Disaster-related prenatal maternal stress, and childhood HPA-axis regulation and anxiety: The QF2011 Queensland Flood Study
Disaster-related prenatal maternal stress, and childhood HPA-axis regulation and anxiety: The QF2011 Queensland Flood Study
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DOI：
10.1016/j.psyneuen.2020.104716
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发表时间：
2020-08-01
影响因子：
3.7
通讯作者：
King, Suzanne
中科院分区：
文献类型：
--
作者：
McLean, Mia A.;Simcock, Gabrielle;King, Suzanne
背景资料：胎儿编程假说认为，产前母体压力（PNMS）影响胎儿发育的各个方面，如下丘脑-肾上腺（HPA）轴，增强对情绪问题的易感性。没有研究使用来自昆士兰州洪水研究（QF 2011）的数据，我们的目的是确定幼儿HPA轴功能是否介导了洪水相关PNMS和4岁儿童焦虑症状之间的关联，以及这种关系是否受到子宫内压力源的时间或孩子的性别的调节。在2011年昆士兰州洪水期间怀孕的妇女（N = 230），随后很快被招募并完成了关于她们客观困难的问卷调查（例如，个人财产损失）、主观痛苦（创伤后症状）和对灾害的认知评估。在16个月时，获得了儿童昼夜皮质醇节律（觉醒反应，每日总输出，昼夜斜率[N=80]）和应激反应（N = 111）的指标。在4年，N = 117母亲报告自己的情绪和他们的孩子的焦虑症状，其中，N = 80也有有效的儿童皮质醇反应数据，和N = 64日间皮质醇节律data.Results：一个更大的皮质醇觉醒反应在16个月介导的主观PNMS和焦虑症状之间的关系在4年。更大的幼儿每日皮质醇分泌预测更多的焦虑症状，独立的PNMS。实验室压力源没有引起皮质醇反应。PNMS的影响并不依赖于儿童性别，也不对妊娠时间的洪水exposure.Conclusions：指数昼夜皮质醇在幼儿期可能代表脆弱性焦虑症状的学龄前儿童，独立的，和以下，暴露于灾难相关的产前母亲的主观痛苦。
Background: The fetal programming hypothesis suggests that prenatal maternal stress (PNMS) influences aspects of fetal development, such as the Hypothalamic Pituitary Adrenal (HPA) axis, enhancing susceptibility to emotional problems. No study (to our knowledge) has investigated this pathway considering development of preschool anxiety symptoms.Using data from the Queensland Flood study (QF2011), our objective was to determine whether toddler HPA-axis functioning mediated the association between aspects of flood-related PNMS and child anxiety symptoms at 4-years, and whether relationships were moderated by the timing of the stressor in utero or by the child's sex.Methods: Women, pregnant during the 2011 Queensland floods (N = 230), were recruited soon afterwards and completed questionnaires regarding their objective hardship (e.g., loss of personal property), subjective distress (post-traumatic-like symptoms) and cognitive appraisal of the disaster. At 16 months, indexes of the child's diurnal cortisol rhythm (awakening response, total daily output, diurnal slope [N=80]), and stress reactivity (N = 111), were obtained. At 4-years, N = 117 mothers reported on their own mood and their children's anxiety symptoms; of these, N = 80 also had valid child cortisol reactivity data, and N = 64 had diurnal cortisol rhythm data.Results: A greater cortisol awakening response at 16 months mediated the relationship between subjective PNMS and anxiety symptoms at 4-years. Greater toddler daily cortisol secretion predicted more anxiety symptoms, independent of PNMS. The laboratory stressor did not elicit a cortisol response. PNMS effects were not dependent upon child sex nor on gestational timing of flood exposure.Conclusions: Indexes of diurnal cortisol in toddlerhood may represent vulnerability for anxiety symptoms in preschoolers, both independent of, and following, exposure to disaster-related prenatal maternal subjective distress.