Effects of exposure to maternal psychosocial stress and stress hormones during peregnancy on endocrine, cardiovascular, metabolic and immune parameters in 6-7 year old children: a prospective cohort study

实证研究支持产前应激暴露作为一系列不良婴儿和成人健康结果的独立风险因素的重要作用。在人类研究中，这一领域的主要局限性在于，这些研究绝大多数(a)采用回顾性设计，(b)使用不利产前条件的间接标记，如出生体重/尺寸减少和妊娠期长短作为随后健康结果的预测因素。为了解决上述局限性，本研究的目的是前瞻性评估产前应激暴露（怀孕期间母亲的社会心理应激和怀孕期间母亲-胎盘应激激素水平）对6-7岁儿童内分泌、心血管、代谢和免疫参数的影响。此外，与其完全依赖于在怀孕期间收集的母亲心理社会压力的自我报告测量，在指数妊娠过程中多个时间点收集的母亲-胎盘压力激素（皮质醇和促肾上腺皮质激素释放激素水平，CRH）的测量将被用作胎儿暴露于产前压力的生物学标记。这项研究的结果将有助于进一步了解胎儿发育过程中的条件是否导致了重要生物系统功能的变化，这些系统是随后健康和疾病风险的基础。

Empirical studies support a significant role for prenatal stress exposure as an independent risk factor for a host of adverse infant and adult health outcomes. In humans, the major limitations in this field are that an overwhelming majority of these studies have (a) employed a retrospective design, and (b) used indirect markers of adverse prenatal conditions such as reduced birth weight/size and length of gestation as predictors of subsequent health outcomes. To address the above limitations, the goal of the present study proposal is to prospectively assess the effects of prenatal stress exposure (psychosocial stress of the mother during pregnancy and maternal-placental stress hormone levels during pregnancy) on endocrine, cardiovascular, metabolic and immune parameters in 6-7 year old children whose mothers’ pregnancies were followed with multiple serial measures. Moreover, instead of relying exclusively on self-report measures of maternal psychosocial stress collected during pregnancy, measures of maternal-placental stress hormones (levels of cortisol and corticotropin releasing hormone, CRH) that also were collected at multiple time points over the course of the index pregnancy will be used as biological markers of fetal exposure to a prenatal stress. Results of the proposed study will contribute to further understand whether conditions during fetal development account for variation in the function of important biological systems that underlie subsequent health and disease risk.