Maternal Stress, HPA Activity, and Fetal/Infant Outcomea

作者：Curt A. Sandman, Pathik D. Wadhwa, Aleksandra Chicz-DeMet, Christine Dunkel‐Schetter, Manuel Porto · 发表于：Annals of the New York Academy of Sciences · 年份：1997 · DOI：10.1111/j.1749-6632.1997.tb46162.x · 被引用次数：237 · 研究领域：Infant Development and Preterm Care、Maternal Mental Health During Pregnancy and Postpartum、Child and Adolescent Psychosocial and Emotional Development

Preliminary conclusions from our research include the possibility that each of the HPA products evaluated, even though correlated (e.g., ACTH and beta E), may be linked to unique and specific outcomes. Maternal stress during the 28-30 weeks of gestation is associated with birth outcome. Increased levels of psychosocial stress were significantly related to gestational age at birth and infant birth weight. Maternal stress during the third trimester was associated with increased maternal plasma levels of ACTH and cortisol. This finding is consistent with possible mechanisms whereby psychosocial stress influences birth outcome. CRH controls the timing of labor and delivery. Precocious elevation of CRH is related to the risk of preterm delivery. This system may be "stress-sensitive." Even though pregnant women may be immunized from stress, the stress signal that is transmitted (release of ACTH and cortisol) is amplified by the placental release of CRH. This possibility has at least two consequences: (1) influencing the timing of delivery and (2) desensitization of hypophyseal corticotrophs and further "protection" of the pregnant women from the results of stress (i.e., release of ACTH and beta E). Beta E appears to influence fetal learning and perhaps the developing nervous system.