Reduced infant birthweight consequent upon maternal exposure to severe life events
Reduced infant birthweight consequent upon maternal exposure to severe life events
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DOI：
10.1097/psy.0b013e318177940d
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发表时间：
2008-07-01
影响因子：
3.3
通讯作者：
Baker, Philip N.
中科院分区：
文献类型：
--
作者：
Khashan, Ali S.;McNamee, Roseanne;Baker, Philip N.
目的：探讨母亲暴露于严重生活事件与胎儿生长发育(出生体重和小于胎龄)的关系。压力与不良妊娠结局有关。方法：在1979年1月1日至2002年12月31日期间，丹麦138万名独生子女的母亲与他们的配偶、父母、兄弟姐妹和大孩子的信息联系在一起。接触被定义为在怀孕期间或怀孕前6个月内亲属死亡或严重疾病。用线性回归检验暴露对新生儿体重的影响。使用对数线性二项回归来评估暴露对小于胎龄儿的影响。结果：亲属在怀孕期间或怀孕前6个月的死亡使新生儿体重减少了27克(调整后估计为-27克，95%可信区间(CI=-33，-22))。母亲接触亲人和死亡与婴儿体重低于第10个百分位数(调整后相对危险度RR=1.17，95%CI=1.13，1.22)和第5个百分位数(调整后RR=1.22，95%CI=1.15，1.29)的风险显著相关。结论：在怀孕前或怀孕期间暴露于严重生活事件的母亲所生婴儿的出生体重明显较低。如果这种关联是因果的，那么与压力相关的出生体重影响的潜在机制包括因怀孕期间暴露在压力下的生活方式的改变以及与压力相关的下丘脑-垂体-肾上腺轴的调节失调。
Objective: To investigate the association between maternal exposure to severe life events and fetal growth (birthweight and small for gestational age). Stress has been associated with adverse pregnancy outcome. Methods: Mothers of 1.38 million singleton live births in Denmark between January 1, 1979 and December 31, 2002 were linked to information on their spouses, parents, siblings, and older children. Exposure was defined as death or serious illness in a relative during pregnancy or in the 6 months before conception. Linear regression was used to examine the effect of exposure on birthweight. Log-linear binomial regression was used to assess the effect of exposure on small for gestational age. Results: Death of a relative during pregnancy or in the 6 months before conception reduced birthweight by 27 g (adjusted estimate -27 g, 95% Confidence Interval (CI = -33, -22). There was a significant association between maternal exposure to, death of a relative and risk of a baby weighing below the 10th percentile (adjusted relative risk (RR) = 1. 17, 95% CI = 1.13, 1.22) and 5th percentile (adjusted RR = 1.22, 95% Cl = 1. 15, 1.29). Conclusions: Mothers exposed to severe life events before conception or during pregnancy have babies with significantly lower birthweight. If this association is causal, the potential mechanisms of stress-related effects on birthweight include changes in lifestyle due to the exposure and stress-related dysregulation of the hypothalamic-pituitary-adrenal axis during pregnancy.