Prenatal Anxiety and its Effects on Child Development

产前焦虑及其对儿童发育的影响

• 批准号: 7202870
• 负责人: Thomas G O'Connor
• 金额: $ 53.31万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-02-01 至 2012-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7202870
• 关键词: Adrenal Glands; Adult; Affect; Animal Experimentation; Animal Model; Animals; Anxiety; Area; Behavioral; Biological; Child; Child Development; Cognitive; Data; Development; Diagnostic; Discipline of obstetrics; Emotional; Exhibits; Hepatitis B; High Prevalence; Human; Hydrocortisone; Hypothalamic structure; Immune; Impairment; Infant; Link; Longitudinal Studies; Measures; Mediating; Mental Health; Nature; Outcome; Parent-Child Relations; Parents; Perinatal; Physiological; Pituitary Gland; Pregnancy; Public Health; Range; Research; Role; Stress; System; T-Lymphocyte; Testing; Tetanus; Translations; Woman; Work; biological adaptation to stress; hypothalamic-pituitary-adrenal axis; immune function; in utero; maternal stress; multidisciplinary; neuronal cell body; parental role; postnatal; prenatal; prevent; programs; prospective; psychologic; response

DESCRIPTION (provided by applicant): Literally dozens of animal studies indicate that offspring of prenatally stressed mothers exhibit a wide range of behavioral, physiological, and immunological impairments that persist into adulthood. Research into the mechanisms involved identifies the hypothalamic-pituitary-adrenal (HPA) axis as the most likely mediating mechanism, and further imply that this system may be "set" or "programmed" in utero. The relevance of these findings and of the programming mechanism to humans is unclear. There is now good correlational evidence that prenatal anxiety is associated with child outcomes, but translation from the animal model to humans is far from complete because of lingering questions about the causal nature of this link, the degree to which both behavioral and biological outcomes are affected, and the mechanisms involved. The proposed study will provide much-needed new information in this line of research by investigating causal hypotheses concerning the HPA axis, testing the links with behavioral and immune outcomes, and examining the role of early parent-infant relationship quality as a moderator of the effects of prenatal anxiety. 200 women, one-half of whom meet diagnostic criteria for anxiety, will be followed prospectively; data on psychological and physiological measures of anxiety will be collected on multiple occasions in pregnancy and the postnatal period. Obstetric, immune, cognitive, HPA axis, and behavioral/emotional outcomes in children will be collected at 2, 6, 12, and 16 months postnatally. For data on immune functioning, we will take advantage of naturally occurring immune stresses in the form of Hepatitis B and tetanus, and will document both B and T cell mediated responses. Scientifically, findings from the proposed multidisciplinary, prospective longitudinal study will provide essential data to evaluate the possibility that a "programming" mechanism associated with prenatal anxiety also exists in humans. These data will also carry substantial public health significance, particularly given what is known about the high prevalence of anxiety in pregnancy. Moreover, the detailed focus on immune function means that these observations will extend this research well beyond mental health, and may illuminate further the mechanisms by which early stress exposure influences psyche and soma.

描述（由申请人提供）：数十项动物研究表明，产前压力大的母亲的后代表现出广泛的行为、生理和免疫缺陷，这些缺陷会持续到成年。对相关机制的研究确定下丘脑-垂体-肾上腺（HPA）轴是最有可能的调节机制，并进一步暗示该系统可能在子宫内被“设置”或“编程”。这些发现和编程机制与人类的相关性尚不清楚。现在有很好的相关证据表明，产前焦虑与孩子的结局有关，但从动物模型到人类模型的转换还远远没有完成，因为这种联系的因果性质、行为和生物学结果受到影响的程度以及所涉及的机制等问题仍然存在。该研究将通过调查HPA轴的因果假设，测试其与行为和免疫结果的联系，以及检查早期亲子关系质量作为产前焦虑影响的调节因素的作用，为这一研究领域提供急需的新信息。将对200名女性进行前瞻性随访，其中一半符合焦虑诊断标准；将在怀孕期间和产后期间多次收集有关焦虑的心理和生理测量数据。将在出生后2、6、12和16个月收集儿童的产科、免疫、认知、HPA轴和行为/情绪结果。对于免疫功能的数据，我们将利用自然发生的乙型肝炎和破伤风形式的免疫应激，并将记录B细胞和T细胞介导的反应。从科学上讲，多学科前瞻性纵向研究的发现将为评估与产前焦虑相关的“编程”机制在人类中也存在的可能性提供必要的数据。这些数据还将具有重大的公共卫生意义，特别是考虑到怀孕期间焦虑的高流行率。此外，对免疫功能的详细关注意味着这些观察将使这项研究远远超出心理健康，并可能进一步阐明早期压力暴露影响心理和躯体的机制。