Broeks Carlinde W, Kok Rianne, Choenni Vandhana, Van Rien, Hoogendijk Witte, Hillegers Manon, Kamperman Astrid, Lambregtse-Van den Berg Mijke P
Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Compr Psychoneuroendocrinol. 2021 Aug 3;7:100078. doi: 10.1016/j.cpnec.2021.100078. eCollection 2021 Aug.
Maternal psychopathology is associated with altered HPA axis functioning in offspring. Most studies have focused on mildly affected populations, but less is known about the effect of severe maternal psychopathology. In our explorative study we investigated in a heterogenic sample of mothers with severe and long-lasting psychiatric disorders, if a diagnosis of depression and severity of general maternal psychiatric symptomatology were associated with infant salivary cortisol reactivity to the Face-to-Face Still-Face (FFSF) paradigm at 6 months of age.
A clinical sample of 36 mother-infant dyads was explored. All mothers fulfilled criteria for a severe psychiatric disorder and had psychiatric complaints for the last two consecutive years. Maternal diagnosis was established during pregnancy using a diagnostic interview and general maternal psychiatric symptom severity was established by self-report at the time of the FFSF procedure. The FFSF paradigm was used to assess infants' response to social stress at the age of 6 months. Infant saliva samples were collected at three time points: 5 min before and 15 and 30 min after the social stressor. Cortisol reactivity was operationalized as incremental Area Under the Curve (AUCi). Potential confounders were identified and adjusted for.
In regression analyses, a negative relationship was found between infant cortisol reactivity (AUCi) during the FFSF paradigm at 6 months and general maternal symptom severity at time of the FFSF paradigm (unadjusted = 36, = -0.331, B = -9.758, SE 4.8, = .048; adjusted = 36, = -0.335, B = -9.868, SE 4.5, p = .039) and for diagnosis of perinatal depression at trend level (unadjusted = 36, = -0.293, B = -8.640, SE 4.8, = .083; adjusted = 36, = -0.317, B = -9.347, SE 4.6, p = .052). Analyses were adjusted for gestational age.
Preliminary results on cortisol reactivity in 6-month-old infants of mothers with severe and long-lasting psychiatric disorders show a significant reduction in the group of mothers who experienced a high level of psychiatric symptoms in the post-partum period, compared to mothers with lower levels of psychiatric symptomatology. The same trend was found for mothers with and without a diagnosis of perinatal depression. Since these infants are considered to be at increased risk for later psychopathology, our study suggests that future longitudinal studies should investigate whether reduced cortisol reactivity in babies could be a marker for any adverse outcomes, besides other possible risk factors (e.g. (epi)genetic phenomena).
母亲的精神病理学与后代下丘脑-垂体-肾上腺（HPA）轴功能改变有关。大多数研究集中在受影响较轻的人群，但对于严重母亲精神病理学的影响了解较少。在我们的探索性研究中，我们调查了患有严重且持久精神疾病的母亲的异质性样本，抑郁诊断和母亲总体精神症状严重程度是否与6个月大婴儿对面对面静止脸（FFSF）范式的唾液皮质醇反应性相关。
对36对母婴二元组的临床样本进行了探索。所有母亲均符合严重精神疾病标准，且在过去连续两年有精神疾病主诉。孕期通过诊断性访谈确定母亲诊断，在FFSF程序时通过自我报告确定母亲总体精神症状严重程度。FFSF范式用于评估6个月大婴儿对社会压力的反应。在三个时间点采集婴儿唾液样本：社会应激源前5分钟、后15分钟和30分钟。皮质醇反应性通过曲线下增量面积（AUCi）来衡量。识别并调整了潜在混杂因素。
在回归分析中，发现6个月时FFSF范式期间婴儿皮质醇反应性（AUCi）与FFSF范式时母亲总体症状严重程度之间存在负相关（未调整：n = 36，r = -0.331，B = -9.758，SE = 4.8，p = 0.048；调整后：n = 36，r = -0.335，B = -9.868，SE = 4.5，p = 0.039），并且在趋势水平上与围产期抑郁诊断存在负相关（未调整：n = 36，r = -0.293，B = -8.640，SE = 4.8，p = 0.083；调整后：n = 36，r = -0.317，B = -9.347，SE = 4.6，p = 0.052）。分析对孕周进行了调整。
对患有严重且持久精神疾病母亲的6个月大婴儿皮质醇反应性的初步结果显示，与精神症状水平较低的母亲相比，产后经历高水平精神症状的母亲组中婴儿皮质醇反应性显著降低。有和没有围产期抑郁诊断的母亲都发现了相同趋势。由于这些婴儿被认为后期患精神病理学的风险增加，我们的研究表明，未来的纵向研究应调查婴儿皮质醇反应性降低是否除其他可能的风险因素（如（表观）遗传现象）外，还可能是任何不良后果的标志物。
