Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Universidad de San Martin de Porres, Facultad de Medicina Humana, Instituto de Investigación, Lima, Peru; Asociaciòn Civil Proyectos en Salud, Lima, Peru.
Psychoneuroendocrinology. 2023 May;151:106072. doi: 10.1016/j.psyneuen.2023.106072. Epub 2023 Feb 23.
Traumatic events, including child abuse and intimate partner violence, are highly prevalent among women of child-bearing age. These traumatic experiences may impact maternal and offspring physical and mental health. A proposed mechanism for these effects is maternal hypothalamic-pituitary-adrenal (HPA) axis dysregulation which can be measured using hair corticosteroid levels.
This study aims to examine the association of child abuse and intimate partner violence exposure with HPA axis functioning, as measured by hair corticosteroid levels in a cohort of pregnant women.
We included data from 1822 pregnant women (mean gestational age 17 weeks) attending a prenatal clinic in Lima, Peru. We extracted cortisol and cortisone concentrations from hair samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Each participant provided 6-cm hair samples: 3 cm hair segment closest to the scalp reflecting HCC in early pregnancy (first three months), and 3-6 cm from the scalp reflecting HCC in pre-pregnancy (three months prior to conception). Multivariable linear regression procedures were used to assess the association between maternal trauma exposure and hair corticosteroid levels.
Overall, women who experienced child abuse on average had higher levels of cortisol (p < 0.01) and cortisone (p < 0.0001) after adjustment for age, race, adult access to basic foods and hair treatments. For the hair segment reflecting early pregnancy, presence of child abuse was associated with a 0.120 log unit increase in cortisol and a 0.260 log unit increase in cortisone (p < 0.001). For the hair segment reflecting pre-pregnancy, a history of child abuse was associated with a 0.100 log unit increase in cortisol and a 0.180 log unit increase in cortisone (p < 0.01). Results also suggested an impact of intimate partner violence on HPA regulation; however, associations were not statistically significant after controlling for child abuse.
These results underscore the long-lasting impacts of exposure to adversity and trauma during early life. Our study findings will have implications for research investigating HPA axis function and long-term effects of violence on corticosteroid regulation.
创伤事件，包括儿童虐待和亲密伴侣暴力，在育龄妇女中非常普遍。这些创伤经历可能会影响母婴身心健康。其影响的一个提出的机制是母体下丘脑-垂体-肾上腺（HPA）轴失调，这可以通过头发皮质类固醇水平来衡量。
本研究旨在探讨在秘鲁利马的一个产前诊所的孕妇队列中，儿童虐待和亲密伴侣暴力暴露与 HPA 轴功能的关系，该功能通过头发皮质类固醇水平来衡量。
我们纳入了 1822 名孕妇（平均妊娠 17 周）的数据。我们使用液相色谱-串联质谱（LC-MS/MS）从头发样本中提取皮质醇和皮质酮浓度。每位参与者提供 6 厘米的头发样本：靠近头皮的 3 厘米头发段反映了妊娠早期（妊娠前三个月）的 HCC，头皮 3-6 厘米的头发段反映了妊娠前（受孕前三个月）的 HCC。使用多变量线性回归程序评估了母体创伤暴露与头发皮质类固醇水平之间的关联。
总体而言，经历过儿童虐待的女性在调整年龄、种族、成人获得基本食物和头发处理后，皮质醇（p<0.01）和皮质酮（p<0.0001）水平平均更高。对于反映妊娠早期的头发段，儿童虐待的存在与皮质醇增加 0.120 对数单位和皮质酮增加 0.260 对数单位有关（p<0.001）。对于反映妊娠前的头发段，儿童虐待史与皮质醇增加 0.100 对数单位和皮质酮增加 0.180 对数单位有关（p<0.01）。结果还表明，亲密伴侣暴力对 HPA 调节有影响；然而，在控制儿童虐待后，这些关联没有统计学意义。
这些结果强调了在生命早期暴露于逆境和创伤的持久影响。我们的研究结果将对研究 HPA 轴功能和暴力对皮质类固醇调节的长期影响产生影响。
