QF2011: a protocol to study the effects of the Queensland flood on pregnant women, their pregnancies, and their children's early development
QF2011: a protocol to study the effects of the Queensland flood on pregnant women, their pregnancies, and their children's early development
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DOI：
10.1186/s12884-015-0539-7
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发表时间：
2015-05-06
影响因子：
3.1
通讯作者：
Ping, Erin Yong
中科院分区：
文献类型：
--
作者：
King, Suzanne;Kildea, Sue;Ping, Erin Yong
背景资料：回顾性研究表明，母亲在怀孕期间暴露于严重的压力源会增加胎儿成年后患各种疾病的风险。对胎儿编程假说的动物研究发现，母体糖皮质激素通过胎盘并改变胎儿大脑发育，特别是下丘脑-垂体-肾上腺轴。然而，有没有孕妇暴露于一个突然发作的独立的压力源，阐明生物心理社会机制负责的各种后果的产前压力在人类后代的前瞻性研究。QF 2011年昆士兰州洪水研究的目的是填补这一空白，并测试助产士团体实践的缓冲作用，产妇护理的连续性的一种形式。方法/设计：2011年1月，澳大利亚昆士兰州发生了30年来最严重的洪水。与此同时，布里斯班的研究人员正在收集孕妇的心理社会数据，进行一项随机对照试验（M@NGO试验），将助产团体实践与标准护理进行比较。我们邀请这些孕妇和其他孕妇参加一项前瞻性的纵向研究，研究洪水对孕产妇、围产期和幼儿结局的产前母亲压力的影响。数据收集包括在招募时和洪水后12个月评估洪水造成的客观困难和主观痛苦。生物样品包括妊娠36周时的母体血液、脐带、脐带血和出生时的胎盘组织。在产后6周和6个月向妇女发送评估产妇和儿童结局的问卷。该方案包括16个月、21/2和4年时的评估。结果包括母亲的精神病理学，以及儿童的认知，行为，运动和身体发育。额外的生物样本包括母亲和儿童的DNA，以及儿童睾酮，昼夜和反应性皮质醇。讨论：产前压力研究是第一次，并将填补重要的空白，在文献中。分析将确定洪水暴露影响母体生物应激反应的程度，这可能会在生物、生化和分子水平上影响母体-胎盘-胎儿轴，改变胎儿发育并影响后代的结局。助产士小组的做法在缓和产妇压力的影响的作用将进行测试。
Background: Retrospective studies suggest that maternal exposure to a severe stressor during pregnancy increases the fetus' risk for a variety of disorders in adulthood. Animal studies testing the fetal programming hypothesis find that maternal glucocorticoids pass through the placenta and alter fetal brain development, particularly the hypothalamic-pituitary-adrenal axis. However, there are no prospective studies of pregnant women exposed to a sudden-onset independent stressor that elucidate the biopsychosocial mechanisms responsible for the wide variety of consequences of prenatal stress seen in human offspring. The aim of the QF2011 Queensland Flood Study is to fill this gap, and to test the buffering effects of Midwifery Group Practice, a form of continuity of maternity care.Methods/design: In January 2011 Queensland, Australia had its worst flooding in 30 years. Simultaneously, researchers in Brisbane were collecting psychosocial data on pregnant women for a randomized control trial (the M@NGO Trial) comparing Midwifery Group Practice to standard care. We invited these and other pregnant women to participate in a prospective, longitudinal study of the effects of prenatal maternal stress from the floods on maternal, perinatal and early childhood outcomes. Data collection included assessment of objective hardship and subjective distress from the floods at recruitment and again 12 months post-flood. Biological samples included maternal bloods at 36 weeks pregnancy, umbilical cord, cord blood, and placental tissues at birth. Questionnaires assessing maternal and child outcomes were sent to women at 6 weeks and 6 months postpartum. The protocol includes assessments at 16 months, 21/2 and 4 years. Outcomes include maternal psychopathology, and the child's cognitive, behavioral, motor and physical development. Additional biological samples include maternal and child DNA, as well as child testosterone, diurnal and reactive cortisol.Discussion: This prenatal stress study is the first of its kind, and will fill important gaps in the literature. Analyses will determine the extent to which flood exposure influences the maternal biological stress response which may then affect the maternal-placental-fetal axis at the biological, biochemical, and molecular levels, altering fetal development and influencing outcomes in the offspring. The role of Midwifery Group Practice in moderating effects of maternal stress will be tested.