A longitudinal investigation of the influence of psychological factors on nausea and vomiting in early pregnancy
A longitudinal investigation of the influence of psychological factors on nausea and vomiting in early pregnancy
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心理因素对妊娠早期恶心呕吐影响的纵向调查
DOI：
10.1007/s00737-022-01262-4
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Hideya Kodama
中科院分区：
文献类型：
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作者：
Kanako Taguchi ;Hitomi Shinohara;Hideya Kodama
本研究的目的是阐明心理因素，可能会影响恶心和呕吐在怀孕期间（NVP）的进展，在早孕的基础上纵向观察。59例孕妇于孕7-9周和孕11-13周间隔4周完成罗兹恶心、呕吐和干呕指数（RINVR）和一般健康问卷（GHQ-28），用光电容积描记仪记录静息心率5 min，测定心率变异性（HRV）指标。根据两个测量点是否存在重度NVP（RINVR ≥ 9分），比较7-9周时的GHQ-28评分（总分和亚类）和HRV指数。在7-9周时没有严重NVP的女性中，在11-13周时发生严重NVP的女性在GHQ-28亚类中的焦虑/失眠水平显著较高（p = 0.018）。从7-9周的焦虑/失眠到11-13周的RINVR的交叉滞后关系显着（β = 0.367，p < 0.001）。在7-9周时重度NVP的女性中，在11-13周时重度症状消退的女性具有显著较高的高频（HF）功率（p = 0.010），并且具有相对较高HF功率的女性表现出RINVR的显著降低（交互效应，p = 0.035）。在怀孕早期，有强烈焦虑/失眠症状的女性往往会出现NVP症状，随着怀孕的进展而变得更加严重。在4周内重度NVP消退的女性中，HF功率较高，表明情绪调节对NVP的早期改善有贡献。
The purpose of this study was to elucidate psychological factors that may influence nausea and vomiting during pregnancy (NVP) progression in early pregnancy based on longitudinal observations. Fifty-nine pregnant women completed the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) and General Health Questionnaire-28 (GHQ-28), and recorded their resting heart rate with photoplethysmography for 5 min to determine heart rate variability (HRV) indexes at 7–9 weeks and 11–13 weeks of gestation with a 4-week interval. GHQ-28 scores (total and subclasses) and HRV indexes at 7–9 weeks were compared among groups classified according to the presence of severe NVP (RINVR ≥ 9 points) at the two measurement points. Among women without severe NVP at 7–9 weeks, women who developed severe NVP at 11–13 weeks had significantly higher levels of anxiety/insomnia in the GHQ-28 subclasses (p = 0.018). The cross-lagged relationship from anxiety/insomnia at 7–9 weeks to RINVR at 11–13 weeks was significant (β = 0.367, p < 0.001). Among women with severe NVP at 7–9 weeks, women whose severe symptoms subsided at 11–13 weeks had significantly higher high-frequency (HF) power (p = 0.010), and women with relatively higher HF power demonstrated a significant reduction in RINVR (interaction effect, p = 0.035). During early pregnancy, women with strong anxiety/insomnia symptoms tend to have NVP symptoms that become more severe as the pregnancy progresses. The higher HF power in women whose severe NVP subsided within 4 weeks suggests a contribution of emotion regulation to early amelioration of NVP.