Dickens Molly J, Pawluski Jodi L, Romero L Michael
&Mother Foundation, Berkeley, CA, United States.
Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Rennes, France.
Front Glob Womens Health. 2020 Nov 4;1:586697. doi: 10.3389/fgwh.2020.586697. eCollection 2020.
As the world faces the health crisis of a global pandemic-with healthcare protocols in overhaul, and patients and care teams experiencing unprecedented levels of stress and unpredictability-we predict that current knowledge gaps in maternal health will inevitably have a lasting impact on the health of women giving birth now and in the near future. Since we are decades away from closing the knowledge gaps we need filled today, we recommend shifting thinking toward a comprehensive conceptual model that merges knowledge of stress physiology, neurobiology, and pregnancy physiology. The model we present here, the , is an expansion of the Reactive Scope Model built upon the concept of Homeostasis and Allostasis. The model provides a framework to consider pathways and interactions across physiological systems to attribute a physiological basis for considering stress exposure and bridge research gaps on mechanisms to measure or target for treatment. Our intention is to provide an adaptable, heuristic framework for discussion of research considerations and new healthcare models that aim to provide the best care for new mothers during and after the COVID-19 pandemic.
随着世界面临全球大流行的健康危机——医疗保健协议全面改革,患者和护理团队承受着前所未有的压力和不可预测性——我们预计,目前孕产妇健康方面的知识差距将不可避免地对现在及不久后分娩的妇女的健康产生持久影响。由于我们距离填补当前所需的知识差距还有数十年时间,我们建议将思维转向一个综合概念模型,该模型融合了应激生理学、神经生物学和妊娠生理学知识。我们在此提出的模型,即 ,是基于内稳态和应变稳态概念构建的反应范围模型的扩展。该模型提供了一个框架,用于考虑生理系统之间的途径和相互作用,为考虑应激暴露归因生理基础,并弥合测量或治疗靶点机制方面的研究差距。我们的目的是提供一个适应性强、具有启发性的框架,用于讨论旨在在新冠疫情期间及之后为新妈妈提供最佳护理的研究考量和新的医疗保健模式。