Fetal Body Composition and Organ Volume Trajectories in Association With Maternal Perceived Stress or Depressive Symptoms in the Fetal 3D Study.

IF 2.1 4区 医学 Q2 ACOUSTICS
Alexandra Jean-Louis, Jessica L Gleason, Zhen Chen, Kathryn A Wagner, William A Grobman, Roger B Newman, Wesley Lee, Robert Gore-Langton, Seth Sherman, John Owen, Deborah A Wing, Daniel W Skupski, Jagteshwar Grewal, Katherine L Grantz
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Abstract

Objectives: Evaluate associations between maternal perceived stress and depressive symptoms, and fetal body composition and organ volumes.

Methods: In the NICHD Fetal 3D Study (2015-2019; n = 2457), stress and depressive symptoms were assessed at enrollment (10-13 weeks). High stress was defined as a Perceived Stress Scale (PSS) score ≥15 and high depressive symptoms, defined as an Edinburgh Postnatal Depression Scale (EPDS) score ≥10. Fetal body composition and organ volumes (cerebellar, lung, liver, and kidney) were measured up to five times between 15 and 40 weeks using three-dimensional (3D) ultrasound technology. Trajectories of body composition and organ volumes across pregnancy by high versus low PSS and EPDS were created using linear mixed models. Overall and weekly differences were compared after adjusting for covariates.

Results: Six hundred (24.4%) women scored ≥15 on the PSS, and 334 (13.6%) scored ≥10 on the EPDS. Fetuses whose mothers had PSS ≥15 had 0.4-0.9 cm3 smaller fractional fat arm volumes between 33 and 37 weeks, 0.2-0.5 cm3 larger fractional fat thigh volumes between 26 and 29 weeks, 4.0-8.0 cm3 larger average lung volumes between 33 and 37 weeks, and 1.0 cm3 smaller liver volumes between 19 and 21 weeks; and for EPDS ≥10, fetuses had 2.0-3.0 cm3 larger cerebellar volumes between 35 and 38 weeks. Findings were statistically significant (P < .05) and similarly robust in sensitivity analyses.

Conclusions: Greater maternal perceived stress and depressive symptoms early in pregnancy were associated with up to an 8.0 cm3 difference in fetal limb adiposity and organ volume growth. While health implications are unclear, our findings support current clinical practice guidelines for prenatal mental health screening.

胎儿3D研究中胎儿身体组成和器官体积轨迹与母亲感知压力或抑郁症状相关
目的:评估母亲感知压力与抑郁症状、胎儿身体组成和器官体积之间的关系。方法:NICHD胎儿3D研究(2015-2019);N = 2457),入组时(10-13周)评估压力和抑郁症状。高压力定义为感知压力量表(PSS)得分≥15分,高抑郁症状定义为爱丁堡产后抑郁量表(EPDS)得分≥10分。在15至40周期间,使用三维(3D)超声技术测量胎儿身体组成和器官体积(小脑、肺、肝和肾)多达5次。使用线性混合模型创建高与低PSS和EPDS在妊娠期间的身体组成和器官体积轨迹。调整协变量后比较总体差异和周差异。结果:600名(24.4%)女性PSS评分≥15分,334名(13.6%)女性EPDS评分≥10分。母亲PSS≥15的胎儿在33 ~ 37周的脂肪臂分数体积小0.4 ~ 0.9 cm3,在26 ~ 29周的脂肪大腿分数体积大0.2 ~ 0.5 cm3,在33 ~ 37周的平均肺体积大4.0 ~ 8.0 cm3,在19 ~ 21周的肝脏体积小1.0 cm3;EPDS≥10时,35 ~ 38周胎儿小脑体积增大2.0 ~ 3.0 cm3。结论:孕妇在妊娠早期感受到的压力和抑郁症状与胎儿肢体脂肪和器官体积生长的差异高达8.0 cm3相关。虽然健康影响尚不清楚,但我们的研究结果支持目前产前心理健康筛查的临床实践指南。
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来源期刊
CiteScore
5.10
自引率
4.30%
发文量
205
审稿时长
1.5 months
期刊介绍: The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound
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