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原标题：孕妇产前心理困扰对婴儿中期肠道免疫功能的影响
背景：母亲产前心理问题会增加儿童过敏性疾病的风险。这可能是通过宿主免疫的途径，涉及肠道分泌免疫球蛋白a（sIgA）。实验动物模型显示，直接或产前母体应激时，肠道微生物组和后代免疫力会发生变化，但这在人类中知之甚少。
方法：研究加拿大健康婴儿纵向发展（CHILD）出生队列的1043个足月婴儿。孕妇感知到压力和抑郁的情况基于怀孕和产后给予的评分量表。用ELISA测定婴儿粪便（平均3.7个月）中sIgA的含量。采用线性和logistic回归检验关联性。
结果：在产前和持续抑郁的母亲中，婴儿粪便中的sIgA浓度非常低（6%女性和2%女性）。 与粪便取样时的母乳喂养状况、婴儿抗生素暴露或其他协变量无关，孕妇产前抑郁症状与婴儿平均sIgA浓度降低（β=-0.07，p<0.01）相关。sIgA的降低会对较大的婴儿（4至8个月）产生很大的影响—无论是否母乳喂养。没有发现婴儿sIgA降低与产后抑郁症状（7%女性）或任何可察觉的压力情况相关。
结论：婴儿粪便中的sIgA浓度与母乳喂养状况无关。尽管孕妇产后情绪会有所改善，但有产前抑郁症状母亲所生下的孩子的粪便sIgA浓度较低，尤其是在大龄婴儿阶段。婴儿粪便中sIgA浓度降低意味着微生物与sIgA的相互作用发生了改变，增加了艰难梭菌定植的风险，并可能在以后的几年里引起过敏性疾病。


延伸阅读
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. 
　　创建过敏性疾病的科研、科普知识交流平台，为过敏患者提供专业诊断、治疗、预防的共享平台。