Physiological reactivity to acute stress during pregnancy

怀孕期间对急性应激的生理反应

• 批准号: 7915341
• 负责人: Lisa Michelle Christian
• 金额: $ 22.1万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-15 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7915341
• 关键词: Acute; Address; African American; Animals; Anxiety; Attenuated; Australia; Biological Assay; Birth Rate; Blood Pressure; Blood Vessels; Canada; Cardiac Output; Cardiovascular Physiology; Cardiovascular system; Catecholamines; Caucasians; Caucasoid Race; Characteristics; Chronic stress; Developed Countries; Discrimination; Distress; Employee Strikes; Endocrine; Europe; Exhibits; Family; Fetal Development; Fetus; Genes; Gestational Age; Glucocorticoid Receptor; Glucocorticoids; Health; Health Services; Health behavior; Hostility; Human; Hydrocortisone; Immune; Immune response; Immune system; Impedance Cardiography; Infection; Inflammation; Inflammatory; Inflammatory Response; Investigation; Knowledge; Lead; Length; Link; Literature; Measurement; Measures; Mediating; Methodology; Minority; Monitor; Mothers; Neurosecretory Systems; Not Hispanic or Latino; Outcome; Participant; Perinatal; Peripheral Resistance; Physiological; Physiological Adaptation; Pregnancy; Pregnant Women; Premature Birth; Psychosocial Stress; Race; Reaction; Receptor Signaling; Recovery; Reporting; Research; Risk; Social support; Socioeconomic Status; Stress; Treatment/Psychosocial Effects; United States; Vascular resistance; Woman; acute stress; base; biological adaptation to stress; cost; depressive symptoms; design; experience; immune function; novel; prevent; psychological stressor; psychosocial; public health relevance; racial difference; receptor function; response; stressor; therapy design

DESCRIPTION (provided by applicant): Preterm delivery, an increasingly frequent occurrence in the United States, is associated with significant family burden and an estimated societal cost of at least $26 billion per year. In the U.S., the preterm birth rate is 12-13% as compared to 5-9% in other developed countries. Persistent racial disparities contribute to this discrepancy. Psychosocial stress and related physiological sequelae may contribute to preterm birth overall, as well as to racial disparities in preterm birth. The experience of chronic stress, such as that conferred by racial minority status, may sensitize physiological stress responses. Indeed, as compared to Caucasians, African-Americans exhibit greater cardiovascular reactivity to a variety of acute stressors. Importantly, blood pressure, glucocorticoid, and catecholamine responses to acute stress are attenuated during healthy pregnancy as compared to nonpregnancy. This adaptation may protect the mother and fetus from potentially detrimental effects of maternal physiological activation. Thus, women who exhibit greater and more extended physiological reactions to everyday stressors may be at increased risk for negative perinatal outcomes. Notably, no studies of acute stress during pregnancy have examined inflammatory immune responses or mechanisms underlying blood pressure change (i.e., cardiac output, total peripheral resistance). Moreover, limited information is available regarding effects of race on physiological adaptation to pregnancy. The current study will address important gaps in the literature by examining cardiovascular, endocrine, and immune reactivity to acute stress among 40 healthy pregnant women (20 Caucasian, 20 African-American) and 40 demographically matched nonpregnant control women. This research is designed to ultimately lead to the identification of women at greater risk for negative perinatal outcomes and elucidation of mechanisms underlying increased risk, providing a basis for individualized health care services. Specific Aim #1: To utilize more comprehensive and advanced methodology to assess physiological reactivity during pregnancy versus nonpregnancy, including measures of inflammation, impedance cardiography, and glucocorticoid receptor function. Hypothesis #1: Pregnant women will show attenuated physiological responses to acute stress as compared to nonpregnant women. Specific Aim #2: To examine racial differences in physiological reactivity during pregnancy versus nonpregnancy. Hypothesis #2: As compared to Caucasian women, African-American women will exhibit greater physiological reactivity to stress during pregnancy and nonpregnancy. Specific Aim #3: To examine psychosocial correlates of physiological reactivity during pregnancy and nonpregnancy. Hypothesis #3: Women reporting greater distress will exhibit greater physiological reactivity during pregnancy and nonpregnancy. Specific Aim #4: To examine associations between physiological reactivity and length of gestation. Hypothesis #4: Greater physiological reactivity to acute stress will predict shorter gestational length. PUBLIC HEALTH RELEVANCE: This study will fill important gaps in our knowledge regarding physiological adaption during pregnancy and effects of race on such adaptation. Information gained from this study will provide the groundwork for the following: 1) identification of women at greater risk of negative perinatal outcomes; 2) describing physiological mechanisms underlying the link between stress and risk of preterm delivery; and 3) providing interventions designed to reduce the effects of stress and promote healthy pregnancy and fetal development.

