母亲心理逆境与南非婴儿肺功能的关联：一项出生队列研究。
Association between maternal psychological adversity and lung function in South African infants: A birth cohort study.
机构信息
Department of Clinical Research (Neurosciences), KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Department of Psychiatry, University of Oxford, Oxford, England.
出版信息
Pediatr Pulmonol. 2020 Jan;55(1):236-244. doi: 10.1002/ppul.24532. Epub 2019 Sep 30.
OBJECTIVE
The association of perinatal psychological adversity (ie, stressors and distress) with infant lung function (ILF) and development is not well studied in Africa and elsewhere. We determined the association between maternal perinatal psychological adversity and ILF in African infants.
DESIGN
Prospective longitudinal follow up of the Drakenstein Child Health Study birth cohort.
PARTICIPANTS
Seven hundred and sixty-two infants aged 6 to 10 weeks and 485 infants who had data for both maternal perinatal psychological adversity and ILF (measured at 6 to 10 weeks and 12 months).
METHODS
The main analyses were based on cross-sectional measures of ILF at each assessment (6 to 10 weeks or 12 months), using generalized linear models, and then on the panel-data of both longitudinal ILF assessments, using generalised estimating equations, that allowed specification of the within-group correlation structure.
RESULTS
Prenatal intimate partner violence (IPV) exposure was associated with reduced respiratory resistance at 6 to 10 weeks (beta coefficient [β] = -.131, P = .023); postnatal IPV with reduced ratio of time to peak tidal expiratory flow over total expiratory time (t /t ) at 12 months (β = -.206, P = .016); and prenatal depression with lower respiratory rate at 6 to 10 weeks (β = -.044, P = .032) and at 12 months (β = -.053, P = .021). Longitudinal analysis found an association of prenatal IPV with reduced t /t (β = -.052, P < .0001); postnatal IPV with decreased functional residual capacity (FRC; β = -.086, P < .0001); prenatal posttraumatic stress disorder with increased FRC (β = .017, P < .0001); prenatal depression with increased FRC (β = .026, P < .0001) and postnatal depression with increased FRC (β = .021, P < .0001).
CONCLUSION
Screening for psychological adversity and understanding the mechanisms involved may help identify children at risk of altered lung development and inform approaches to treatment.
目的
围产期心理逆境（即压力源和痛苦）与婴儿肺功能（ILF）和发育之间的关系在非洲和其他地区尚未得到充分研究。我们确定了母亲围产期心理逆境与非洲婴儿 ILF 之间的关联。
设计
对 Drakenstein 儿童健康研究出生队列进行前瞻性纵向随访。
参与者
762 名 6 至 10 周龄婴儿和 485 名同时具有围产期母亲心理逆境和 ILF 数据的婴儿（分别在 6 至 10 周和 12 个月时测量）。
方法
主要分析基于每次评估时 ILF 的横断面测量（6 至 10 周或 12 个月），使用广义线性模型，然后使用纵向 ILF 评估的面板数据，使用广义估计方程，允许指定组内相关结构。
结果
产前亲密伴侣暴力（IPV）暴露与 6 至 10 周时呼吸阻力降低有关（β系数[β]=-0.131，P=0.023）；产后 IPV 与 12 个月时潮气流时间比（t / t ）缩短有关（β=-0.206，P=0.016）；产前抑郁与 6 至 10 周时呼吸频率降低有关（β=-0.044，P=0.032）和 12 个月时呼吸频率降低有关（β=-0.053，P=0.021）。纵向分析发现产前 IPV 与 t / t 降低有关（β=-0.052，P<0.0001）；产后 IPV 与功能残气量（FRC）降低有关（β=-0.086，P<0.0001）；产前创伤后应激障碍与 FRC 增加有关（β=0.017，P<0.0001）；产前抑郁与 FRC 增加有关（β=0.026，P<0.0001），产后抑郁与 FRC 增加有关（β=0.021，P<0.0001）。
结论
筛查心理逆境并了解相关机制可能有助于识别肺发育异常的儿童，并为治疗方法提供信息。
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