Maternal and pediatric health and disease: integrating biopsychosocial models and epigenetics

摘要: The concepts of allostasis (stability through adaptation) and accumulated life stress (McEwen's allostatic load) aim to understand childhood adult outcomes. Chronic malnutrition, changes in social condition, adverse early-life experiences may program phenotypes contribute long-lasting disease risk. However, integration course approaches, economic contexts, comparison among different biopsychosocial models has not generally been explored. This review critically examines the literature evaluates recent insights into how environmental can alter lifelong hypothalamic-pituitary-adrenal axis immune system responsiveness induce metabolic neurodevelopmental maladaptation. Models overlap but consider conditions. Concepts include allostasis, which incorporates hormonal responses predictable changes, Geronimus's "weathering," aims explain socially structured, repeated accumulate increase vulnerability. Weathering emphasizes roles internalized/interpersonal racism outcomes disparities. For Mexican immigrants Americans, "acculturation" framework proven especially useful explore disparities, including preterm birth neuropsychiatric risks childhood. Complexities assessments research epigenetic mechanisms mediating effects physical, nutritional, psychological, are reviewed.