描述（由申请人提供）：早产在美国越来越常见，与重大的家庭负担和估计每年至少260亿美元的社会成本相关。在美国，早产率为12-13%，而其他发达国家为5-9%。持续的种族差异造成了这种差异。总体而言，社会心理压力和相关的生理后遗症可能导致早产，也可能导致早产的种族差异。慢性应激的经历，如少数民族身份所赋予的，可能使生理应激反应敏感。的确，与白种人相比，非裔美国人对各种急性压力源表现出更强的心血管反应。重要的是，与非妊娠相比，健康妊娠期间血压、糖皮质激素和儿茶酚胺对急性应激的反应减弱。这种适应可以保护母亲和胎儿免受母体生理激活的潜在有害影响。因此，对日常压力源表现出更大、更持久的生理反应的妇女，围产期不良后果的风险可能会增加。值得注意的是，没有关于怀孕期间急性应激的研究检查了炎症免疫反应或血压变化的机制（即心输出量，总外周阻力）。此外，关于种族对怀孕生理适应的影响的信息有限。目前的研究将通过检查40名健康孕妇（20名白种人，20名非裔美国人）和40名人口统计学匹配的非怀孕对照妇女的心血管，内分泌和免疫反应性来解决文献中的重要空白。这项研究的目的是最终确定围产儿不良结局风险较大的妇女，并阐明风险增加的机制，为个性化医疗保健服务提供基础。具体目标#1：利用更全面和先进的方法来评估怀孕期间与非怀孕期间的生理反应性，包括炎症、阻抗心动图和糖皮质激素受体功能的测量。假设1：与非孕妇相比，孕妇对急性应激的生理反应会减弱。具体目标#2：检查怀孕和非怀孕期间生理反应的种族差异。假设2：与白人女性相比，非裔美国女性在怀孕和非怀孕期间对压力表现出更大的生理反应。具体目标#3：检查怀孕和非怀孕期间生理反应的社会心理相关性。假设3：报告更大痛苦的女性在怀孕和非怀孕期间会表现出更大的生理反应。具体目的#4：研究生理反应性与妊娠期长短之间的关系。假设4：对急性应激的生理反应越强，妊娠期越短。公共卫生相关性：这项研究将填补我们关于怀孕期间生理适应和种族对这种适应的影响的知识的重要空白。从本研究中获得的信息将为以下方面提供基础：1)识别围产期阴性结局风险较大的妇女；2)描述压力与早产风险之间联系的生理机制；3)提供干预措施，旨在减少压力的影响，促进健康妊娠和胎儿发育。

项目成果

Stress and Immune Function during Pregnancy: An Emerging Focus in Mind-Body Medicine.

• DOI: 10.1177/0963721414550704
• 发表时间: 2015-02-27
• 期刊: Current directions in psychological science
• 影响因子: 7.2
• 作者: Christian LM

Optimizing benefits of influenza virus vaccination during pregnancy: potential behavioral risk factors and interventions.

• DOI: 10.1016/j.vaccine.2014.03.075
• 发表时间: 2014-05-23
• 期刊: VACCINE
• 影响因子: 5.5
• 作者: Christian, Lisa M.

Polyunsaturated Fatty Acid (PUFA) Status in Pregnant Women: Associations with Sleep Quality, Inflammation, and Length of Gestation.

• DOI: 10.1371/journal.pone.0148752
• 发表时间: 2016
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Christian LM;Blair LM;Porter K;Lower M;Cole RM;Belury MA
• 通讯作者: Belury MA

Effects of stress and depression on inflammatory immune parameters in pregnancy.

• DOI: 10.1016/j.ajog.2014.06.042
• 发表时间: 2014-09
• 期刊: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
• 影响因子: 9.8
• 作者: Christian, Lisa M.

Maternal depressive symptoms, sleep, and odds of spontaneous early birth: implications for racial inequities in birth outcomes.

母亲抑郁症状、睡眠和自然早产的几率：对出生结果种族不平等的影响。

• DOI: 10.1093/sleep/zsab133
• 发表时间: 2021
• 期刊: Sleep
• 影响因子: 5.6
• 作者: Christian,LisaM;Webber,Shannon;Gillespie,Shannon;Strahm,AnnaM;Schaffir,Jonathan;Gokun,Yevgeniya;Porter,Kyle
• 通讯作者: Porter,Kyle