Prenatal stress

产前应激
  • 文章类型: Journal Article
    畸胎学研究表明,产前应激和产前物质暴露对儿童神经发育结局都有显著影响。利用人类研究,这篇叙述性综述的目的是探讨这些暴露可能代表儿童认知和行为发展的复杂产前和产后风险的程度。对HPA轴及其在怀孕期间的功能以及产前应激的类型和操作的理解为理解产前应激影响大脑和行为发育的直接和间接机制提供了背景。反过来,评估产前物质暴露研究在理解变量方面的重要性,这些变量表明与产前应激的潜在相互作用,包括对新颖性的反应性。唤醒,和儿童早期的应激反应。产前应激暴露和产前物质暴露对神经发育结果包括唤醒和情绪调节的异同,认知,行为,应激反应性,和精神病理学的风险进行了总结。产前应激和/或物质暴露的致畸研究的进一步考虑包括确定和解决方法学挑战,在研究中拥抱产前和产后环境的复杂性,以及将育儿和弹性纳入未来研究的重要性。
    Teratological research shows that both prenatal stress and prenatal substance exposure have a significant impact on neurodevelopmental outcomes in children. Using human research, the purpose of this narrative review is to explore the degree to which these exposures may represent complex prenatal and postnatal risks for the development of cognition and behavior in children. An understanding of the HPA axis and its function during pregnancy as well as the types and operationalization of prenatal stress provide a context for understanding the direct and indirect mechanisms by which prenatal stress affects brain and behavior development. In turn, prenatal substance exposure studies are evaluated for their importance in understanding variables that indicate a potential interaction with prenatal stress including reactivity to novelty, arousal, and stress reactivity during early childhood. The similarities and differences between prenatal stress exposure and prenatal substance exposure on neurodevelopmental outcomes including arousal and emotion regulation, cognition, behavior, stress reactivity, and risk for psychopathology are summarized. Further considerations for teratological studies of prenatal stress and/or substance exposure include identifying and addressing methodological challenges, embracing the complexity of pre-and postnatal environments in the research, and the importance of incorporating parenting and resilience into future studies.
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  • 文章类型: Journal Article
    从一开始,产前压力就越来越被认为是影响个体生活的重要因素。这篇全面的综述探讨了产前应激及其对行为的影响之间的复杂关系,认知,和精神病理学。主要研究结果表明,产前压力会导致后代出现广泛的不良后果,包括神经发育障碍,情绪失调,认知缺陷,情绪障碍,和精神病理学状况的风险增加。这些作用机制涉及表观遗传修饰,下丘脑-垂体-肾上腺(HPA)轴失调,神经发育改变,炎症过程,以及大脑结构和功能的变化。此外,调节因素,如产妇压力水平,产妇心理健康,社会经济地位,社会支持,早期逆境可以显著影响产前应激的影响。审查还讨论了干预和预防策略,强调产前减压计划的重要性,孕产妇心理健康支持,营养干预,以及针对高危人群的有针对性的早期干预措施。这些发现对公共卫生和临床实践具有重要意义。强调需要采取全面的产前护理方法,优先考虑产妇的福祉,并减轻产前压力的持久影响。解决这一关键问题有望在未来实现更健康的世代和更强大的社区。
    Prenatal stress is increasingly recognized as a significant factor impacting an individual\'s life from the beginning. This comprehensive review explores the intricate relationship between prenatal stress and its effects on behaviour, cognition, and psychopathology. Key findings reveal that prenatal stress can lead to a wide range of adverse outcomes in offspring, including neurodevelopmental disorders, emotional dysregulation, cognitive deficits, mood disorders, and an increased risk of psychopathological conditions. These effects\' mechanisms involve epigenetic modifications, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, neurodevelopmental alterations, inflammatory processes, and changes in brain structure and function. Moreover, moderating factors such as maternal stress levels, maternal mental health, socioeconomic status, social support, and early-life adversity can significantly influence the impact of prenatal stress. The review also discusses intervention and prevention strategies, emphasizing the importance of prenatal stress reduction programs, maternal mental health support, nutritional interventions, and targeted early interventions for at-risk populations. These findings have substantial implications for public health and clinical practice, highlighting the need for a holistic approach to prenatal care that prioritizes maternal well-being and mitigates the lasting effects of prenatal stress. Addressing this critical issue promises healthier generations and stronger communities in the future.
