Gill S K, Maltepe C, Koren G
The Motherisk Program, The Hospital for Sick Children, Toronto, Ontario, Canada.
J Obstet Gynaecol. 2009 Jan;29(1):13-6. doi: 10.1080/01443610802628528.
Nausea and vomiting of pregnancy (NVP) is experienced by the majority of pregnant women, and can negatively affect a women's quality of life. It has been suggested in observational studies that iron-containing prenatal multivitamins may increase the severity of NVP. The objective of this study was to determine whether decreasing iron exposure can mitigate NVP symptoms. Data were collected from a prospective cohort at the Motherisk Program in Toronto. Women (n = 97) seeking advice on managing severe NVP were advised to discontinue prenatal multivitamin administration and switch to folic acid, an adult multivitamin or a children's chewable multivitamin. Two-thirds (63 out of 97) (p < 0.001) of those women qualitatively reported an improvement in NVP symptoms after discontinuation of iron-containing prenatal multivitamins. These findings were verified quantitatively using both the pregnancy-unique quantification of emesis and nausea (PUQE) (p < 0.001) and well-being (p < 0.001) scoring systems. This is the first interventional study showing that discontinuation of iron results in improvement of NVP symptoms. Our data suggest that avoiding iron-containing prenatal multivitamins in the first trimester is effective in improving NVP symptoms in the majority of pregnant women suffering from morning sickness.
大多数孕妇都会经历妊娠恶心和呕吐（NVP），这会对女性的生活质量产生负面影响。观察性研究表明，含铁的产前多种维生素可能会加重NVP的严重程度。本研究的目的是确定减少铁的摄入量是否可以减轻NVP症状。数据来自多伦多Motherisk项目的一个前瞻性队列。寻求严重NVP管理建议的女性（n = 97）被建议停止服用产前多种维生素，并改用叶酸、成人多种维生素或儿童咀嚼型多种维生素。三分之二（97名中的63名）（p < 0.001）的女性定性报告称，停用含铁的产前多种维生素后，NVP症状有所改善。这些发现通过妊娠呕吐和恶心独特量化（PUQE）评分系统（p < 0.001）和幸福感评分系统（p < 0.001）进行了定量验证。这是第一项表明停用铁剂可改善NVP症状的干预性研究。我们的数据表明，在孕早期避免服用含铁的产前多种维生素对改善大多数患有晨吐的孕妇的NVP症状有效。
