Baranov Victoria, Frost Allison, Hagaman Ashley, Simmons Julian G, Manzoor Muhammad S, Biroli Pietro, Bhalotra Sonia, Rahman Atif, Sikander Siham, Maselko Joanna
Department of Economics, Faculty of Business and Economics, The University of Melbourne, Australia.
Carolina Population Center, University of North Carolina, Chapel Hill, USA.
SSM Ment Health. 2022 Dec;2. doi: 10.1016/j.ssmmh.2022.100082. Epub 2022 Mar 6.
Disruptions in the hypothalamic-pituitary-adrenal (HPA) axis are thought to be key neuroendocrine mechanisms involved in psychopathology and may have intergenerational impacts. Hair-derived HPA hormones offer a measure of long-term HPA axis activity that may be useful in assessing maternal and infant health. Building on a community-based randomized control trial of a perinatal depression intervention in Pakistan, we examine intervention effects on HPA axis activity in a subsample of mothers and infants.
HPA axis activity was assessed using hair-derived cortisol, cortisone, and dehydroepiandosterone (DHEA). Hair samples were collected from mother-child dyads at one year postpartum from prenatally depressed women randomized to a cognitive-behavioral intervention (n = 35 dyads) or to enhanced usual care (n = 37 dyads), and from a comparison sample of women who screened negative for depression in pregnancy (n = 35 dyads).
The intervention group had 38 percent =0.01) lower maternal cortisol levels and 45 percent ( < 0.01) lower maternal cortisone compared to the EUC group. Maternal DHEA levels were higher among women in the intervention group compared to the EUC group by 29 percent ( = 0.02). Intergenerational intervention effects show higher DHEA levels in infants by 43% ( = 0.03). Infant cortisol and cortisone did not differ across groups.
Results suggest that the perinatal depression intervention has effects on HPA axis activity in both mothers and children, providing evidence that treating maternal depression may impact physiological stress system functioning intergenerationally. In addition, utilizing hair-derived biomarkers of HPA-axis activity is a potentially useful clinical indicator of intervention impacts on the neuroendocrine system.
下丘脑 - 垂体 - 肾上腺（HPA）轴功能紊乱被认为是精神病理学中关键的神经内分泌机制，且可能具有代际影响。毛发衍生的HPA激素可衡量HPA轴的长期活动，这可能有助于评估母婴健康。基于巴基斯坦一项围产期抑郁症干预措施的社区随机对照试验，我们在母婴子样本中研究了干预对HPA轴活动的影响。
使用毛发衍生的皮质醇、可的松和脱氢表雄酮（DHEA）评估HPA轴活动。产后一年，从随机分配到认知行为干预组（n = 35对）或强化常规护理组（n = 37对）的产前抑郁女性母婴对子中收集毛发样本，并从孕期抑郁症筛查阴性的女性对照样本（n = 35对）中收集毛发样本。
与强化常规护理组相比，干预组母亲的皮质醇水平降低了38%（P = 0.01），可的松水平降低了45%（P < 0.01）。与强化常规护理组相比，干预组母亲的DHEA水平高出29%（P = 0.02）。代际干预效应显示，干预组婴儿的DHEA水平高出43%（P = 0.03）。各组婴儿的皮质醇和可的松水平无差异。
结果表明，围产期抑郁症干预对母亲和儿童的HPA轴活动均有影响，这为治疗母亲抑郁症可能会代际影响生理应激系统功能提供了证据。此外，利用毛发衍生的HPA轴活动生物标志物是干预对神经内分泌系统影响的潜在有用临床指标。
