邻苯二甲酸酯暴露与围产期抑郁发生风险关系的研究进展

Advances on relationship between phthalate exposure and perinatal depression

  • 摘要: 围产期抑郁是一种发生于妊娠期及产后一年内的心理疾病,会严重影响孕产妇的身心健康,导致后代的认知及行为发育不全,产生潜在的多代效应,因此确定其潜在的可变风险因素至关重要。邻苯二甲酸酯(PAEs)作为常见的环境内分泌干扰物,可以通过多种机制影响孕产妇雌激素变化,是孕产妇抑郁发生风险的重要潜在可变危险因素。目前,关于PAEs与围产期抑郁的相关性研究仍十分有限,PAEs影响围产期抑郁的机制尚未明确。基于国内外现有的流行病学和毒理学研究,本文简要介绍了孕产妇PAEs暴露存在多途径、高剂量、长期暴露的特点,重点回顾了当前流行病学研究现状,指出部分特定PAEs种类与围产期抑郁发生风险增加可能存在的关联,并总结归纳了激素−神经递质通路、炎症介导、基因调控等可能是PAEs暴露与围产期抑郁发生风险之间的潜在生物学机制。最后对未来如何科学有效地开展探索PAEs暴露与孕产妇围产期抑郁风险的关联性研究提出了展望,以期为科学预防孕产妇抑郁症状的发生与发展提供更多高质量证据。

     

    Abstract: Perinatal depression is a psychological disorder that occurs during pregnancy and within one year of delivery, which can seriously affect the physical and mental health of pregnant and postpartum women, as well as the cognitive and behavioral abilities of offspring, with potential multigenerational effects. Therefore, it is important to identify its potential modifiable risk factors. Phthalic acid esters (PAEs), as common environmental endocrine disruptors, can affect maternal estrogen through multiple mechanisms and are important potential modifiable risk factors for developing maternal perinatal depression. At present, studies on the correlation between PAEs and perinatal depression are still very limited, and the mechanisms by which PAEs affect perinatal depression have not been clarified. Based on existing epidemiological and toxicological studies at home and abroad, the article briefly introduced the characteristics of multiple pathways, high doses, and long-term exposure to maternal PAEs, focused on reviewing the current status of epidemiological studies, pointed out the possible associations between some specific PAEs exposure and elevated risk of perinatal depression. It also summarized the potential roles of hormone-neurotransmitter pathway, inflammation mediation, gene regulation, and other possible mechanisms in the association between exposure to PAEs and perinatal depression. The article concluded with a look at how future research on the association between exposure to PAEs and perinatal depression can be scientifically validated, with a view to providing more high-quality evidence for the scientific prevention of the onset and progression of maternal depressive symptoms.

     

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