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孕晚期母亲焦虑:对胎动和胎儿心率的影响。

Maternal anxiety in late pregnancy: effect on fetal movements and fetal heart rate.

作者信息

Sjöström Karin, Valentin Lil, Thelin Thomas, Marsál Karel

机构信息

Department of Obstetrics and Gynecology, University Hospital, Malmö, S-205 02 Malmö, Sweden.

出版信息

Early Hum Dev. 2002 Apr;67(1-2):87-100. doi: 10.1016/s0378-3782(01)00256-0.

Abstract

AIM

To determine whether maternal state and trait anxiety levels affect fetal movements or fetal heart rate (FHR) in the third trimester.

SUBJECTS

Forty-one healthy pregnant nulliparous women not on medication and with a singleton pregnancy.

STUDY DESIGN

Maternal anxiety was assessed using the Spielberger State- Trait Anxiety Inventory (Form Y) at 36 gestational weeks. The fetuses of the women were examined at 37-40 gestational weeks with ultrasound observation of fetal movements and cardiotocography (CTG). The results of the fetal examinations were compared between women with low and high anxiety scores (low scores being defined as scores below the median and high scores as scores equal to or above the median of the study population), and correlation analyses between anxiety scores and the outcome variables were performed.

OUTCOME MEASURES

The presence and duration (expressed as a percentage of the total examination time) of FHR patterns A, B, C, and D, the percentage duration of fetal movements in each FHR pattern, baseline FHR and FHR variability in each FHR pattern.

RESULTS

The presence of FHR patterns A, B, C, and D, the duration of FHR patterns A, B, and C, FHR variability in FHR patterns A, B, and C, baseline FHR and the percentage duration of fetal movements in each FHR pattern did not differ between women with low and high state and trait anxiety scores. In fetuses with FHR pattern D, the duration of FHR pattern D increased with increasing maternal trait anxiety scores, (rho=0.88; p=0.008), and FHR variability in FHR pattern D increased with maternal state and trait anxiety scores (r=0.86, p=0.01; r=0.96, p=0.001).

CONCLUSION

Maternal anxiety does not seem to affect fetal movements or baseline FHR in late pregnancy, but there is a possible association between maternal anxiety and the duration of FHR pattern D and FHR variability in FHR pattern D.

摘要

目的

确定孕晚期孕妇的状态焦虑和特质焦虑水平是否会影响胎动或胎儿心率(FHR)。

对象

41名未用药的健康初孕单胎孕妇。

研究设计

在孕36周时使用斯皮尔伯格状态-特质焦虑量表(Y型)评估孕妇焦虑情况。在孕37 - 40周时对这些孕妇的胎儿进行超声观察胎动和胎心监护(CTG)检查。比较焦虑评分低和高的孕妇(低评分定义为低于研究人群中位数的分数,高评分定义为等于或高于研究人群中位数的分数)的胎儿检查结果,并对焦虑评分与结果变量进行相关性分析。

观察指标

FHR模式A、B、C和D的出现情况及持续时间(以总检查时间的百分比表示)、每种FHR模式下胎动的持续时间百分比、每种FHR模式下的基线FHR和FHR变异性。

结果

状态焦虑和特质焦虑评分低和高的孕妇之间,FHR模式A、B、C和D的出现情况、FHR模式A、B和C的持续时间、FHR模式A、B和C中的FHR变异性、基线FHR以及每种FHR模式下胎动的持续时间百分比均无差异。在FHR模式为D的胎儿中,FHR模式D的持续时间随孕妇特质焦虑评分升高而增加(rho = 0.88;p = 0.008),FHR模式D中的FHR变异性随孕妇状态焦虑和特质焦虑评分升高而增加(r = 0.86,p = 0.01;r = 0.96,p = 0.001)。

结论

孕妇焦虑在妊娠晚期似乎不会影响胎动或基线FHR,但孕妇焦虑与FHR模式D的持续时间以及FHR模式D中的FHR变异性之间可能存在关联。

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