Association of Prenatal Maternal Anxiety With Fetal Regional Brain Connectivity
Association of Prenatal Maternal Anxiety With Fetal Regional Brain Connectivity
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DOI：
10.1001/jamanetworkopen.2020.22349
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发表时间：
2020-12-07
影响因子：
13.8
通讯作者：
Limperopoulos, Catherine
中科院分区：
文献类型：
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作者：
De Asis-Cruz, Josepheen;Krishnamurthy, Dhineshvikram;Limperopoulos, Catherine
这项队列研究评估产前产妇的心理困扰与在体内胎儿大脑静息状态的功能connections.Importance产妇在怀孕期间的心理困扰与不良产科结局和儿童神经精神缺陷的关联。目前无法在体内询问胎儿脑功能，可以提供关键的见解的发病和时间的改变神经发育轨迹。目的探讨产前母亲应激、焦虑和抑郁与胎儿脑静息状态功能连接的关系。设计，设置和参与者这项队列研究包括2016年1月至2019年4月期间扫描的孕妇。从华盛顿地区的低风险产科诊所前瞻性地招募了总共50名健康怀孕的孕妇，并在华盛顿的国家儿童医院进行了扫描。母亲的压力、焦虑和抑郁。主要结果和测量采用多元距离矩阵回归分析产前母亲压力、焦虑和抑郁与全脑连接的关系。产前母亲的压力，焦虑和抑郁进行了评估，分别使用感知压力量表，Spielberger状态焦虑量表和Spielberger特质焦虑量表，和爱丁堡产后抑郁量表。从100个功能定义的感兴趣区域测量全脑连接。结果本研究分析了50例健康孕妇（平均[SD]胎龄，33.77 [5.51]）的胎儿（平均[SD]胎龄，33.52 [4周]）的59个静息态功能连接磁共振图像数据集。问卷的平均（SD）分数如下：Spielberger状态焦虑量表，26.66（6.72）（范围，20-48）; Spielberger特质焦虑量表，28.09（6.62）（范围，20-50）;知觉压力量表，9.27（5.13）（范围，1-25）;爱丁堡产后抑郁量表3.24（2.84）（范围，0-14）。使用Spielberger特质和状态焦虑量表测量的产前母亲焦虑评分与胎儿连接性的差异相关（Spielberger状态焦虑量表：伪R-2 = 0.019，P = 0.04; Spielberger特质焦虑量表：伪R-2 = 0.021，P = 0.007）。大脑半球间的连接，如涉及顶额叶和枕叶联合皮质的连接，与母亲产前焦虑减少有关，脑干和感觉运动区之间的连接与较高的焦虑评分有关。结论和相关性在这项队列研究中，产前母亲焦虑和胎儿脑功能连接障碍之间存在关联，表明胎儿编程改变。早期发生的功能偏差表明需要更广泛地筛查孕妇的焦虑症状。问题母亲的心理困扰和胎儿大脑功能连接之间的联系是什么？结果在这项队列研究的50名妇女与59个胎儿扫描，产前母亲的特质和状态焦虑与增加静息状态之间的感觉运动和脑干区的功能连接和减少颞顶皮质和基底神经节之间的连接。我们的研究结果表明，产前暴露于焦虑和神经网络连接中断之间存在关联。
This cohort study assesses the association of prenatal maternal psychological distress with in vivo fetal brain resting state functional connectivity.Importance Maternal psychological distress during pregnancy is associated with adverse obstetric outcomes and neuropsychiatric deficits in children. Currently unavailable in vivo interrogation of fetal brain function could provide critical insights into the onset and timing of altered neurodevelopmental trajectories. Objective To investigate the association between prenatal maternal stress, anxiety, and depression and in vivo fetal brain resting state functional connectivity. Design, Setting, and Participants This cohort study included pregnant women scanned between January 2016 and April 2019. A total of 50 pregnant women with healthy pregnancies were prospectively recruited from low-risk obstetric clinics in the Washington DC area and were scanned at Children's National in Washington DC. Exposures Maternal stress, anxiety, and depression. Main Outcomes and Measures The association of prenatal maternal stress, anxiety, and depression with whole-brain connectivity was analyzed using multivariate distance matrix regression. Prenatal maternal stress, anxiety, and depression were assessed using the Perceived Stress Scale, Spielberger State Anxiety Inventory and Spielberger Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale, respectively. Whole-brain connectivity was measured from 100 functionally defined regions of interest. Results This study analyzed 59 resting-state functional connectivity magnetic resonance image data sets from the fetuses (mean [SD] gestational age, 33.52 [4 weeks]) of 50 healthy pregnant women (mean [SD] age, 33.77 [5.51]). Mean (SD) scores for the questionnaires were as follows: Spielberger State Anxiety Inventory, 26.66 (6.72) (range, 20-48); Spielberger Trait Anxiety Inventory, 28.09 (6.62) (range, 20-50); Perceived Stress Scale, 9.27 (5.13) (range, 1-25); and Edinburgh Postnatal Depression Scale 3.24 (2.84) (range, 0-14). Prenatal maternal anxiety scores measured using the Spielberger Trait and State Anxiety Inventories were associated with differences in fetal connectivity (Spielberger State Anxiety Inventory: pseudo-R-2 = 0.019, P = .04; Spielberger Trait Anxiety Inventory: pseudo-R-2 = 0.021, P = .007). Interhemispheric connections, such as those involving the parietofrontal and occipital association cortices, were associated with reduced maternal prenatal anxiety, and those between the brainstem and sensorimotor areas were associated with higher anxiety scores. Conclusions and Relevance In this cohort study, an association was found between prenatal maternal anxiety and disturbances in fetal brain functional connectivity, suggesting altered fetal programming. Early onset of functional deviations suggests the need for more widespread screening of pregnant women for symptoms of anxiety.Question What is the association between maternal psychological distress and fetal brain functional connectivity? Findings In this cohort study of 50 women with 59 fetal scans, prenatal maternal trait and state anxiety were associated with increased resting state functional connectivity between sensorimotor and brainstem areas and reduced connectivity between temporoparietal cortices and basal ganglia. Meaning Our findings suggest an association between prenatal exposure to anxiety and disrupted connectivity of neural networks.