Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
J Affect Disord. 2021 Jan 1;278:643-649. doi: 10.1016/j.jad.2020.09.077. Epub 2020 Sep 29.
Maternal stress and nutrition during pregnancy are two of the most commonly studied factors in the context of fetal development. However, few investigators have considered the combined effects of stress and diet in pregnant women and their offspring.
To determine the impact of maternal stress on offspring birth weight, and the potential mediating role of maternal dietary patterns.
A total of 3542 pregnant women and their singleton live births were recruited from Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC). Maternal stress was assessed using the Life Event Scale for Pregnant Women (LESPW) in early and late pregnancy. Food frequency questionnaire (FFQ) was performed to evaluate maternal diet in late pregnancy. Multiple linear regression was conducted to estimate the associations between maternal stress and child birth weight. Logistic regression was performed to calculate the association between maternal stress and small for gestational age (SGA)/large for gestational age (LGA). The bootstrap method was used to investigate the mediating effects of maternal dietary patterns.
Maternal subjective events stress (β = 0.367) and total stress (β = 0.079) in early pregnancy, and positive objective life events stress (β = 0.275) in late pregnancy, were positively associated with birth weight. Maternal dietary pattern of "high-fat and sugar" mediated the associations between subjective events stress and total stress during early pregnancy and birth weight. An increased risk for LGA was observed among women exposed to relatively higher stress during early pregnancy (OR, 1.416; 95% CI, 1.035-1.937). No statistically significant associations were found between maternal stress during late pregnancy and child birth weight or SGA/LGA.
Maternal life events stress during early pregnancy significantly increases neonatal birth weight and risk for LGA, which may mediate by a "high-fat and sugar" dietary pattern.
The lack of biological markers limits the explanation of the mechanism. The assessment of diet used food intake frequency to evaluate dietary characteristics, which may miss information of energy intake.
在胎儿发育的研究中，母体压力和孕期营养是两个最常被研究的因素。然而，很少有研究人员考虑到孕妇及其后代压力和饮食的综合影响。
确定母体压力对后代出生体重的影响，以及母体饮食模式的潜在中介作用。
本研究共纳入 3542 名来自上海母婴配对队列（Shanghai MCPC）的孕妇及其单胎活产儿。在妊娠早期和晚期，使用孕妇生活事件量表（LESPW）评估母体压力。在妊娠晚期使用食物频率问卷（FFQ）评估母体饮食。采用多元线性回归估计母体压力与儿童出生体重之间的关系。采用 logistic 回归计算母体压力与小于胎龄儿（SGA）/大于胎龄儿（LGA）之间的关系。采用自举法探讨母体饮食模式的中介作用。
妊娠早期母体主观事件压力（β=0.367）和总压力（β=0.079）以及妊娠晚期阳性客观生活事件压力（β=0.275）与出生体重呈正相关。妊娠早期母体主观事件压力和总压力与出生体重之间的关联可通过“高脂肪和高糖”饮食模式来解释。与妊娠早期压力较大的女性相比，LGA 的风险增加（OR=1.416，95%CI：1.035-1.937）。妊娠晚期母体压力与儿童出生体重或 SGA/LGA 之间无统计学显著关联。
妊娠早期母体生活事件压力显著增加新生儿出生体重和 LGA 的风险，这可能通过“高脂肪和高糖”饮食模式来介导。
缺乏生物标志物限制了对机制的解释。饮食评估使用食物摄入量频率来评估饮食特征，这可能会遗漏能量摄入信息。