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  • 文章类型: Review
    怀孕期间的压力会对产妇的心理健康造成严重的不良后果。产前压力的早期评估可以帮助确定治疗需求和适当的干预措施。健康的社会决定因素的差异会导致压力,但是,在健康框架的社会决定因素中,怀孕期间的压力构成尚不清楚。
    概述如何在美国暴露于三种主要社会压力源的孕妇中定义和测量产前压力:与食物有关的不安全,住房,和移民。
    我们纳入了所有关注粮食不安全背景下怀孕期间压力的研究,住房不稳定,移民,鉴于他们最近由于新冠肺炎大流行和持续的政治言论而关注政策,此外,他们在美国妇产科学院(ACOG)的健康筛查工具的社会决定因素的重要性。
    我们搜索了PubMed,Scopus,和WebofScience在2012年1月至2022年1月之间发表的文章。
    使用试点图表工具,我们从选择的文章中提取了相关的研究信息,并分析了与压力有关的内容。
    最初的搜索确定了1,023篇文章,其中24人符合我们的纳入标准。没有一项研究定义产前压力,只有一个人使用了产前窘迫问卷,产前压力特定的工具来测量它。感知压力量表是七项研究中最常用的工具。15项研究测量了25种替代暴露,研究人员认为这些暴露与压力有关,15项研究中有4项没有解释测量与压力之间的关联.
    我们的研究结果表明,在健康的社会决定因素的背景下,如何定义和测量产前压力存在根本的不一致。限制不同研究结果的比较和有效干预措施的潜在发展,以促进更好的孕产妇心理健康。
    Stress during pregnancy can lead to significant adverse outcomes for maternal mental health. Early evaluation of prenatal stress can help identify treatment needs and appropriate interventions. Disparities in the social determinants of health can contribute to stress, but what constitutes stress during pregnancy within the social determinants of health framework is poorly understood.
    To scope how prenatal stress is defined and measured among pregnant people exposed to three prominent social stressors in the United States: insecurity pertaining to food, housing, and immigration.
    We included all studies that focused on stress during pregnancy in the context of food insecurity, housing instability, and immigration, given their recent policy focus due to the COVID-19 pandemic and ongoing political discourse, in addition to their importance in American College of Obstetricians and Gynecologists (ACOG\'s) social determinants of health screening tool.
    We searched PubMed, Scopus, and Web of Science for articles published between January 2012 and January 2022.
    Using a piloted charting tool, we extracted relevant study information from the selected articles and analyzed the content pertaining to stress.
    An initial search identified 1,023 articles, of which 24 met our inclusion criteria. None of the studies defined prenatal stress, and only one used the Prenatal Distress Questionnaire, a prenatal stress-specific tool to measure it. The Perceived Stress Scale was the most common instrument used in seven studies. Fifteen studies measured over 25 alternative exposures that researchers theorized were associated with stress, and 4 of the 15 studies did not explain the association between the measure and stress.
    Our findings demonstrate a fundamental inconsistency in how prenatal stress is defined and measured in the context of social determinants of health, limiting the comparison of results across studies and the potential development of effective interventions to promote better maternal mental health.
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  • 文章类型: Systematic Review
    暴露于早期生活压力(ELS),儿童和青春期的产前或产后,会显著影响身心健康。肠道微生物在人类健康中的作用,尤其是心理健康,变得越来越明显。本系统综述旨在总结评估ELS对人体肠道微生物组影响的临床数据。根据PRISMA指南进行系统评价(CRD42022351092),ELS被认为是在产前和生命早期(童年和青春期)暴露于心理压力源。十三篇文章符合所有纳入标准,所有的研究都发现了产前和产后ELS与肠道微生物组之间的联系。然而,我们未能找到与产前或产后压力相关的共识微生物组特征,或者两者兼而有之。结果的不一致可能归因于各种因素,如不同的实验设计,年龄检查,问卷,样品收集和分析方法的时间安排,人口规模小,以及压力源的类型。使用类似压力源和验证压力措施的其他研究,以及更高分辨率的微生物组分析方法,需要得出关于压力与人类肠道微生物组之间联系的明确结论。
    Exposure to early life stress (ELS), prenatal or postnatal during childhood and adolescence, can significantly impact mental and physical health. The role of the intestinal microbiome in human health, and particularly mental health, is becoming increasingly evident. This systematic review aims to summarize the clinical data evaluating the effect of ELS on the human intestinal microbiome. The systematic review (CRD42022351092) was performed following PRISMA guidelines, with ELS considered as exposure to psychological stressors prenatally and during early life (childhood and adolescence). Thirteen articles met all inclusion criteria, and all studies reviewed found a link between ELS and the gut microbiome in both prenatal and postnatal periods. However, we failed to find consensus microbiome signatures associated with pre- or postnatal stress, or both. The inconsistency of results is likely attributed to various factors such as different experimental designs, ages examined, questionnaires, timing of sample collection and analysis methods, small population sizes, and the type of stressors. Additional studies using similar stressors and validated stress measures, as well as higher-resolution microbiome analytical approaches, are needed to draw definitive conclusions about the links between stress and the human gut microbiome.
