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孕期急性应激时的心脏迷走神经控制:与生活应激和情感支持的关系。

Cardiac vagal control in response to acute stress during pregnancy: Associations with life stress and emotional support.

机构信息

Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Department of Biostatistics and Bioinformatics, Emory University, GA, USA.

出版信息

Psychophysiology. 2021 Jun;58(6):e13808. doi: 10.1111/psyp.13808. Epub 2021 Mar 13.

Abstract

Life stressors during pregnancy can disrupt maternal stress regulation and negatively impact offspring health. Despite the important role of cardiac vagal control (e.g., heart rate variability; HRV) in stress regulation, few studies have investigated how life stressors and emotional support influence vagal control during pregnancy. This study aimed to (a) characterize patterns of cardiac vagal control in response to a stressor administered in pregnancy, and (b) examine the effects of life stress and emotional support on vagal control during rest, reactivity, and recovery. Participants included 191 pregnant women (79% Black; 21% White) living in an urban U.S. city (73% receiving public assistance). Heart rate (HR) and HRV (indexed by RMSSD) were recorded continually during the preparation, task, and recovery periods of the Trier Social Stress Test (TSST). Participants reported recent life stressors (e.g., relationship problems, financial hardship) and emotional support. Piecewise growth curve modeling was used to model rates of reactivity and recovery, adjusting for gestational age at time of assessment and recent health problems. Life stress predicted greater HR and HRV reactivity to the TSST as well as greater HRV recovery (vagal rebound). However, associations were only evident for women reporting high emotional support. Results suggest that pregnant women living with frequent life stressors may exhibit more rapid autonomic responses to acute stress, including more rapid vagal rebound after stressors, potentially reflecting physiological adaptation to anticipated high-stress environments; emotional support may enhance these responses. Studies are needed to investigate long-term health outcomes related to this stress response pattern.

摘要

怀孕期间的生活压力会干扰母体的应激调节,对后代的健康产生负面影响。尽管心脏迷走神经控制(例如心率变异性;HRV)在应激调节中起着重要作用,但很少有研究调查生活压力和情感支持如何影响怀孕期间的迷走神经控制。本研究旨在:(a) 描述怀孕期间应激源作用下心脏迷走神经控制的反应模式;(b) 研究生活压力和情感支持对休息、反应性和恢复期间迷走神经控制的影响。参与者包括 191 名生活在美国城市的孕妇(79%黑人;21%白人)(73%接受公共援助)。在特里尔社会应激测试(TSST)的准备、任务和恢复期间,连续记录心率(HR)和 HRV(以 RMSSD 为指标)。参与者报告了最近的生活压力源(例如,人际关系问题、经济困难)和情感支持。分段增长曲线模型用于对反应性和恢复率进行建模,调整评估时的孕龄和最近的健康问题。生活压力预测了对 TSST 的更高的 HR 和 HRV 反应性,以及更高的 HRV 恢复(迷走神经反弹)。然而,这些关联仅在报告高情感支持的女性中明显。结果表明,生活压力大的孕妇可能对急性应激表现出更快的自主反应,包括应激后更快的迷走神经反弹,这可能反映了对预期高压力环境的生理适应;情感支持可能会增强这些反应。需要研究与这种应激反应模式相关的长期健康结果。

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