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童年创伤对母亲及其幼儿头发皮质醇浓度的代际影响。

Intergenerational impact of childhood trauma on hair cortisol concentrations in mothers and their young infants.

作者信息

Broeks Carlinde W, Molenaar Nina, Brouwer Marlies, van den Akker Erica L T, van Rossum Elisabeth F C, Van Rien, van den Berg Sjoerd A A, Hillegers Manon, Hoogendijk Witte J G, Burger Huibert, Bockting Claudi, Kamperman Astrid M, Lambregtse-Van den Berg Mijke P

机构信息

Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

出版信息

Compr Psychoneuroendocrinol. 2023 Jan 20;14:100167. doi: 10.1016/j.cpnec.2023.100167. eCollection 2023 May.

Abstract

BACKGROUND

Alterations in stress regulation and function of the hypothalamic-pituitary-adrenal (HPA) axis during infancy may be a risk factor for the development of psychopathology later in life. Maternal childhood trauma, depression, anxiety and stressful life events are individually associated with HPA axis dysregulation. Less is known about their interdependent influence on maternal and infant stress regulation in at risk populations. In a sample of mothers with a history of depressive-, and/or anxiety disorders and their infants we explored if a history of maternal childhood trauma, current depressive and anxiety symptomatology, and recent life events were associated with maternal and infant long-term cortisol levels three months postpartum.

METHODS

Data were available of 89 mothers and 49 infants. All mothers fulfilled criteria for a lifetime depressive or anxiety disorder. Diagnosis was established with a diagnostic interview. Current depressive symptomatology was assessed with the Edinburgh Postnatal Depression Scale (EPDS), current anxiety with the State-Trait Anxiety Inventory (STAI), maternal childhood trauma with the Childhood Trauma Questionnaire (CTQ) and recent life events with the Everyday Problem Checklist (EPC). Maternal and infant hair cortisol concentrations (HCC) were quantified with liquid chromatography with tandem mass spectrometry (LC-MS/MS) three months after birth. Total scores of the CTQ and subscales, EPDS, STAI, and EPC were regressed on maternal and infant HCC using regression analyses. Differences in HCC regarding trauma history were tested with t-tests. Potential confounders were identified and adjusted for.

RESULTS

In regression analyses, a positive curvilinear relationship was found between CTQ total score and maternal HCC (n = 83, B = 0.076, SE 0.033, p = .021), but not for current depression (n = 88, B = -0.001, SE 0.011, p = .931), current anxiety (n = 88, B = 0.002, SE 0.004, p = .650) or recent life events (n = 89, B = 0.018, SE 0.032, p = .568). Analyses were adjusted for confounders. A negative linear relationship was found between maternal CTQ score and infant HCC (n = 49, β = -0.264, B = -0.006, SE 0.003, p = .052), but not for current maternal depression (n = 45, β = -0.182, B = -0.011, SE 0.008, p = .164), current maternal anxiety (n = 45, β = -0.209, B = -0.005, SE 0.003, p = .113) or recent life events (n = 46, β = -0.128, B = -0.022, SE 0.023, p = .325). Analyses were adjusted for relevant infant hair characteristics. Specifically, maternal emotional and physical neglect were related to HCC in both mothers and infants.

CONCLUSIONS

Results suggest that maternal childhood trauma is more prominent in altering maternal and infant long-term cortisol levels than perinatal depressive and anxiety symptomatology or recent life stressors in mothers with a history of depressive and/or anxiety disorders, and their infants. As infants of mothers with psychopathology are at increased risk for later psychiatric disease, future studies should investigate the interplay of possible risk factors for transgenerational transmission, intra-uterine programming of the HPA axis, including (epi-)genetic phenomena, of the HPA axis, and the influence of parenting impairment.

摘要

背景

婴儿期应激调节及下丘脑 - 垂体 - 肾上腺(HPA)轴功能的改变可能是日后发生精神病理学问题的一个风险因素。母亲童年创伤、抑郁、焦虑及生活应激事件各自都与HPA轴功能失调相关。关于它们对高危人群中母婴应激调节的相互依存影响,人们了解较少。在一组有抑郁和/或焦虑症病史的母亲及其婴儿样本中,我们探究了母亲童年创伤史、当前抑郁和焦虑症状以及近期生活事件是否与产后三个月母婴的长期皮质醇水平相关。

方法

有89位母亲和49名婴儿的数据。所有母亲均符合终生抑郁或焦虑症的标准。通过诊断访谈确定诊断。用爱丁堡产后抑郁量表(EPDS)评估当前抑郁症状,用状态 - 特质焦虑量表(STAI)评估当前焦虑,用儿童创伤问卷(CTQ)评估母亲童年创伤,用日常问题清单(EPC)评估近期生活事件。出生三个月后,用液相色谱串联质谱法(LC - MS/MS)对母婴头发皮质醇浓度(HCC)进行定量。使用回归分析将CTQ总分及各分量表、EPDS、STAI和EPC的总分与母婴HCC进行回归分析。用t检验检测HCC在创伤史方面的差异。识别并校正潜在混杂因素。

结果

在回归分析中,发现CTQ总分与母亲HCC之间存在正曲线关系(n = 83,B = 0.076,SE 0.033,p = 0.021),但当前抑郁(n = 88,B = -0.001,SE 0.011,p = 0.931)、当前焦虑(n = 88,B = 0.002,SE 0.004,p = 0.650)或近期生活事件(n = 89,B = 0.018,SE 0.032,p = 0.568)与母亲HCC之间无此关系。分析已校正混杂因素。发现母亲CTQ得分与婴儿HCC之间存在负线性关系(n = 49,β = -0.264,B = -0.006,SE 0.003,p = 0.052),但当前母亲抑郁(n = 45,β = -0.182,B = -0.011,SE 0.008,p = 0.164)、当前母亲焦虑(n = 45,β = -0.209,B = -0.005,SE 0.003,p = 0.113)或近期生活事件(n = 46,β = -0.128,B = -0.022,SE 0.023,p = 0.325)与婴儿HCC之间无此关系。分析已校正相关婴儿头发特征。具体而言,母亲的情感忽视和身体忽视与母婴双方的HCC均相关。

结论

结果表明,对于有抑郁和/或焦虑症病史的母亲及其婴儿,母亲童年创伤在改变母婴长期皮质醇水平方面比围产期抑郁和焦虑症状或近期生活应激源更为突出。由于有精神病理学问题的母亲的婴儿日后患精神疾病的风险增加,未来研究应调查可能的风险因素在跨代传递、HPA轴的宫内编程(包括(表观)遗传现象)中的相互作用,以及养育障碍的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ab/9930158/c9eb96a56777/gr1.jpg

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