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  • 文章类型: Journal Article
    背景:受孕前和怀孕期间的压力与不良的母婴健康有关。产前皮质醇水平的变化可能是将压力与不良母婴健康联系起来的主要生物学途径。尚未全面审查研究从儿童到怀孕的母体压力与产前皮质醇之间的关联。
    方法:当前对48篇论文的范围综述综合了研究报告,这些研究报告了受孕前和怀孕期间的压力与怀孕期间的母体皮质醇之间的关系。合格的研究测量童年,近端的孕前时期,怀孕,或基于压力暴露或评估的终生压力,并在怀孕期间测量唾液或头发中的皮质醇。
    结果:更高的母亲儿童期压力与更高的皮质醇觉醒反应以及跨研究的昼夜皮质醇模式的典型妊娠特异性变化相关。相比之下,大多数关于孕前和产前压力的研究报告称与皮质醇无关联,而那些报告显著影响的研究方向不一致。一些研究发现,怀孕期间压力与皮质醇之间的关联随包括社会支持和环境污染在内的多种调节因素而变化。
    结论:尽管许多研究已经评估了母体压力对产前皮质醇的影响,这篇范围界定综述是第一个综合关于这一主题的现有文献。受孕前和怀孕期间的压力与产前皮质醇之间的关联可能取决于压力的发育时机和几种调节剂。与近端孕前或妊娠压力相比,产妇的儿童期压力与产前皮质醇的关系更为一致。我们讨论了可能导致混合发现的方法和分析因素。
    Stress before conception and during pregnancy is associated with less favorable maternal and child health. Alterations in prenatal cortisol levels may serve as a central biological pathway linking stress to adverse maternal and child health. Research examining associations between maternal stress from childhood through pregnancy and prenatal cortisol has not been comprehensively reviewed.
    The current scoping review of 48 papers synthesizes studies reporting on associations between stress before conception and during pregnancy with maternal cortisol in pregnancy. Eligible studies measured childhood, the proximal preconception period, pregnancy, or lifetime stress based on stress exposures or appraisals and measured cortisol in saliva or hair during pregnancy.
    Higher maternal childhood stress was associated with higher cortisol awakening responses and alterations in typical pregnancy-specific changes in diurnal cortisol patterns across studies. In contrast, most studies of preconception and prenatal stress reported null associations with cortisol and those reporting significant effects were inconsistent in direction. A few studies found that the associations between stress and cortisol during pregnancy varied as a function of several moderators including social support and environmental pollution.
    Although many studies have evaluated effects of maternal stress on prenatal cortisol, this scoping review is the first to synthesize existing literature on this topic. The association between stress before conception and during pregnancy and prenatal cortisol may depend on the developmental timing of stress and several moderators. Maternal childhood stress was more consistently associated with prenatal cortisol than proximal preconception or pregnancy stress. We discuss methodological and analytic factors that may contribute to mixed findings.
