Reconceptualizing Prenatal Stress as a Multilevel Phenomenon Will Reduce Health Disparities.
Reconceptualizing Prenatal Stress as a Multilevel Phenomenon Will Reduce Health Disparities.
复制标题
将产前压力重新概念化为多层次现象将减少健康差异。
DOI：
10.1016/j.biopsych.2022.05.004
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发表时间：
2022
影响因子：
10.6
通讯作者：
Hendrix,CassandraL
中科院分区：
文献类型：
--
作者：
Hendrix,CassandraL
在过去的三十年里，我们对疾病或胎儿程序化的发育起源的理解取得了长足进步(1)。我们对胎儿编程的理解的一个主要贡献是能够使用功能磁共振成像(FMRI)非侵入性地检查婴儿早期甚至子宫中的神经发育。这项fMRI工作的结果支持临床前的发现，即当母亲的压力、抑郁和焦虑对发育中的功能连接体产生强大的代际影响时，孤立的妊娠(2)。在这一期的生物精神病学中，Brady等人(2022)量化了怀孕期间可能形成新生儿额边缘回路发育的二元、家庭和社区水平的暴露(3)。具体地说，家庭心理社会优势的综合指标(即收入与需求之比、保险状况、母亲教育、营养和地区贫困指数)与母亲压力和人口普查区域水平的社区暴力和财产犯罪数据使用地理编码的参与者地址相结合。除了家庭优势、更多的财产和暴力邻里犯罪的指数之外，新生儿的前部默认模式网络与丘脑的功能耦合较弱；这些关联在一定程度上是由母亲压力的增加所调节的。这些新的发现为社区水平的特征在怀孕期间通过增加个体内部压力和可能也通过其他机制促进神经编程效应的概念提供了必要的经验支持。
Our understanding of the developmental origins of disease, or fetal programming, has blossomed over the past three decades (1). One major contribution to our understanding of fetal programming has been the ability to noninvasively examine neural development during the earliest stages of infancy and even in utero using functional magnetic resonance imaging (fMRI). Results from this fMRI work support preclinical findings that isolate gestation as a time when maternal stress, depression, and anxiety yield powerful intergenerational impacts on the developing functional connectome (2).In this issue of Biological Psychiatry, Brady et al.(2022) quantify dyadic, household, and community-level exposures during pregnancy that may shape developing frontolimbic circuitry in newborns (3). Specifically, composite metrics of household psychosocial advantage (ie, income-to-needs ratio, insurance status, maternal education, nutrition, and area deprivation index) were combined with maternal stress and census-tract level data on neighborhood violent and property crimes using geocoded participant addresses. Over and above indices of household advantage, greater property and violent neighborhood crime was associated with weaker functional coupling of the anterior default mode network with the thalamus in newborns; these associations were in part mediated by increases in maternal stress. These novel findings provide needed empirical support for the notion that community-level features contribute to neural programming effects during pregnancy, both via increased intraindividual stress and likely via other mechanisms as well.