。本综述首先描述了胎儿肾上腺皮质的发育、胎盘皮质醇的代谢以及妊娠期间胎儿皮质醇暴露的各种来源。然后，我们总结了在头发和指甲皮质醇测量出现之前，“经典”评估产前皮质醇暴露的方法所获得的结果。最后，我们讨论了头发皮质醇方法学的最初发展和验证，及其随后在慢性应激研究中的应用，以及最近关于与产前应激和其他感兴趣变量相关的母体和新生儿头发或指甲皮质醇浓度的发现。
