Physiological reactivity to acute stress during pregnancy

怀孕期间对急性应激的生理反应

基本信息

批准号：
7915341
负责人：
Lisa Michelle Christian
金额：
$ 22.1万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-15 至 2012-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7915341
关键词：
Acute Address African American Animals Anxiety Attenuated Australia Biological Assay Birth Rate Blood Pressure Blood Vessels Canada Cardiac Output Cardiovascular Physiology Cardiovascular system Catecholamines Caucasians Caucasoid Race Characteristics Chronic stress Developed Countries Discrimination Distress Employee Strikes Endocrine Europe Exhibits Family Fetal Development Fetus Genes Gestational Age Glucocorticoid Receptor Glucocorticoids Health Health Services Health behavior Hostility Human Hydrocortisone Immune Immune response Immune system Impedance Cardiography Infection Inflammation Inflammatory Inflammatory Response Investigation Knowledge Lead Length Link Literature Measurement Measures Mediating Methodology Minority Monitor Mothers Neurosecretory Systems Not Hispanic or Latino Outcome Participant Perinatal Peripheral Resistance Physiological Physiological Adaptation Pregnancy Pregnant Women Premature Birth Psychosocial Stress Race Reaction Receptor Signaling Recovery Reporting Research Risk Social support Socioeconomic Status Stress Treatment/Psychosocial Effects United States Vascular resistance Woman acute stress base biological adaptation to stress cost depressive symptoms design experience immune function novel prevent psychological stressor psychosocial public health relevance racial difference receptor function response stressor therapy design

项目摘要

DESCRIPTION (provided by applicant): Preterm delivery, an increasingly frequent occurrence in the United States, is associated with significant family burden and an estimated societal cost of at least $26 billion per year. In the U.S., the preterm birth rate is 12-13% as compared to 5-9% in other developed countries. Persistent racial disparities contribute to this discrepancy. Psychosocial stress and related physiological sequelae may contribute to preterm birth overall, as well as to racial disparities in preterm birth. The experience of chronic stress, such as that conferred by racial minority status, may sensitize physiological stress responses. Indeed, as compared to Caucasians, African-Americans exhibit greater cardiovascular reactivity to a variety of acute stressors. Importantly, blood pressure, glucocorticoid, and catecholamine responses to acute stress are attenuated during healthy pregnancy as compared to nonpregnancy. This adaptation may protect the mother and fetus from potentially detrimental effects of maternal physiological activation. Thus, women who exhibit greater and more extended physiological reactions to everyday stressors may be at increased risk for negative perinatal outcomes. Notably, no studies of acute stress during pregnancy have examined inflammatory immune responses or mechanisms underlying blood pressure change (i.e., cardiac output, total peripheral resistance). Moreover, limited information is available regarding effects of race on physiological adaptation to pregnancy. The current study will address important gaps in the literature by examining cardiovascular, endocrine, and immune reactivity to acute stress among 40 healthy pregnant women (20 Caucasian, 20 African-American) and 40 demographically matched nonpregnant control women. This research is designed to ultimately lead to the identification of women at greater risk for negative perinatal outcomes and elucidation of mechanisms underlying increased risk, providing a basis for individualized health care services. Specific Aim #1: To utilize more comprehensive and advanced methodology to assess physiological reactivity during pregnancy versus nonpregnancy, including measures of inflammation, impedance cardiography, and glucocorticoid receptor function. Hypothesis #1: Pregnant women will show attenuated physiological responses to acute stress as compared to nonpregnant women. Specific Aim #2: To examine racial differences in physiological reactivity during pregnancy versus nonpregnancy. Hypothesis #2: As compared to Caucasian women, African-American women will exhibit greater physiological reactivity to stress during pregnancy and nonpregnancy. Specific Aim #3: To examine psychosocial correlates of physiological reactivity during pregnancy and nonpregnancy. Hypothesis #3: Women reporting greater distress will exhibit greater physiological reactivity during pregnancy and nonpregnancy. Specific Aim #4: To examine associations between physiological reactivity and length of gestation. Hypothesis #4: Greater physiological reactivity to acute stress will predict shorter gestational length. PUBLIC HEALTH RELEVANCE: This study will fill important gaps in our knowledge regarding physiological adaption during pregnancy and effects of race on such adaptation. Information gained from this study will provide the groundwork for the following: 1) identification of women at greater risk of negative perinatal outcomes; 2) describing physiological mechanisms underlying the link between stress and risk of preterm delivery; and 3) providing interventions designed to reduce the effects of stress and promote healthy pregnancy and fetal development.

描述（由申请人提供）：早产在美国越来越常见，它给家庭带来沉重负担，估计每年至少造成 260 亿美元的社会成本。在美国，早产率为 12-13%，而其他发达国家为 5-9%。持续存在的种族差异导致了这种差异。心理社会压力和相关的生理后遗症可能导致整体早产，以及早产的种族差异。长期压力的经历，例如少数族裔身份所带来的压力，可能会使生理压力反应变得敏感。事实上，与白种人相比，非洲裔美国人对各种急性压力源表现出更强的心血管反应性。重要的是，与非怀孕期间相比，健康怀孕期间血压、糖皮质激素和儿茶酚胺对急性应激的反应会减弱。这种适应可以保护母亲和胎儿免受母体生理激活的潜在有害影响。因此，对日常压力源表现出更大、更持久的生理反应的女性可能面临更大的围产期不良后果的风险。值得注意的是，没有关于妊娠期间急性应激的研究检查炎症免疫反应或血压变化的机制（即心输出量、总外周阻力）。此外，关于种族对怀孕生理适应影响的信息有限。目前的研究将通过检查 40 名健康孕妇（20 名白种人、20 名非裔美国人）和 40 名人口统计匹配的非怀孕对照女性对急性应激的心血管、内分泌和免疫反应，来弥补文献中的重要空白。这项研究旨在最终识别出围产期不良结局风险较高的女性，并阐明风险增加的潜在机制，为个性化医疗保健服务提供基础。具体目标#1：利用更全面、更先进的方法来评估怀孕期间与非怀孕期间的生理反应，包括炎症、心阻抗图和糖皮质激素受体功能的测量。假设#1：与非孕妇相比，孕妇对急性应激的生理反应会减弱。具体目标#2：检查怀孕期间与非怀孕期间生理反应的种族差异。假设#2：与白人女性相比，非洲裔美国女性在怀孕和非怀孕期间对压力表现出更大的生理反应。具体目标#3：检查怀孕和非怀孕期间生理反应的社会心理相关性。假设#3：报告更大痛苦的女性在怀孕和非怀孕期间会表现出更大的生理反应。具体目标#4：检查生理反应性与妊娠时长之间的关联。假设#4：对急性应激的生理反应越大，妊娠长度就越短。公共卫生相关性：这项研究将填补我们在怀孕期间的生理适应以及种族对这种适应的影响方面的知识的重要空白。从这项研究中获得的信息将为以下工作奠定基础：1）确定围产期不良结果风险较大的女性； 2）描述压力与早产风险之间联系的生理机制； 3) 提供旨在减少压力影响并促进健康妊娠和胎儿发育的干预措施。