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  • 文章类型: Journal Article
    在早期发育过程中暴露于压力可能导致神经生物学功能改变,从而增加了以后患精神疾病的风险。与这些结果相关的一个潜在机制是神经胶质密度和形态的破坏,尽管啮齿动物研究的结果相互矛盾。为了解决这个问题,我们对啮齿动物研究进行了系统评价和荟萃分析,研究了产前应激(PNS)和早期应激(ELS)对小胶质细胞的影响,星形胶质细胞,以及后代中的少突胶质细胞密度和形态。我们的荟萃分析表明,暴露于PNS或ELS的动物显示小胶质细胞密度显着增加,以及少突胶质细胞密度降低。此外,ELS暴露引起小胶质细胞大小增加。然而,我们无法确定对星形胶质细胞的显著影响.Meta回归表明,实验性应激方案,性别,年龄,和分析的组织类型是影响这些结果的重要协变量。重要的是,PNS小胶质细胞在幼小动物中显示出更高的估计,而ELS效应在成年动物中更强。这组数据加强了神经胶质细胞的改变可以在整个发育过程中在应激诱导的功能障碍中发挥作用。
    Exposure to stress during early development may lead to altered neurobiological functions, thus increasing the risk for psychiatric illnesses later in life. One potential mechanism associated with those outcomes is the disruption of glial density and morphology, despite results from rodent studies have been conflicting. To address that we performed a systematic review and meta-analysis of rodent studies that investigated the effects of prenatal stress (PNS) and early life stress (ELS) on microglia, astrocyte, and oligodendrocyte density and morphology within the offspring. Our meta-analysis demonstrates that animals exposed to PNS or ELS showed significant increase in microglia density, as well as decreased oligodendrocyte density. Moreover, ELS exposure induced an increase in microglia soma size. However, we were unable to identify significant effects on astrocytes. Meta-regression indicated that experimental stress protocol, sex, age, and type of tissue analyzed are important covariates that impact those results. Importantly, PNS microglia showed higher estimates in young animals, while the ELS effects were stronger in adult animals. This set of data reinforces that alterations in glial cells could play a role in stress-induced dysfunctions throughout development.
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  • 文章类型: Journal Article
    动物在气质和压力反应等内在特征上有所不同,并且这些信息对于实验者识别更同质的动物子集是有用的,这些动物子集显示出特定研究结果的风险一致性。这些信息也可以用于平衡实验组,确保实验中的动物具有相似的特征。在这次审查中,我们描述了加州国家灵长类动物研究中心的生物行为评估计划,which,自2001年成立以来,一直为科学家提供有关内在特征的定量信息,以进行主题选择和平衡,并以殖民地管理人员为管理目的。我们描述了该计划并回顾了与哮喘有关的研究,自闭症,行为抑制,等。,其中BBA程序用于选择动物。我们还回顾了我们的工作,表明诸如饲养等因素,氯胺酮暴露,和产前经验可以影响生物行为组织的方式,一些研究人员可能希望在他们的研究中控制。关注受试者群体的内在特征与对精准医学日益增长的兴趣是一致的,并且可以导致动物数量的减少。为调查人员节省时间和金钱,减少动物的痛苦。
    Animals vary on intrinsic characteristics such as temperament and stress responsiveness, and this information can be useful to experimentalists for identifying more homogeneous subsets of animals that show consistency in risk for a particular research outcome. Such information can also be useful for balancing experimental groups, ensuring animals within an experiment have similar characteristics. In this review, we describe the BioBehavioral Assessment Program at the California National Primate Research Center, which, since its inception in 2001, has been providing quantitative information on intrinsic characteristics to scientists for subject selection and balancing, and to colony management staff for management purposes. We describe the program and review studies relating to asthma, autism, behavioral inhibition, etc., where the BBA Program was used to select animals. We also review our work, showing that factors such as rearing, ketamine exposure, and prenatal experience can affect biobehavioral organization in ways that some investigators might want to control for in their studies. Attention to intrinsic characteristics of subject populations is consistent with the growing interest in precision medicine and can lead to a reduction in animal numbers, savings in time and money for investigators, and reduced distress for the animals.
