Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
Psychoneuroendocrinology. 2023 Jul;153:106115. doi: 10.1016/j.psyneuen.2023.106115. Epub 2023 Apr 18.
Stress before conception and during pregnancy is associated with less favorable maternal and child health. Alterations in prenatal cortisol levels may serve as a central biological pathway linking stress to adverse maternal and child health. Research examining associations between maternal stress from childhood through pregnancy and prenatal cortisol has not been comprehensively reviewed.
The current scoping review of 48 papers synthesizes studies reporting on associations between stress before conception and during pregnancy with maternal cortisol in pregnancy. Eligible studies measured childhood, the proximal preconception period, pregnancy, or lifetime stress based on stress exposures or appraisals and measured cortisol in saliva or hair during pregnancy.
Higher maternal childhood stress was associated with higher cortisol awakening responses and alterations in typical pregnancy-specific changes in diurnal cortisol patterns across studies. In contrast, most studies of preconception and prenatal stress reported null associations with cortisol and those reporting significant effects were inconsistent in direction. A few studies found that the associations between stress and cortisol during pregnancy varied as a function of several moderators including social support and environmental pollution.
Although many studies have evaluated effects of maternal stress on prenatal cortisol, this scoping review is the first to synthesize existing literature on this topic. The association between stress before conception and during pregnancy and prenatal cortisol may depend on the developmental timing of stress and several moderators. Maternal childhood stress was more consistently associated with prenatal cortisol than proximal preconception or pregnancy stress. We discuss methodological and analytic factors that may contribute to mixed findings.
受孕前和孕期的压力与母婴健康状况不佳有关。产前皮质醇水平的变化可能是将压力与母婴健康不良联系起来的核心生物学途径。目前，还没有全面审查过从儿童期到孕期的母亲压力与产前皮质醇之间的关联的研究。
本研究对 48 篇论文进行了范围综述，综合了研究受孕前和孕期母亲压力与孕期皮质醇之间关联的研究。合格的研究根据压力暴露或评估，测量了童年、近期受孕前时期、怀孕或终生压力，并在怀孕期间测量了唾液或头发中的皮质醇。
较高的母亲童年压力与皮质醇觉醒反应较高和典型的妊娠特异性日间皮质醇模式变化有关。相比之下，大多数关于受孕前和孕期压力的研究报告与皮质醇无关联，而那些报告有显著影响的研究结果方向不一致。一些研究发现，怀孕期间压力与皮质醇之间的关联随几个调节因素的变化而变化，包括社会支持和环境污染。
尽管许多研究评估了母亲压力对产前皮质醇的影响，但本范围综述是首次综合该主题的现有文献。受孕前和孕期的压力与产前皮质醇之间的关联可能取决于压力的发展时间和几个调节因素。母亲的童年压力与产前皮质醇的关联比近期受孕前或孕期压力更一致。我们讨论了可能导致混合结果的方法和分析因素。
