原標(biāo)題：孕婦產(chǎn)前心理困擾對(duì)嬰兒中期腸道免疫功能的影響
背景：母親產(chǎn)前心理問題會(huì)增加兒童過敏性疾病的風(fēng)險(xiǎn)。這可能是通過宿主免疫的途徑，涉及腸道分泌免疫球蛋白a（sIgA）。實(shí)驗(yàn)動(dòng)物模型顯示，直接或產(chǎn)前母體應(yīng)激時(shí)，腸道微生物組和后代免疫力會(huì)發(fā)生變化，但這在人類中知之甚少。
方法：研究加拿大健康嬰兒縱向發(fā)展（CHILD）出生隊(duì)列的1043個(gè)足月嬰兒。孕婦感知到壓力和抑郁的情況基于懷孕和產(chǎn)后給予的評(píng)分量表。用ELISA測定嬰兒糞便（平均3.7個(gè)月）中sIgA的含量。采用線性和logistic回歸檢驗(yàn)關(guān)聯(lián)性。
結(jié)果：在產(chǎn)前和持續(xù)抑郁的母親中，嬰兒糞便中的sIgA濃度非常低（6%女性和2%女性）。 與糞便取樣時(shí)的母乳喂養(yǎng)狀況、嬰兒抗生素暴露或其他協(xié)變量無關(guān)，孕婦產(chǎn)前抑郁癥狀與嬰兒平均sIgA濃度降低（β=-0.07，p<0.01）相關(guān)。sIgA的降低會(huì)對(duì)較大的嬰兒（4至8個(gè)月）產(chǎn)生很大的影響—無論是否母乳喂養(yǎng)。沒有發(fā)現(xiàn)嬰兒sIgA降低與產(chǎn)后抑郁癥狀（7%女性）或任何可察覺的壓力情況相關(guān)。
結(jié)論：嬰兒糞便中的sIgA濃度與母乳喂養(yǎng)狀況無關(guān)。盡管孕婦產(chǎn)后情緒會(huì)有所改善，但有產(chǎn)前抑郁癥狀母親所生下的孩子的糞便sIgA濃度較低，尤其是在大齡嬰兒階段。嬰兒糞便中sIgA濃度降低意味著微生物與sIgA的相互作用發(fā)生了改變，增加了艱難梭菌定植的風(fēng)險(xiǎn)，并可能在以后的幾年里引起過敏性疾病。


延伸閱讀
Clinical & Experimental Allergy
Maternal psychological distress before birth influences gut immunity in mid-infancy
DOI: 10.1111/CEA.13551
Abstract:
Background: Maternal pre-postnatal psychosocial distress increases the risk for childhood allergic disease. This may occur through a host immunity pathway that involves intestinal secretory Immuno-globulin A(sIgA). Experimental animal models show changes in the gut microbiome and immunity of offspring when exposed to direct or prenatal maternal stress, but little is known in humans.
Methods: 1043 term infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort were studied. Trajectories of maternal perceived stress and depression were based on scored-scales administered in pregnancy and postpartum. sIgA was quantified in infant stool (mean age 3.7 months) with Immundiagnostik ELISA. Linear and logistic regression were employed to test associations.
Results: Very low fecal sIgA concentrations were more common in infants of mothers in the antepartum and persistent depression trajectories (6% and 2% of women respectively). Independent of breastfeeding status at fecal sampling, infant antibiotic exposure or other covariates, the antepartum depressive symptom trajectory was associated with reduced mean infant sIgA concentrations (β= -0.07, p<0.01) and a 2-fold risk for lowest quartile concentrations (OR, 1.86; 95% CI: 1.02, 3.40). This lowering of sIgA yielded a large effect size in older infants (4-8 months) – breastfed and not. No associations were seen with postpartum depressive symptoms (7% of women) or with any of the perceived stress trajectories.
Conclusions: Despite improved mood postpartum and independent of breastfeeding status, mothers experiencing antepartum depressive symptoms delivered offspring who exhibited lower fecal sIgA concentrations especially in later infancy. The implications of lowered sIgA concentrations in infant stool are altered microbe-sIgA interactions, greater risk for C. difficile colonization and atopic disease in later years. 
　　創(chuàng)建過敏性疾病的科研、科普知識(shí)交流平臺(tái)，為過敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺(tái)。