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  • 文章类型: Journal Article
    Exposure to prenatal stress (PNS) can lead to long-lasting neurobiological and behavioral consequences for the offspring, which may enhance the susceptibility for mental disorders. The hypothalamus-pituitary-adrenal (HPA) axis and the immune system are two major factors involved in the stress response. Here, we performed a systematic review and meta-analysis of rodent studies that investigated the effects of PNS exposure on the HPA axis and inflammatory cytokines in adult offspring. Our analysis shows that animals exposed to PNS display a consistent increase in peripheral corticosterone (CORT) levels and central corticotrophin-releasing hormone (CRH), while decreased levels of its receptor 2 (CRHR2). Meta-regression revealed that sex and duration of PNS protocol are covariates that moderate these results. There was no significant effect of PNS in glucocorticoid receptor (GR), CRH receptor 1 (CRHR1), pro- and anti-inflammatory cytokines. Our findings suggest that PNS exposure elicits long-lasting effects on the HPA axis function, providing an important tool to investigate in preclinical settings key pathological aspects related to early-life stress exposure. Furthermore, researchers should be aware of the mixed outcomes of PNS on inflammatory markers in the adult brain.
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  • 文章类型: Journal Article
    本研究系统地回顾了从PubMed收集的56篇评估怀孕期间头发皮质醇浓度的文章,Scopus,和WebofScience于8/9/19和6/29/20更新。我们的目标是根据已发表的研究确定三个月的参考范围。任何给定样本的大部分(例如,70%,-1SD至+1SD)的范围预计在三个月1和2中介于0和34.15pg/mg之间,在三个月3中介于8.59和44pg/mg之间,范围非常宽(例如,>250pg/mg的值)和更高的值(例如,来自一个特定实验室的200s-300s平均值高达768pg/mg)。由于已知因素,例如不同实验室和测定类型返回的值差异,因此在整个怀孕期间划定头发皮质醇浓度的参考范围具有挑战性。我们观察到分析后数据和数据准备步骤的描述不一致。主要发现包括,在所有三个三个月的研究中,只有一半的研究显示平均水平持续增加(大多数通过分段回顾性评估)。变化模式具有相当大的可变性。没有一项研究报告了个体的变化模式。检查人员内部变更是该领域的重要下一步。我们得出的结论是,研究人员应该更清楚地报告围绕异常值的决策,units,以及未来数据转换的细节,以提高我们比较研究结果的能力,为了了解报告的HCC值的差异,并可能了解文献中报告的HCC与其他表型的相关性差异。
    The present study systematically reviewed 56 articles that assessed hair cortisol concentrations during pregnancy collected from PubMed, Scopus, and Web of Science on 8/9/19 and updated on 6/29/20. Our goals were to establish reference ranges by trimester based on published studies. The majority of any given sample (e.g., 70 %, the range of -1SD to +1SD) is expected to fall between 0 and 34.15 pg/mg in trimester 1 and 2, and between 8.59 and 44 pg/mg in trimester 3, with very wide ranges (e.g., values of >250 pg/mg) and substantially higher values (e.g., averages of 200\'s-300\'s reaching as high as 768 pg/mg) coming out of one specific lab. Delineating a reference range for hair cortisol concentrations across pregnancy is challenging because of known factors like differences in values returned by different laboratories and assay types. We observed inconsistency in descriptions of the data and data preparation steps post-assay. Key findings include that only half of the studies examining all three trimesters showed a constant increase in mean levels (most retrospectively assessed via segmenting), with considerable variability in patterns of change. None of the studies reported individual patterns of change. Examining within-person changes are an important next step for the field. We conclude that researchers should more clearly report decisions around outliers, units, and specifics of data transformations in the future in order to improve our ability to compare findings across studies, to understand differences in HCC values reported, and potentially to understand differences in reported associations of HCC with other phenotypes in the literature.
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  • 文章类型: Journal Article
    Gestational period plays critical role in neuropsychological development. One of the genes that undergoes changes by prenatal stress (PNS) exposure, is the gene coding brain derived neurotrophic factor (BDNF). Studies have reported different patterns of change following PNS in BDNF, which emphasizes the complexity of the issue. In this review, systematic search of PubMed, Scopus, Web of Science and Cochrane CENTRAL databases was performed. Primary searches resulted in 2132 studies and finally 43 studies were found to meet the inclusion criteria. Transcriptional and epigenetic changes of BDNF gene in the brain were recorded. Decreased or unchanged BDNF total mRNA and BDNF mature protein, with hypermethylation of the coding exons were the most reported changes. However, stress paradigm, gender of the fetus and the day of sacrifice were found to significantly affect the results. Hippocampus and prefrontal cortex are the most vulnerable regions. They can show long lasting and persistent transcriptional and epigenetics changes of BDNF gene following PNS. Further studies evaluating the importance of these findings in humans are essential.
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