Socioeconomic disadvantage, gestational immune activity, and neurodevelopment in early childhood
Socioeconomic disadvantage, gestational immune activity, and neurodevelopment in early childhood
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DOI：
10.1073/pnas.1617698114
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发表时间：
2017-06-27
影响因子：
11.1
通讯作者：
Goldstein, Jill M.
中科院分区：
文献类型：
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作者：
Gilman, Stephen E.;Hornig, Mady;Goldstein, Jill M.
在经济上处于不利地位的家庭中长大的儿童在成年后面临更大的健康不良风险，这表明健康方面的不平等具有早期根源。从孩子的角度来看，暴露于经济困难可能早在怀孕时就开始开始，可能是通过母体对产前压力源的神经内分泌免疫反应，这对神经发育产生了不利影响。在这里，我们调查是否社会经济的不利因素与妊娠期免疫活动，以及这种活动是否与婴儿期后代的异常。我们分析了新英格兰家庭研究中1，494名参与者的母亲血清中5种免疫标志物（IL-1 β、IL-6、IL-8、IL-10和TNF-α）的浓度，这些免疫标志物与母亲社会经济劣势水平及其在4个月和1岁时对后代神经异常的影响有关。最弱势妊娠的IL-8中位浓度较低[-1.53 log（pg/mL）; 95% CI：-1.81，-1.25]。这些妊娠的后代在4个月[比值比（OR）= 4.61; CI = 2.84，7.48]和1年（OR = 2.05; CI = 1.08，3.90）时神经系统异常的风险显著较高。这种较高的风险部分归因于胎儿暴露于较低的母体IL-8，这也预测了4个月（OR = 7.67; CI = 4.05，14.49）和1年（OR = 2.92; CI = 1.46，5.87）时神经系统异常的较高风险。研究结果支持母体免疫活性在胎儿神经发育中的作用，部分由于社会经济劣势而加剧。这一发现揭示了一个潜在的病理生理学途径，参与代际传递的社会经济不平等的健康。
Children raised in economically disadvantaged households face increased risks of poor health in adulthood, suggesting that inequalities in health have early origins. From the child's perspective, exposure to economic hardship may begin as early as conception, potentially via maternal neuroendocrine-immune responses to prenatal stressors, which adversely impact neurodevelopment. Here we investigate whether socioeconomic disadvantage is associated with gestational immune activity and whether such activity is associated with abnormalities among offspring during infancy. We analyzed concentrations of five immune markers (IL-1 beta, IL-6, IL-8, IL-10, and TNF-alpha) in maternal serum from 1,494 participants in the New England Family Study in relation to the level of maternal socioeconomic disadvantage and their involvement in offspring neurologic abnormalities at 4 mo and 1 y of age. Median concentrations of IL-8 were lower in the most disadvantaged pregnancies [-1.53 log(pg/mL); 95% CI: -1.81, -1.25]. Offspring of these pregnancies had significantly higher risk of neurologic abnormalities at 4 mo [odds ratio (OR) = 4.61; CI = 2.84, 7.48] and 1 y (OR = 2.05; CI = 1.08, 3.90). This higher risk was accounted for in part by fetal exposure to lower maternal IL-8, which also predicted higher risks of neurologic abnormalities at 4 mo (OR = 7.67; CI = 4.05, 14.49) and 1 y (OR = 2.92; CI = 1.46, 5.87). Findings support the role of maternal immune activity in fetal neurodevelopment, exacerbated in part by socioeconomic disadvantage. This finding reveals a potential pathophysiologic pathway involved in the intergenerational transmission of socioeconomic inequalities in health.