Hjollund N H, Jensen T K, Bonde J P, Henriksen T B, Andersson A M, Kolstad H A, Ernst E, Giwercman A, Skakkebaek N E, Olsen J
Department of Occupational Medicine, Aarhus University Hospital, Denmark.
Fertil Steril. 1999 Jul;72(1):47-53. doi: 10.1016/s0015-0282(99)00186-7.
To assess the effect of psychological distress on time to first pregnancy.
A follow-up study of time to pregnancy with prospective data on distress, with controlling for potential confounding variables.
Two university hospitals.
PATIENT(S): Danish couples (n = 430) who were planning their first pregnancy and had no previous reproductive experience were followed for six menstrual cycles. Psychological distress was measured in each menstrual cycle by the General Health Questionnaire.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): A clinically recognized pregnancy or a biochemical pregnancy detected in urine samples from each period of vaginal bleeding.
RESULT(S): For cycles with the highest distress score (General Health Questionnaire score >80th percentile), the probability of conception per cycle was 12.8%, compared with 16.5% in other cycles (adjusted odds ratio [OR] 0.6; 95% confidence interval [CI] 0.4-1.0). The effect of distress was found almost exclusively among women with long menstrual cycles (OR 0.1; 95% CI 0.01-0.4 and OR 0.9; 95% CI 0.5-1.4 for women with cycles of > or =35 and <35 days, respectively). An increased incidence of early embryonal loss was also found among highly distressed women with long cycles, but was based on a small number of observations.
CONCLUSION(S): Psychological distress may be a risk factor for reduced fertility in women with long menstrual cycles.
评估心理困扰对首次怀孕时间的影响。
一项关于怀孕时间的随访研究，收集有关困扰的前瞻性数据，并控制潜在的混杂变量。
两家大学医院。
丹麦夫妇（n = 430），他们计划首次怀孕且此前无生育经历，随访六个月经周期。每个月经周期通过一般健康问卷测量心理困扰程度。
无。
在每个阴道出血期的尿液样本中检测到的临床确诊妊娠或生化妊娠。
在困扰评分最高的周期（一般健康问卷评分>第80百分位数）中，每个周期的受孕概率为12.8%，而在其他周期为16.5%（调整后的优势比[OR]为0.6；95%置信区间[CI]为0.4 - 1.0）。困扰的影响几乎仅在月经周期长的女性中发现（月经周期≥35天和<35天的女性，OR分别为0.1；95% CI为0.01 - 0.4和OR为0.9；95% CI为0.5 - 1.4）。在月经周期长且困扰程度高的女性中也发现早期胚胎丢失的发生率增加，但基于少量观察结果。
心理困扰可能是月经周期长的女性生育力降低的一个风险因素。
