College of Medicine, Drexel University, Philadelphia, PA.
Department of Biology, Bucknell University, Lewisburg, Pennsylvania.
Am J Obstet Gynecol. 2016 Jul;215(1):94.e1-8. doi: 10.1016/j.ajog.2016.01.177. Epub 2016 Jan 30.
The developmental origin of the health and disease hypothesis is based on the premise that many chronic diseases have their roots in fetal development. Specifically, maternal stress during pregnancy is associated with altered fetal development and many adverse long-term health outcomes. Although the mechanisms underlying this effect are currently unclear, at the cellular level 1 possible mediator is the regulation of telomere length. Telomere dynamics appear to play a role in disease progression, and an adverse intrauterine environment may contribute in the establishment of short telomeres in newborns. In accordance with this, it was recently reported that prenatal stress is significantly associated with shorter mean newborn telomere length. However, this finding has yet to be replicated, and currently we know nothing about whether different size classes of telomeres within the telomere length distribution are differentially affected by prenatal stress. Examining telomere length frequency distributions is important, because the shortest telomeres in the distribution appear to be the most indicative of telomere dysfunction and thus the best predictors of mortality and morbidity in humans.
We investigated the effects of intrauterine exposure to maternal stress over the whole course of gestation on newborn mean telomere length and telomere length frequency distributions.
We conducted a prospective cohort study of 24 mother-newborn dyads at an urban teaching hospital. Pregnant women with nonanomalous, uncomplicated pregnancies were recruited and assessed in the third trimester of gestation. Maternal psychosocial stress was quantified using the Holmes and Rahe Stress Scale and categorized as high stress (≥300 points) or low stress (≤299 points) exposure. Newborn telomere length was measured from cord blood at delivery using the Telomere Restriction Fragment assay.
We found a significant negative association between maternal stress and newborn telomere length (β = -0.463, P = 0.04). Newborns whose mothers experienced a high level of stress during pregnancy had significantly shorter telomere length (6.98 ± 0.41 kb) compared to newborns of mothers with low stress (8.74 ± 0.24 kb; t = -3.99, P = .003). Moreover, the difference in newborn telomere length between high-stress and low-stress mothers was due to a shift in the telomere length distribution, with the high-stress group showing an underrepresentation of longer telomeres and an over-representation of shorter telomeres.
Our findings replicate those of other recent studies and also show, for the first time, that the prenatal stress-associated difference in newborn mean telomere length is due to a shift in the overall telomere distribution.
健康与疾病起源假说的理论基础是许多慢性疾病都源于胎儿发育阶段。具体而言,妊娠期间的母体压力会导致胎儿发育异常,并引发许多长期不良健康后果。虽然目前尚不清楚这种影响的发生机制,但在细胞层面上,端粒长度的调节可能是其中 1 个中介因素。端粒动力学似乎在疾病进展中发挥作用,宫内不良环境可能导致新生儿端粒变短。有鉴于此,最近有研究报告称,产前压力与新生儿端粒平均长度缩短显著相关。然而,这一发现尚未得到复制,目前我们尚不清楚在端粒长度分布内,不同大小类别的端粒是否会受到产前压力的不同影响。检查端粒长度的频率分布很重要,因为分布中最短的端粒似乎最能反映端粒功能障碍,因此是预测人类死亡率和发病率的最佳指标。
我们研究了妊娠全程子宫内暴露于母体压力对新生儿端粒平均长度和端粒长度频率分布的影响。
我们对一家城市教学医院的 24 对母婴进行了前瞻性队列研究。招募了无异常、无并发症妊娠的孕妇,并在妊娠晚期进行评估。采用 Holmes 和 Rahe 应激量表对孕妇的心理社会应激进行量化,并分为高应激(≥300 分)或低应激(≤299 分)暴露。分娩时从脐血中使用端粒限制片段分析测量新生儿端粒长度。
我们发现,母体应激与新生儿端粒长度呈显著负相关(β=-0.463,P=0.04)。与低应激母亲的新生儿相比,妊娠期间经历高应激的母亲的新生儿端粒长度明显更短(6.98±0.41 kb)(t=-3.99,P=0.003)。此外,高应激和低应激母亲的新生儿端粒长度差异是由于端粒长度分布的改变所致,高应激组较长端粒的数量减少,较短端粒的数量增加。
我们的研究结果与其他最近的研究结果一致,并且首次表明,与产前压力相关的新生儿端粒平均长度差异是由于整体端粒分布的改变所致。