Role of psychosocial and nutritional stress on poor pregnancy outcome
Role of psychosocial and nutritional stress on poor pregnancy outcome
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DOI：
10.1093/jn/133.5.1709s
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发表时间：
2003-05-01
影响因子：
4.2
通讯作者：
Culhane, J
中科院分区：
文献类型：
--
作者：
Hobel, C;Culhane, J
流行病学证据表明，母亲心理社会压力、剧烈体力活动和禁食是早产和低出生体重的独立危险因素。来自临床研究的数据一直表明，与年龄匹配的对照组受试者相比，早产妇女的促肾上腺皮质激素释放激素水平显著升高。由于促肾上腺皮质激素释放激素的产生似乎是应激敏感的，这种神经肽可能在应激经历、工作压力和禁食与早产风险之间的生理调节中发挥关键作用。除了促肾上腺皮质激素释放激素升高对分娩的直接影响外，它还可能具有免疫调节作用，因此促肾上腺皮质激素释放激素水平高的女性可能更容易受到感染或感染的病理后果。我们回顾了将母亲压力、身体污渍和禁食与早产和低出生体重联系起来的流行病学数据，并回顾了这些暴露可能增加早产风险的可能的生物学途径。这些曝光的时机被认为是重要的。未来针对这些暴露的研究和临床计划必须在怀孕前考虑评估和干预。
Epidemiological evidence suggests that maternal psychosocial stress, strenuous physical activity and fasting are independent risk factors for preterm birth and low birth weight. Data from clinical studies consistently demonstrate that women in preterm labor have significantly elevated levels of corticotropin-releasing hormone compared with age-matched control subjects. Because production of corticotropin-releasing hormone appears to be stress sensitive, this neuropeptide may play a critical role in the physiological mediation among stressful experiences, work stress and fasting and risk of preterm birth. In addition to the direct effect of elevated corticotropin-releasing hormone on the initiation of labor, it may have an immunomodulatory effect such that women with high levels of corticotropin-releasing hormone may be more susceptible to infection or the pathological consequences of infection. We review the epidemiological data linking maternal stress, physical stain and fasting to preterm birth and low birth weight and review the plausible biological pathways through which these exposures may increase risk of preterm birth. The timing of these exposures is considered important. Future research and clinical programs addressing these exposures must consider assessments and interventions before pregnancy.