Mazzotta P, Stewart D, Atanackovic G, Koren G, Magee L A
Motherisk Program, University of Toronto, Ontario, Canada.
J Psychosom Obstet Gynaecol. 2000 Sep;21(3):129-36. doi: 10.3109/01674820009075620.
Unlike severe nausea and vomiting of pregnancy (NVP), it is not known whether milder forms of NVP have been associated with psychosocial morbidity. We undertook the study to explore the prevalence of psychosocial morbidity by severity of NVP, and determine whether, after correction for severity of nausea/vomiting, there is a relationship between psychosocial morbidity and women's decisions to take anti-emetics as a reflection of their distress due to NVP. From 1996-97, an NVP Healthline was advertised. Callers underwent semi-structured interviews about both their NVP and associated psychosocial morbidity in a previous pregnancy. Most of the 3201 callers resided in Canada, worked outside the home, reported on planned pregnancy (a median of) 4 years before, and described severe (> 5 episodes/day of) nausea and vomiting. More severe nausea/vomiting was associated with more frequent feelings of depression, consideration of termination of pregnancy, adverse effects on women's relationships with their partners or their partners' everyday lives, and the perceived likelihood that NVP would harm their baby (p < 0.0001). However, all psychosocial factors were reported by a clinically important proportion of women with mild nausea/vomiting (0-1 episodes/day). The severity of vomiting was most closely related to women's decisions to take anti-emetics, but other psychosocial factors were also independently associated with anti-emetic therapy. We conclude that psychosocial morbidity is evident across the spectrum of severity of nausea and vomiting among women with NVP. The severity of nausea or vomiting does not appear adequately to reflect the distress caused by NVP, as reflected by women's decisions to take anti-emetic therapy.
与妊娠剧吐（NVP）不同，尚不清楚较轻形式的NVP是否与心理社会发病率相关。我们开展这项研究以探讨不同严重程度NVP的心理社会发病率，并确定在校正恶心/呕吐严重程度后，心理社会发病率与女性服用止吐药的决定之间是否存在关联，后者可反映她们因NVP产生的痛苦。1996年至1997年期间，一则NVP健康热线广告发布。来电者就其之前妊娠期间的NVP及相关心理社会发病率接受了半结构化访谈。3201名来电者大多居住在加拿大，在外工作，报告称（中位时间）4年前为计划妊娠，并描述有严重（每天>5次发作）的恶心和呕吐。更严重的恶心/呕吐与更频繁的抑郁情绪、考虑终止妊娠、对女性与其伴侣关系或伴侣日常生活的不利影响以及认为NVP会伤害其婴儿的可能性相关（p<0.0001）。然而，有临床意义比例的轻度恶心/呕吐（每天0 - 1次发作）女性也报告了所有心理社会因素。呕吐严重程度与女性服用止吐药的决定关系最为密切，但其他心理社会因素也与止吐治疗独立相关。我们得出结论，心理社会发病率在患有NVP的女性恶心和呕吐严重程度的整个范围内都很明显。恶心或呕吐的严重程度似乎不能充分反映NVP所造成的痛苦，这一点从女性服用止吐药的决定中可以看出。
