RESUMO
Maternal exposure to stress or adversity during pregnancy has been associated with negative health effects for the offspring including psychiatric symptoms. Programming of the hypothalamic-pituitary-adrenal (HPA) axis has been suggested as one mediating process. In order to investigate possible long term effects of stressors during pregnancy, we followed 70 children and their mothers from pregnancy up to nine years aiming to investigate if maternal cortisol levels and distress/exposure to partner violence were associated with child psychiatric symptoms and child cortisol levels at follow-up. Maternal distress was evaluated using The Self Reporting Questionnaire, exposure to partner violence by an instrument from WHO and child psychiatric symptoms with Child Behavior Checklist (CBCL). We adjusted the analyses for gestational week, gender, SES, perinatal data and maternal distress/exposure to partner violence at child age of nine years. Elevated maternal cortisol levels during pregnancy, as a possible marker of maternal stress load, were correlated with higher CBCL-ratings, especially concerning externalizing symptoms. Maternal cortisol levels during pregnancy were not associated with child cortisol levels at child age of nine years. Maternal distress and exposure to partner violence during pregnancy were neither associated with child psychiatric symptoms nor child cortisol levels. To conclude, intrauterine exposure to elevated cortisol levels was associated with higher ratings on offspring psychopathology at nine years of age. The lack of association between maternal cortisol levels during pregnancy and child cortisol levels does not support the hypothesis of fetal programming of the HPA-axis, but reliability problems may have contributed to this negative finding.
Assuntos
Hidrocortisona/metabolismo , Transtornos Mentais/epidemiologia , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/metabolismo , Estresse Psicológico/epidemiologia , Estresse Psicológico/metabolismo , Adulto , Criança , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/metabolismo , Nicarágua/epidemiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Estudos Prospectivos , Análise de Regressão , Saliva/metabolismo , Fatores Socioeconômicos , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto JovemRESUMO
La epidemia de obesidad, con un marcado incremento de su prevalencia en embarazadas, constituye un problema crítico de salud pública en el mundo. Los factores de riesgo relacionados con la obesidad son múltiples, entre ellos, el bajo peso al nacer, ocasionado por las condiciones adversas de la vida intrauterina, lo que influye posteriormente en la aparición de la obesidad. Tales evidencias pueden ser explicadas a través de la teoría de la programación fetal como mecanismo de producción de obesidad en la vida extrauterina, lo que conformó el tema abordado en el presente trabajo.
The epidemic of obesity, with a marked increase of its prevalence in pregnant women, constitutes a critical problem for public health in the world. The risk factors related to obesity are multiple, among them, low birth weight, caused by the adverse conditions of the intra-uterine life, what later influences on the emergence of obesity. Such evidences can be explained through the theory of the fetal programming as mechanism for causing obesity in the extrauterine life, what constituted the topic discussed in this work.