Sex-specific associations between prenatal negative life events and birth outcomes.
Sex-specific associations between prenatal negative life events and birth outcomes.
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产前负面生活事件与出生结果之间的性别特异性关联。
DOI：
10.1080/10253890.2019.1608944
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Wright,RosalindJ
中科院分区：
文献类型：
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作者：
Rosa,MariaJosé;Nentin,Farida;BosquetEnlow,Michelle;Hacker,MicheleR;Pollas,Nastasia;Coull,Brent;Wright,RosalindJ
母亲的心理社会压力会对妊娠期的长短和胎儿的发育产生负面影响。这些影响可能是性别特异性的，但尚未得到广泛研究。本研究的目的是检查产前母亲压力和出生结果之间的关联，以及影响是否会因性别而改变。产前母亲的压力指数的母亲负性生活事件（NLE）的得分确定在527个城市母亲，较高的NLE得分表明更大的压力。出生结局包括胎龄、早产（PTB）（<37周）和胎龄评分的出生体重。采用改良Poisson回归和线性模型评估产前NLE评分与出生结局的相关性。通过纳入NLE评分和性别分层分析中的性别交互作用项来评估性别差异。在校正了母亲年龄、教育程度、种族/民族和孕前体重指数（BMI）的分析中，产前压力增加与胎龄（天）缩短相关（β= −0.63，[95%CI −1.20，−0.06]）。这种影响是性别特异性的，在男婴中，产前压力增加与胎龄缩短相关，以及PTB风险增加（分别为β= −1.35 [95% CI −2.17，−0.54]和RR = 1.18 [95% CI 0.99，1.42]），但不包括女婴（分别为β= 0.15 [95%CI −0.63，0.94]和RR = 0.85，[95%CI 0.65，1.11]）。产前压力与出生体重分数无关。我们的研究结果支持的重要性，心理社会压力作为一个编程因素，可能有性别特异性的影响胎儿的不良结局。了解产前压力对出生结果的性别特异性影响可能会为预防策略提供信息。LAY SUMMARY母亲在怀孕期间经历的更高压力与怀孕时间较短有关，与女婴相比，男婴的影响更强。
Maternal psychosocial stress can negatively impact gestational length and development of the fetus. These effects may be sex-specific but have not been extensively studied. The objective of this study was to examine the associations between prenatal maternal stress and birth outcomes and whether effects are modified by sex. Prenatal maternal stress was indexed by a maternal negative life events (NLEs) score ascertained in 527 urban mothers; a higher NLE score indicates greater stress. Birth outcomes included gestational age, preterm birth (PTB) (<37 weeks), and birthweight for gestational agez-scores. Modified Poisson regression and linear models were used to evaluate associations of prenatal NLE scores with birth outcomes. Sex differences were assessed by inclusion of an interaction term for sex by NLE score and in sex-stratified analyses. In analyses adjusted for maternal age, education, race/ethnicity, and pre-pregnancy body mass index (BMI), increasing prenatal stress was associated with shortened gestational age (days) (β= −0.63, [95% CI −1.20, −0.06]). This effect was sex specific, with increasing prenatal stress associated with shortened gestational age, as well as increased risk of PTB, in male infants (β= −1.35 [95% CI −2.17, −0.54] and RR = 1.18 [95% CI 0.99, 1.42], respectively) but not female infants (β= 0.15 [95%CI −0.63, 0.94] and RR = 0.85, [95%CI 0.65, 1.11], respectively). Prenatal stress was not associated with birthweightz-scores. Our results support the importance of psychosocial stress as a programming factor that may have sex-specific effects for adverse fetal outcomes. Understanding sex-specific effects of prenatal stress on birth outcomes may inform prevention strategies.LAY SUMMARYHigher stress experienced by mothers in pregnancy was associated with shorter length of pregnancy and the effect was stronger in male infants when compared to female infants.