Sherman Paul W, Flaxman Samuel M
Department of Neurobiology and Behavior, Cornell University, Ithaca, NY 14853, USA.
Am J Obstet Gynecol. 2002 May;186(5 Suppl Understanding):S190-7. doi: 10.1067/mob.2002.122593.
The proximate mechanisms underlying gestational nausea and vomiting have been intensively studied, but the possibility that the symptoms themselves serve a useful function has only recently been considered seriously. We synthesized evidence to evaluate various hypotheses for the adaptive significance of nausea and vomiting of pregnancy, as well as the possibility that symptoms are nonfunctional byproducts of pregnancy hormones. We found greatest support for the hypothesis that normal levels of nausea and vomiting of pregnancy (excluding hyperemesis) protect pregnant women and their embryos from harmful substances in food, particularly pathogenic microorganisms in meat products and toxins in strong-tasting plants. We discuss the data that support critical predictions of this "maternal and embryo protection hypothesis" (and contradict other hypotheses), as well as appropriate implications of these results. Knowledge that normal nausea and vomiting of pregnancy indicates the functioning of a woman's defense system, rather than a bodily malfunction, may reassure patients and enable health care providers to develop new ways of minimizing the uncomfortable symptoms.
妊娠恶心和呕吐的直接机制已得到深入研究，但这些症状本身可能具有有益功能这一可能性直到最近才受到认真考虑。我们综合了证据，以评估关于妊娠恶心和呕吐适应性意义的各种假说，以及这些症状可能是妊娠激素无功能副产物的可能性。我们发现，“妊娠恶心和呕吐（不包括妊娠剧吐）的正常水平可保护孕妇及其胚胎免受食物中有害物质的侵害，尤其是肉类产品中的致病微生物和味道浓烈植物中的毒素”这一假说得到了最多支持。我们讨论了支持这一“母体和胚胎保护假说”关键预测（并与其他假说相矛盾）的数据，以及这些结果的适当影响。了解到妊娠时正常的恶心和呕吐表明女性防御系统在发挥作用，而非身体机能出现故障，可能会让患者安心，并使医疗保健人员能够开发出新方法，尽量减轻这些不适症状。
