Долгосрочное влияние недоношенности на постнеонатальное становление нейрогормональной регуляции

Рассмотрены психофизиологические и нейроэндокринные отличия, свойственные недоношенным детям как результат отдаленных последствий перинатального периода. Основное внимание уделено эффектам гипоталамо-гипофизарно-адреналовой «стресс-системы», перепрограммирование работы которой происходит во время осложненной беременности, в родах и постнатально под действием болевого стресса от медицинских манипуляций. Крайне сенситивный ко всем этим воздействиям, мозг недоношенного малыша развивается в условиях активации стресс-системы и приобретает несколько отличные функциональные свойства, помимо самостоятельных нейроанатомических отличий вследствие преждевременных родов. Изменение нейрогуморальных паттернов, выявленное у родившихся глубоко недоношенными детей в детском и подростковом возрасте, затрагивает регуляцию психических процессов, поведения, метаболизм и циркадные ритмы (регуляция сна и бодрствования), которые отличаются от таковых у родившихся доношенных сверстников. Эти наблюдения позволяют рассматривать трудности обучения, поведения и более низкие когнитивные оценки у нормативно развивающихся глубоконедоношенных детей в комплексе гормональной дисрегуляции.

1. McMillen I.C., Schwartz J., Coulter C.L. et al. Early embryonic environment, the fetal pituitary-adrenal axis and the timing of parturition. Endocr Res 2004; 30: 4: 845–850.

2. Florio P., Zatelli M.C., Reis F.M. et al. Corticotropin releasing hormone: a diagnostic marker for behavioral and reproductive disorders? Front Biosci 2007; 12: 551–560.

3. Grunau R.E., Cepeda I.L., Chau C.M. еt al. Neonatal pain-related stress and NFKBIA genotype are associated with altered cortisol levels in preterm boys at school age. PLoS One 2013; 8: 9: e73926.

4. Ball G., Boardman J.P., Aljabar P. et al. The influence of preterm birth on the developing thalamocortical connectome. Cortex 2013; 49: 6: 1711–1721.

5. Quesada A.A., Tristão R.M., Pratesi R. et al. Hyper-responsiveness to acute stress, emotional problems and poorer memory in former preterm children. Stress 2014; 17: 5: 389–399.

6. Brummelte S., Chau C.M., Cepeda I.L. еt al. Cortisol levels in former preterm children at school age are predicted by neonatal procedural pain-related stress. Psychoneuroendocrin 2015; 51: 151–163.

7. Ranger M., Synnes A.R., Vinall J. et al. Internalizing behaviours in school-age children born very preterm are predicted by neonatal pain and morphine exposure. Eur J Pain 2014; 18: 6: 844–852.

8. Vinall J., Grunau R.E. Impact of repeated procedural painrelated stress in infants born very preterm. Pediatr Res 2014; 75: 5: 584–587.

9. Wingenfeld K., Wolf O.T. Effects of cortisol on cognition in major depressive disorder, posttraumatic stress disorder and borderline personality disorder – 2014 Curt Richter Award Winner. Psychoneuroendocrin 2015; 51: 282–295.

10. Goldberg S., Carter C., Lojkasek M. et al. Prediction of behavior problems in four-year-olds born prematurely. Annual Progress in Child Psychiatry and Child Development 1991; 92–113.

11. Perkinson-Gloor N., Hagmann-von Arx P., Brand S. et al. The role of sleep and the hypothalamic-pituitary-adrenal axis for behavioral and emotional problems in very preterm children during middle childhood. J Psychiatr Res 2015; 60: 141–147.

12. Wolbeek M., de Sonneville L.M., de Vries W.B. еt al. Early life intervention with glucocorticoids has negative effects on motor development and neuropsychological function in 14–17 yearold adolescents. Psychoneuroendocrin 2013; 38: 7: 975–986.

13. Van Wassenaer A.G., Kok J.H. Trials with thyroid hormone in preterm infants: clinical and neurodevelopmental effects. Semin Perinatol 2008; 32: 6: 423-430.

14. Thompson D.K., Warfield S.K., Carlin J.B. et al. Perinatal risk factors altering regional brain structure in the preterm infant. Brain 2007; 130: 3: 667–677.

15. Haldipur P., Bharti U., Alberti C. et al. Preterm delivery disrupts the developmental program of the cerebellum. PLoS One 2011; 6: 8: e23449.

16. Van Braeckel K.N., Taylor H.G. Visuospatial and visuomotor deficits in preterm children: the involvement of cerebellar dysfunctioning. Dev Med Child Neurol 2013; 55: 4: 19–22.

17. Keunen K., Kersbergen K.J., Groenendaal F. et al. Brain tissue volumes in preterm infants: prematurity, perinatal risk factors and neurodevelopmental outcome: a systematic review. J Matern Fetal Neonatal Med 2012; 25: 1: 89–100.

18. Ball G., Pazderova L., Chew A. et al. Thalamocortical Connectivity Predicts Cognition in Children Born Preterm. Cereb Cortex 2015: http://www.ncbi.nlm.nih.gov/ pubmed/25596587.

19. Woodward L.J., Moor S., Hood K.M. et al. Very preterm children show impairments across multiple neurodevelopmental domains by age 4 years. Arch Dis Child Fetal Neonatal Ed 2009; 94: F339–344.

20. Soleimani F., Zaheri F., Abdi F. Long-term neurodevelopmental outcomes after preterm birth. Iran Red Crescent Med J 2014; 16: 6: e17965.

21. Aanes S., Bjuland K.J., Skranes J. et al. Memory function and hippocampal volumes in preterm born very-low-birth-weight (VLBW) young adults. Neuroimage 2015; 105: 76–83.

22. Hatzinger M., Brand S., Perren S. et al. Electroencephalographic sleep profiles and hypothalamic-pituitary-adrenocortical (HPA)-activity in kindergarten children: early indication of poor sleep quality associated with increased cortisol secretion. J Psychiatr Res 2008; 42: 7: 532–543.

23. Karimzadeh P. Psycho-cognitive behavioral problems in sleep disordered children. Neural Regen Res 2012; 7: 8: 635–639.

24. Lemola S., Perkinson-Gloor N., Hagmann-von Arx P. et al. Morning cortisol secretion in school-age children is related to the sleep pattern of the preceding night. Psychoneuroendocrinology 2015; 52: 297–301.

25. Hagmann-von Arx P., Perkinson-Gloor N., Brand S. et al. In school-age children who were born very preterm sleep efficiency is associated with cognitive function. Neuropsychobiol 2014; 70: 4: 244–252.

26. Miller G.E., Chen E., Parker K.J. Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a model of behavioral and biological mechanisms. Psychol Bull 2011; 137: 959–997.

27. Dougherty L.R., Smith V.C., Olino T.M. et al. Maternal psychopathology and early child temperament predict young children’s salivary cortisol 3 years later. J Abnormal Child Psych 2013; 41: 4: 531–542.