Panelli Danielle M, Diwan Mira, Cruz Giovanna I, Leonard Stephanie A, Chueh Jane, Gotlib Ian H, Bianco Katherine
Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
Department of Psychology, Stanford University, Stanford, CA, USA.
Brain Behav Immun Health. 2022 Sep 3;25:100506. doi: 10.1016/j.bbih.2022.100506. eCollection 2022 Nov.
Leukocyte telomere length (LTL) is a biomarker that is affected by older age, psychosocial stress, and medical comorbidities. Despite the relevance of these factors to obstetric practice, little is known about LTL in pregnancy. Our study explored longitudinal LTL dynamics in pregnant and non-pregnant people.
This pilot study compares changes in LTL between pregnant and non-pregnant people over time, explores potential correlations between LTL and mental health measures, and investigates associations between short first-trimester LTL and adverse pregnancy outcomes.
This was a prospective pilot cohort study of nulliparous pregnant and non-pregnant people between ages 18 and 50 who presented for care at a single institution from January to November 2020. Pregnant people were enrolled between 10 and 14 weeks gestation. Participants had two blood samples drawn for LTL; the first on the day of enrollment and the second on postpartum day 1 (pregnant cohort) or 7 months later (non-pregnant cohort). LTL was measured using quantitative PCR. The primary outcome was the difference between pregnant and non-pregnant people in LTL change between the two timepoints (basepair difference per 30-day period). Secondary outcomes included differences in responses to the Patient Health Questionnaire-9 (PHQ-9) and a survey about stress related to COVID-19. Differences in LTL were tested using t-tests and linear regression models, both crude and adjusted for age. A subgroup analysis was conducted within the pregnant cohort to examine whether shorter first-trimester LTL was associated with adverse pregnancy outcomes. We conducted t-tests to compare LTL between people with and without each categorical outcome and computed Pearson correlation coefficients between LTL and continuous outcomes such as gestational age at delivery.
46 pregnant and 30 non-pregnant people were enrolled; 44 pregnant and 18 non-pregnant people completed all LTL assessments. There were no between-group differences in LTL change (-4.2 ± 22.2 bp per 30 days pregnant versus -6.4 11.2 bp per 30 days non-pregnant, adjusted beta 2.1, 95% CI -9.0-13.2, p = 0.60). The prevalence of depression and pandemic-related stress were both low overall. The two groups did not differ in PHQ-9 scores, and no correlations were significant between LTL and PHQ-9 scores. Among the 44 pregnant people, shorter first-trimester LTL was significantly correlated with earlier gestational age at delivery (r = 0.35, p = 0.02).
In this exploratory pilot cohort of reproductive-aged people with low levels of psychological stress, we described baseline changes in LTL over time in pregnant and non-pregnant participants. We found a correlation between shorter first-trimester LTL and earlier gestational age at delivery, which warrants further investigation in a larger cohort.
白细胞端粒长度（LTL）是一种受年龄增长、心理社会压力和合并症影响的生物标志物。尽管这些因素与产科实践相关，但关于孕期LTL的了解甚少。我们的研究探讨了孕妇和非孕妇的LTL纵向动态变化。
这项初步研究比较了孕妇和非孕妇随时间的LTL变化，探讨LTL与心理健康指标之间的潜在相关性，并研究孕早期LTL缩短与不良妊娠结局之间的关联。
这是一项前瞻性初步队列研究，研究对象为2020年1月至11月在单一机构就诊的18至50岁未生育的孕妇和非孕妇。孕妇在妊娠10至14周时入组。参与者采集两份血液样本用于检测LTL；第一份在入组当天采集，第二份在产后第1天（孕妇队列）或7个月后（非孕妇队列）采集。使用定量PCR测量LTL。主要结局是两个时间点之间孕妇和非孕妇LTL变化的差异（每30天的碱基对差异）。次要结局包括对患者健康问卷-9（PHQ-9）的反应差异以及一项关于与COVID-19相关压力的调查。使用t检验和线性回归模型测试LTL的差异，包括粗模型和按年龄调整的模型。在孕妇队列中进行亚组分析，以检查孕早期LTL较短是否与不良妊娠结局相关。我们进行t检验以比较有或无每种分类结局的人群之间的LTL，并计算LTL与连续结局（如分娩时的孕周）之间的Pearson相关系数。
共纳入46名孕妇和30名非孕妇；44名孕妇和18名非孕妇完成了所有LTL评估。LTL变化在组间无差异（孕妇每30天-4.2±22.2 bp，非孕妇每30天-6.4±11.2 bp，调整后的β为2.1，95%CI为-9.0至13.2，p = 0.60）。总体而言，抑郁症和大流行相关压力的患病率均较低。两组在PHQ-9评分上没有差异，LTL与PHQ-9评分之间也没有显著相关性。在44名孕妇中，孕早期LTL较短与分娩时较早的孕周显著相关（r = 0.35，p = 0.02）。
在这个心理压力水平较低的育龄人群探索性初步队列研究中，我们描述了孕妇和非孕妇参与者随时间的LTL基线变化。我们发现孕早期LTL较短与分娩时较早的孕周之间存在相关性，这值得在更大的队列中进一步研究。
