Course of ante- and postnatal depressive symptoms related to mothers' HPA axis regulation.
Course of ante- and postnatal depressive symptoms related to mothers' HPA axis regulation.
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与母亲 HPA 轴调节相关的产前和产后抑郁症状的过程。
DOI：
10.1037/abn0000348
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发表时间：
2018
影响因子：
4.6
通讯作者：
Knight,Bettina
中科院分区：
文献类型：
--
作者：
Laurent,Heidemarie;Goodman,SherrylH;Stowe,ZacharyN;Halperin,Meeka;Khan,Faaiza;Wright,Dorianne;Nelson,BenjaminW;Newport,DJeffrey;Ritchie,JamesC;Monk,Catherine;Knight,Bettina
鉴于怀孕期间和产后第一年抑郁症的高健康成本，重要的是要了解在这段时间内症状的出现和持续的机制。在一系列的2项研究中，我们的目的是澄清母亲的生理应激调节-应激相关的下丘脑-垂体-肾上腺（HPA）轴激活-和抑郁症状的过程之间的双向关系。在研究1中，230名从妇女心理健康项目招募的孕妇在妊娠24周、30周和36周时在心理社会压力的背景下提供了3份唾液样本。她们自我报告了怀孕三个月和产后第一年的抑郁症状。多水平模型显示，怀孕期间唾液皮质醇升高的妇女表现出产前和产后症状不断升级的过程，暗示HPA过度激活是情绪问题恶化的前兆。在研究2中，来自社区的54位母亲在产后3个月、6个月、12个月和18个月时自我报告抑郁症状。在18个月大时，他们与婴儿一起参与了一项二元压力任务，并提供了4份唾液样本用于皮质醇测定。对于患有终生抑郁症的母亲来说，产后症状的升级过程预示着更高，更平坦的皮质醇反应曲线。总之，这些研究的结果表明，对于高风险的母亲，抑郁症恶化的轨迹可能既源于神经内分泌应激过度激活，又引起神经内分泌应激过度激活。这些研究结果表明，在产前和产后期间，需要更多地关注抑郁症状的过程，而不是在任何特定时间的症状水平，以表征健康风险。（PsycInfo数据库记录（c）2022阿帕，保留所有权利）
Given high health costs of depression during pregnancy and the first postnatal year, it is important to understand mechanisms involved in the emergence and perpetuation of symptoms during this time. In a series of 2 studies, we aim to clarify bidirectional relations between mothers’ physiological stress regulation—stress-related activation of the hypothalamic-pituitary-adrenal (HPA) axis—and their course of depressive symptoms. In Study 1, 230 pregnant women recruited from a women’s mental health program gave 3 saliva samples in the context of psychosocial stress at 24, 30, and 36-weeks gestation. They self-reported depressive symptoms across the three trimesters of pregnancy and first year postpartum. Multilevel models revealed women with elevated salivary cortisol during pregnancy showed a course of escalating ante-and postnatal symptoms, implicating HPA hyperactivation as a precursor to worsening mood problems. In Study 2, 54 mothers from a community sample self-reported depressive symptoms at 3, 6, 12, and 18 months postnatal. At 18 months, they participated in a dyadic stress task with their infant and gave 4 saliva samples for cortisol assay. For mothers with a lifetime depression diagnosis, an escalating course of postnatal symptoms predicted a higher, flatter cortisol response profile. Together, the results of these studies suggest that for high-risk mothers, a trajectory of worsening depression may both follow from and give rise to neuroendocrine stress hyperactivation. These findings suggest greater attention is warranted to course of depressive symptoms across the ante-and postnatal period, rather than symptom levels at any given time, to characterize health risks.(PsycInfo Database Record (c) 2022 APA, all rights reserved)