Prospective Relations Between Prenatal Maternal Cortisol and Child Health Outcomes.
Prospective Relations Between Prenatal Maternal Cortisol and Child Health Outcomes.
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产前母亲皮质醇与儿童健康结果之间的前瞻性关系。
DOI：
10.1097/psy.0000000000000705
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发表时间：
2019
影响因子：
3.3
通讯作者：
Jones,DamonE
中科院分区：
文献类型：
--
作者：
Roettger,MichaelE;Schreier,HannahMC;Feinberg,MarkE;Jones,DamonE
本研究的目的是在接下来的3年中，研究孕妇产前对人际应激源的皮质醇反应与儿童健康之间的纵向前瞻性关系。方法123名孕妇在怀孕12-32周(M(SD)=22.4(4.9)周)之前和之后提供了第一个孩子的唾液皮质醇样本。当孩子6个月大(n=114)、1岁(n=116)和3岁(n=105)时，母亲报告了儿童的总体健康和儿童疾病的几个指标(看医生、发烧、耳朵和呼吸道感染)。利用纵向回归模型分析了三个时间点母亲产前皮质醇反应性与恢复和以后儿童健康的关系。结果在夫妻冲突讨论中，母亲的皮质醇反应性越高，母亲自我报告的总体儿童健康状况越好(p=。0 16，95%CI=0.0 6~1.3 0，科恩的f=0.045)。更高的皮质醇反应性也与母亲报告生病就诊的较低发生率有关(发生率比率95%CI=0.25-0.83，p=。006)、发热(95%CI=0.25-0.73，p=.002)、耳部感染(95%CI=0.25~0.58，p<；和呼吸道感染(95%CI=0.08-1.11，p=.073)。皮质醇恢复与研究结果无关(均为p>；0.05)。孕产妇产前抑郁症状缓和了皮质醇反应与儿童总体健康之间的关系(p=。034，交互作用项的95%CI=0.07-1.87)，但没有其他健康结果(P‘s&>0.05)。在抑郁症状较轻的女性中，皮质醇反应性与儿童整体健康无关；在抑郁症状水平较高的女性中，皮质醇反应性较强与儿童整体健康状况较好相关。结论本研究提供了纵向证据，表明怀孕期间母亲对显著的人际应激源有较高的皮质醇反应性与较少的儿童健康问题和较好的婴儿期和儿童早期总体儿童健康报告有关。
ObjectiveThe aim of the study was to investigate prospective, longitudinal associations between maternal prenatal cortisol response to an interpersonal stressor and child health for the subsequent 3 years.MethodsOne hundred twenty-three women expecting their first child provided salivary cortisol samples between 12 and 32 weeks of gestation (M (SD)= 22.4 (4.9) weeks) before and after a videotaped couple conflict discussion with their partner. Mothers reported on overall child health and several indicators of child illness (sick doctor visits, fevers, ear, and respiratory infections) when children were 6 months (n= 114), 1 (n= 116), and 3 (n= 105) years old. Associations between maternal prenatal cortisol reactivity and recovery and later child health at each of the three time points were analyzed using longitudinal regression models.ResultsGreater cortisol reactivity in response to the couple conflict discussion was associated with maternal self-report of better overall child health (p=. 016, 95% CI= 0.06–1.30, Cohen's f= 0.045) across the study period. Greater cortisol reactivity was also associated with lower incidence rate ratios for maternal reports of sick doctor visits (incidence rate ratio 95% CI= 0.25–0.83, p=. 006), fevers (95% CI= 0.25–0.73, p=. 002), ear infections (95% CI= 0.25–0.58, p<. 001), and respiratory infections (95% CI= 0.08–1.11, p=. 073). Cortisol recovery was unrelated to study outcomes (all p's> 0.05). Maternal prenatal depressive symptoms moderated the association between cortisol reactivity and overall child health (p=. 034, 95% CI= 0.07–1.87 for interaction term) but no other health outcomes (p's> 0.05). Among women with lower depressive symptoms, cortisol reactivity was not associated with overall child health; among women with higher levels of depressive symptoms, greater cortisol reactivity was associated with better overall child health.ConclusionsThis study provides longitudinal evidence that greater maternal cortisol reactivity to a salient interpersonal stressor during pregnancy is associated with fewer child health problems and better maternal report of overall child health during infancy and into early childhood.
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