产前产妇压力和长期神经发育结果:叙述回顾。

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Dimitris Baroutis, Ioanna Myrto Sotiropoulou, Rafail Mantzioros, Marianna Theodora, George Daskalakis, Panagiotis Antsaklis
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引用次数: 0

摘要

妊娠期间的母亲压力越来越被认为是影响胎儿发育的一个重要因素,对后代的神经发育结果有潜在的长期影响。了解产前应激暴露的机制和影响对围产期护理的预防和干预策略至关重要。内容:这篇综述综合了流行病学、神经生物学和临床研究对产前产妇压力的长期影响的研究结果。它探索了广泛的压力源——包括心理困扰、抑郁、焦虑和急性创伤事件,如自然灾害——以及它们与后代从婴儿期到青春期的认知、行为和情感结果的关系。讨论了关键的生物学机制,包括母体-胎盘-胎儿轴的改变,HPA轴失调,胎盘基因表达改变,表观遗传修饰和神经炎症反应。神经影像学和生物标志物研究被强调为大脑结构和功能的压力相关变化提供证据。总结:目前的文献支持怀孕期间母亲压力与儿童神经发育挑战风险增加之间的密切联系。这些包括执行功能缺陷、焦虑和抑郁症状增加、情绪失调以及对精神疾病的易感性。这种影响似乎被暴露的时间、遗传倾向和出生后的环境所缓和。展望:虽然证据基础不断增长,但方法上的局限性,如压力评估的可变性和不一致的随访时间仍然存在。未来的研究应强调纵向的、生物标志物知情的设计和评估旨在减少产前压力的干预措施。将孕产妇心理健康支持纳入常规产前护理可能为改善孕产妇和儿童结局提供一条有希望的途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prenatal maternal stress and long-term neurodevelopmental outcomes: a narrative review.

Introduction: Maternal stress during pregnancy has been increasingly recognized as a significant factor influencing fetal development, with potential long-term effects on neurodevelopmental outcomes in offspring. Understanding the mechanisms and implications of prenatal stress exposure is crucial for informing preventative and interventional strategies in perinatal care.

Content: This narrative review synthesizes findings from epidemiological, neurobiological, and clinical research on the long-term consequences of prenatal maternal stress. It explores a broad spectrum of stressors - including psychological distress, depression, anxiety, and acute traumatic events such as natural disasters - and their associations with cognitive, behavioral, and emotional outcomes in offspring from infancy through adolescence. Key biological mechanisms are discussed, including alterations in the maternal-placental-fetal axis, HPA axis dysregulation, placental gene expression changes, epigenetic modifications, and neuroinflammatory responses. Neuroimaging and biomarker studies are highlighted to provide evidence for stress-related changes in brain structure and function.

Summary: Current literature supports a robust association between maternal stress during pregnancy and a heightened risk of neurodevelopmental challenges in children. These include deficits in executive function, increased anxiety and depressive symptoms, emotional dysregulation, and susceptibility to psychiatric disorders. The effects appear to be moderated by timing of exposure, genetic predispositions, and the postnatal environment.

Outlook: While the evidence base is growing, methodological limitations such as variability in stress assessment and inconsistent follow-up durations persist. Future research should emphasize longitudinal, biomarker-informed designs and evaluate interventions aimed at reducing prenatal stress. Integrating maternal mental health support into routine prenatal care may offer a promising pathway to improving both maternal and child outcomes.

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来源期刊
Journal of Perinatal Medicine
Journal of Perinatal Medicine 医学-妇产科学
CiteScore
4.40
自引率
8.30%
发文量
183
审稿时长
4-8 weeks
期刊介绍: The Journal of Perinatal Medicine (JPM) is a truly international forum covering the entire field of perinatal medicine. It is an essential news source for all those obstetricians, neonatologists, perinatologists and allied health professionals who wish to keep abreast of progress in perinatal and related research. Ahead-of-print publishing ensures fastest possible knowledge transfer. The Journal provides statements on themes of topical interest as well as information and different views on controversial topics. It also informs about the academic, organisational and political aims and objectives of the World Association of Perinatal Medicine.
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