Psychological distress and SSRI use predict variation in inflammatory cytokines during pregnancy.
Psychological distress and SSRI use predict variation in inflammatory cytokines during pregnancy.
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心理困扰和SSRI使用预测怀孕期间炎症性细胞因子的变化。
DOI：
10.4236/ojog.2013.31a034
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发表时间：
2013-02
期刊：
影响因子：
--
通讯作者：
Wong B
中科院分区：
文献类型：
--
作者：
Latendresse G;Ruiz RJ;Wong B
有证据支持这样的假设，即母亲的心理困扰对妊娠结局产生不利影响，炎症标志物和胎盘产生的促肾上腺皮质激素释放激素（pCRH）可能是介导因素。本研究的主要目的是探讨孕妇心理困扰、使用选择性5-羟色胺再摄取抑制剂（pCRH）和孕妇妊娠期间血浆炎症标志物之间的关系。在100名孕妇中完成了母体血浆pCRH、白细胞介素-1，6和10、C-反应蛋白、巨噬细胞移动抑制因子和肿瘤坏死因子-α的测量。完成了抑郁、焦虑和感知压力的测量，以及人口统计学/行为数据的收集，例如选择性5-羟色胺再摄取抑制剂（SSRIs）的使用。妊娠14-20周时IL-6、IL-10与抑郁、焦虑、压力感知有显著相关。同样在妊娠14 - 20周时，pCRH水平为第4四分位数的女性的IL 10水平显著较低，妊娠期间服用SSRI的女性的IL 1 β、IL 6和IL 10显著较低。在控制了母亲年龄、BMI、pCRH水平和SSRI使用后，心理困扰仍然可以解释母亲炎症标志物的变化。这些结果可能表明，未来的研究应该集中在抑郁和焦虑是否在怀孕期间得到有效治疗，以及这种情况如何有助于免疫系统途径导致不良妊娠结局。
Evidence supports the premise that maternal psychological distress adversely affects pregnancy outcomes and that inflammatory markers and placentally-produced corticotrophin-releasing hormone (pCRH) are likely mediating factors. The primary aim of the study was to explore the associations between maternal psychological distress, use of selective serotonin re-uptake inhibitors, pCRH, and maternal plasma inflammatory markers during pregnancy. Measures of maternal plasma pCRH, Interleukins-1, 6, & 10, C-Reactive Protein, Macrophage Migration Inhibitory Factor, and Tumor Necrosis Factor-α were completed in 100 pregnant women. Measures of depression, anxiety, and perceived stress were completed, as well as collection of demographic/behavioral data, e.g. use of selective serotonin re-uptake inhibitors (SSRIs). Significant correlations were found at 14–20 weeks gestation between IL-6 & 10, and depression, anxiety, and perceived stress. Also at 14 – 20 weeks gestation, IL10 levels were significantly lower in women with 4th quartile pCRH levels and IL1β, IL6, and IL10 were significantly lower among women who took an SSRI during pregnancy. After controlling for maternal age, BMI, pCRH level, and SSRI use, psychological distress remained to explain variation in maternal inflammatory markers. These results might suggest that future research should focus on whether depression and anxiety are effectively being treated during pregnancy, and how such a scenario might contribute to an immune system pathway to poor pregnancy outcome.