Department of Psychiatry, Oregon Health and Science University, Portland, Oregon.
Department of Psychiatry, Oregon Health and Science University, Portland, Oregon.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2022 May;7(5):461-470. doi: 10.1016/j.bpsc.2021.10.012. Epub 2021 Oct 27.
Heightened psychological stress during pregnancy has repeatedly been associated with increased risk for development of behavior problems and psychiatric disorders in offspring. This review covers a rapidly growing body of research with the potential to advance a mechanistic understanding of these associations grounded in knowledge about maternal-placental-fetal stress biology and fetal brain development. Specifically, we highlight research employing magnetic resonance imaging to examine the infant brain soon after birth in relation to maternal psychological stress during pregnancy. This approach increases capacity to identify specific alterations in brain structure and function and to differentiate between effects of pre- versus postnatal exposures. We then focus on the extensive preclinical literature and emerging research in humans that have found that heightened maternal inflammation during pregnancy as a mechanism through which maternal stress influences the developing fetal brain. We place these findings in the context of recent work identifying psychotherapeutic interventions that have been found to be effective for reducing psychological stress among pregnant individuals and that also show promise for reducing inflammation. We argue that a focus on inflammation, among other mechanistic pathways, may lead to a productive and necessary integration of research focused on the effects of maternal psychological stress on offspring brain development and on prevention and intervention studies aimed at reducing maternal psychological stress during pregnancy. In addition to increasing capacity for common measurements and understanding potential mechanisms of action relevant to maternal mental health and fetal neurodevelopment, this focus may inform and broaden thinking about prevention and intervention strategies.
怀孕期间心理压力的增加与后代行为问题和精神障碍的风险增加有关。这篇综述涵盖了大量正在发展的研究，这些研究有可能基于对母体-胎盘-胎儿应激生物学和胎儿大脑发育的知识，推进对这些关联的机制理解。具体来说，我们强调了利用磁共振成像研究出生后婴儿大脑与怀孕期间母体心理压力之间关系的研究。这种方法增加了识别大脑结构和功能特定变化的能力，并能够区分产前和产后暴露的影响。然后，我们专注于大量的临床前文献和新兴的人类研究，这些研究发现，怀孕期间母体炎症增加是母体应激影响发育中胎儿大脑的一种机制。我们将这些发现置于最近确定的心理治疗干预措施的背景下，这些干预措施已被证明可有效减轻孕妇的心理压力，并且也有望减轻炎症。我们认为，关注炎症等机制途径，可能会导致针对母体心理压力对后代大脑发育的影响以及旨在减轻怀孕期间母体心理压力的预防和干预研究的富有成效和必要的整合。除了增加对与母体心理健康和胎儿神经发育相关的常见测量和潜在作用机制的理解能力外，这种关注还可能为预防和干预策略提供信息和拓宽思路。
