母体应激影响胎儿发育的胎盘机制研究进展
华天桢¹, 高灵通¹, 张治宇², 赵厚铭¹, 高路^1,3,4,*
1海军军医大学基础医学院生理学教研室，上海 200433；²海军军医大学长征医院健康管理中心，上海 200003；³上海市胚胎源性疾病重点实验室，上海 200030；⁴上海市辅助生殖和生殖遗传重点实验室，上海 200000
摘要
胎盘是维系母体与胎儿的唯一纽带，是母体维持正常妊娠进程和胎儿正常发育的基础。母体应激是多种因素导致的母体生理、心理变化，主要特征是升高的糖皮质激素影响下丘脑-垂体-靶腺轴，引发体内激素的分泌变化，并调节应激相关基因的表达，改变胎盘的重量、代谢、营养转运等，进而对胎儿发育造成影响。本文首先简介母体应激的表征及其对子代的影响，进而阐述应激状态下机体的相应变化，最后阐明研究已证实的母体应激影响胎儿发育的胎盘机制，并提出尚未得到深入研究的重要问题。研究母体应激对胎儿发育的影响及具体作用机制可为多种应激相关妊娠疾病的治疗提供理论基础。
关键词： 母体应激; 胎盘; 胎儿发育; 糖皮质激素; 下丘脑-垂体-靶腺轴
分类号：R339.2;R335;R339.3

Placental mechanisms underlying the effects of maternal stress on the fetal development
HUA Tian-Zhen¹, GAO Ling-Tong¹, ZHANG Zhi-Yu², ZHAO Hou-Ming¹, GAO Lu^1,3,4,*
1Department of Physiology, College of Basic Medical Sciences, Naval Medical University, Shanghai 200433, China；²Department of Health Management, Changzheng Hospital, Naval Medical University, Shanghai 200003, China；³Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China；⁴Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200000, China
Abstract
Placenta is the only link between the pregnant woman and fetus, and the basis for maintaining the normal pregnancy process and fetal development. Maternal stress is the maternal physiological and psychological changes caused by various factors, characterized by the increased level of glucocorticoid, which affects the hypothalamic-pituitary-target gland axis and regulates the expression of target genes. Maternal stress also changes the weight, metabolism and nutrient transportation of the placenta, which will substantially influence the development of fetus. This paper will firstly summarize the characteristics of maternal stress and its influence on offspring. Then, the changes in the body under maternal stress will be described. Finally, we will clarify the proven mechanisms underlying maternal stress and raise some important problems that have not been clarified in this area. The study of maternal stress on fetus and its underlying mechanisms will serve as theoretical basis for the diagnosis and treatment of the stress- related pregnant diseases and disorders.


Key words: maternal stress; placenta; fetal development; glucocorticoid; hypothalamic-pituitary-target gland axis

收稿日期：2020-09-26　　录用日期：2021-02-08
通讯作者：高路　　E-mail: roadgao@163.com
引用本文：
华天桢, 高灵通, 张治宇, 赵厚铭, 高路. 母体应激影响胎儿发育的胎盘机制研究进展[J]. 生理学报 2021; 73 (6): 991-998.
HUA Tian-Zhen, GAO Ling-Tong, ZHANG Zhi-Yu, ZHAO Hou-Ming, GAO Lu. Placental mechanisms underlying the effects of maternal stress on the fetal development. Acta Physiol Sin 2021; 73 (6): 991-998 (in Chinese with English abstract).



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