在低收入城市家庭，母亲的压力和抑郁、2型反应，以及3岁儿童反复喘息之间的关系
2016/11/09
摘要
理论基础:母亲抑郁症、产前和早期生活压力可能会通过对免疫系统的潜在影响而导致儿童喘息疾病的发生。
目的:为了检验这一假设：妊娠和早期生命阶段母亲的压力和/或抑郁与儿童三岁时反复喘息和吸入性过敏原的敏感性，以及从刺激外周血单核细胞（PBMCs）改变细胞因子反应性（增强2型或减少病毒诱导的细胞因子反应）之间的相关关系。
方法：城市环境与儿童哮喘（URECA）是四个城市哮喘高危的出生队列研究（N = 560）。母亲的压力、抑郁和儿童喘息发作通过出生时就开始的季度问卷调查进行评估。用逻辑和线性回归分析技术研究母亲压力/抑郁与儿童三岁时反复喘息和PBMC细胞因子的反应性之间的关系。
测量与主要结果:总体而言，166（36%）名儿童在3岁时出现反复喘息。第2年和第3年母亲的压力与复发性喘息呈正相关（P＜0.05）。母亲抑郁症（任何一年）与反复喘息显著相关（P≤0.01）。这些相关性在累计压力和抑郁的纵向分析中也十分显著（P≤0.02）。压力或抑郁都不与吸入性变应原致敏或抗病毒反应相关。与我们最初的假设相反，产前和产后1年的压力和抑郁与部分2型细胞因子的反应呈现显著的负相关。
结论:在哮喘高危的城市儿童中，母亲的压力与抑郁与反复喘息显著相关，但没有增加过敏或减少抗病毒反应。
（苏欣 审校）
Am J Respir Crit Care Med. 2016 Sep 21. [Epub ahead of print]
Relationships Among Maternal Stress and Depression, Type 2 Responses, and Recurrent Wheezing at Age 3 Years in Low Income Urban Families.
Ramratnam SK1, Visness CM2, Jaffee KF Ms3, Bloomberg GR4, Kattan M5, Sandel MT Md6, Wood RA Md7, Gern JE8, Wright RJ9.
Author information
Abstract
RATIONALE:Maternal depression and prenatal and early life stress may influence childhood wheezing illnesses, potentially through effects on immune development.
OBJECTIVE:To test the hypothesis that maternal stress and/or depression during pregnancy and early life are associated with recurrent wheezing and aeroallergen sensitivity and altered cytokine responses (enhanced type-2 or reduced virus-induced cytokine responses) from stimulated peripheral blood mononuclear cells (PBMCs) at age three years.
METHODS:The Urban Environment and Childhood Asthma (URECA) is a birth cohort at high risk for asthma (n=560) in four inner cities. Maternal stress, depression, and childhood wheezing episodes were assessed by quarterly questionnaires beginning at birth. Logistic and linear regression techniques were used to examine the relation of maternal stress/depression to recurrent wheezing and PBMC cytokine responses at age 3 years.
MEASUREMENTS AND MAIN RESULTS:Overall, 166 (36%) children had recurrent wheeze at age 3. Measures of maternal perceived stress at years 2 and 3 were positively associated with recurrent wheeze (P<0.05). Maternal depression (any year) was significantly associated with recurrent wheezing (P≤0.01). These associations were also significant when considered in a longitudinal analysis of cumulative stress and depression (P≤0.02). Neither stress nor depression were significantly related to aeroallergen sensitization or antiviral responses. Contrary to our original hypothesis, prenatal and year 1 stress and depression had significant inverse associations with several type 2 cytokine responses.
CONCLUSIONS:In urban children at high risk for asthma, maternal perceived stress and depression were significantly associated with recurrent wheezing, but not increased atopy or reduced antiviral responses.
KEYWORDS:Cytokines; Depression; Psychological stress; URECA; recurrent wheezing
Am J Respir Crit Care Med. 2016 Sep 21. [Epub ahead of print]
