Mechanisms & Effects of Prenatal Maternal Affect on Pregnancy & Infant Development

机制

• 批准号: 8457627
• 负责人: Mary E Coussons-Read
• 金额: $ 64.53万
• 依托单位: UNIVERSITY OF COLORADO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8457627
• 关键词: Accounting; Address; Affect; Affective; Altitude; Antibody Formation; Anxiety; Behavioral; Biological; Biological Markers; Birth; CRH gene; Caring; Clinical Management; Collaborations; Data; Data Set; Developed Countries; Development; Distress; Emotional; Event; Exhibits; Fetal Development; Future; Healthcare; Human; Hydrocortisone; Immune; Immunization; Immunologics; Infant; Infant Development; Infant Health; Infant Mortality; Inflammation; Inflammatory; Interleukin-6; Intervention; Intervention Studies; Investigation; Life; Life Stress; Los Angeles; Low Birth Weight Infant; Measures; Mediating; Mental Depression; Mental Health; Mood Disorders; Moods; Mothers; Outcome; Pathway interactions; Perinatal; Physiological; Pituitary-Adrenal System; Play; Population; Postpartum Period; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Prenatal care; Psychoneuroimmunology; Recruitment Activity; Research; Risk; Role; Sampling; Sea; Site; Stress; Symptoms; System; TNF gene; Testing; Translating; United States; Vitamin D; Woman; Work; biopsychosocial; care burden; clinical practice; depressive symptoms; experience; foot; infant outcome; neurobehavioral; postnatal; prenatal; prospective; psychologic; public health relevance; relating to nervous system; residence; response; secretory immune system; stressor

DESCRIPTION (provided by applicant): Despite improvements in prenatal care, the rate of poor pregnancy outcomes such as preterm birth (PTB; < 37 weeks gestation) and low birth weight (LBW) remains high in the United States. This project will provide important evidence concerning the relationships between antenatal maternal mood disorders, pregnancy-specific stress, and poor pregnancy outcomes, as well as what these relationships mean for infant immunologic and neurobehavioral development. The proposed research will test the hypothesis that prenatal maternal mood disorders (anxiety and/or depression) and symptoms increase the risk of poor pregnancy outcomes and compromise infant behavioral and immunological development in the first year of life, and that activation of the HPA axis and increased inflammatory activity in the perinatal period plays a significant role in these effects. Notably, although previous work has examined the role of "overall stress" (i.e., perceived stress, life events) in pregnancy and infant outcome the present study builds on the research team's prior work to assess the importance of emotional states specific to pregnancy (i.e., pregnancy-specific anxiety and distress) in the effects of mood on pregnancy and infant outcome. Completion of the proposed studies will advance the understanding of the psychoneuroimmunology of pregnancy and provide prospective evidence of the effects of prenatal maternal mood and pregnancy-specific stress on birth and infants' immunological and behavioral development in the first year of life. Moreover, the richness of the resulting dataset will allow us to conduct additional exploratory analyses to investigate (1) the role of vitamin D i the relationships under investigation, given growing evidence of its involvement in inflammation, mood disorders, and birth outcome; (2) if and how residence at moderate altitude (5280 feet above sea level) may play a role in these effects; and (3) how prenatal maternal biopsychosocial variables may impact maternal mood, stress, and neural-immune status in the postpartum. To summarize, this project will provide new data about how maternal mood translates into changes in infant health and pregnancy outcome, the physiological systems involved in these effects, and how emotional states of pregnancy play into these effects. These data will support care of pregnant women's mental health, and may ultimately help to reduce the occurrence of poor pregnancy and infant outcomes, especially in populations that are more likely to have higher-than-average levels of stress and mood symptoms.

描述（由申请人提供）：尽管产前护理有所改善，但在美国，妊娠结局的率（PTB; <37周）和低出生体重（LBW）在美国仍然很高。该项目将提供有关产前母体情绪障碍，妊娠特异性压力和妊娠结局不良的关系的重要证据，以及这些关系对婴儿免疫学和神经行为的意义。拟议的研究将检验以下假设：产前母体情绪障碍（焦虑和/或抑郁症）和症状增加了妊娠不良结局的风险，并损害了生命第一年的婴儿行为和免疫学发展，而HPA轴的激活以及HPA轴的激活在这些影响中起着重要作用。值得注意的是，尽管以前的工作已经研究了“总体压力”（即感知压力，生活事件）在怀孕和婴儿结果中的作用，但本研究基于研究团队的先前工作，以评估对怀孕对妊娠特定的情绪状态的重要性（即怀孕特定焦虑和困扰）在情绪对怀孕和婴儿结果的影响。拟议研究的完成将提高人们对怀孕心理免疫学的理解，并提供预期的证据，证明产前产妇的情绪和特定于妊娠的压力对出生和婴儿在生命的第一年的免疫学和行为发展的影响。此外，所得数据集的丰富性将使我们能够进行其他探索性分析，以调查（1）维生素D I所研究的关系的作用，鉴于越来越多的证据表明其参与炎症，情绪障碍和出生结果； （2）如果以及在中等高度（海平面上5280英尺）的住所如何在这些影响中起作用； （3）产前孕产妇生物心理社会变量如何影响产后的母体情绪，压力和神经免疫状态。总而言之，该项目将提供有关孕产妇情绪如何转化为婴儿健康和妊娠结局的变化，涉及这些作用的生理系统以及怀孕的情绪状态如何影响这些影响的新数据。这些数据将支持护理孕妇的心理健康，并最终可能有助于减少怀孕和婴儿预后不良的发生，尤其是在人群中更有可能具有高于平均水平的压力和情绪症状的人群中。