Department of Psychiatry (J-Block), Groote Schuur Hospital, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.
Arch Womens Ment Health. 2010 Aug;13(4):359-64. doi: 10.1007/s00737-010-0144-8. Epub 2010 Jan 30.
Although studies have found associations between maternal distress/anxiety and alterations in blood flow, data across different trimesters are inconsistent. We, therefore, sought to determine the association between measures of distress and uterine blood flow in all three trimesters. Healthy women with low-risk singleton pregnancies were recruited from antenatal clinics. Women were assessed at 13-14 weeks (T1), 21-22 weeks (T2), and 32-33 weeks (T3) of gestation with measures of distress and anxiety (the K10, Perceived Stress Scale, and the State Subscale of the Spielberger State-Trait Anxiety Inventory [STAI]) and with uterine Doppler flow velocity studies. The Trait Subscale of the STAI was done either at T1 or T2. Thirty women were seen at T1, 79 women were seen at T2, and 59 women were seen at T3. No significant correlations were found between measures of distress and anxiety and umbilical artery pulsatility index (PI) or middle cerebral artery PI at any time-point. Small positive correlations between trait anxiety and uterine artery PI were found, but these were not significant after adjustment for alcohol and nicotine use (any use as well as problem drinking/nicotine dependence). At T3 but not T1 or T2, women scoring above 20 on the K10 (a standardized cutoff for the presence of axis I psychiatric disorders) had higher uterine artery PI than those scoring below 20.This was significant after adjusting for alcohol and nicotine use, as well as when nicotine dependence was considered. This work highlights the complexities of the relationship between increased measures of distress and anxiety and changes in the placental circulation. Further work in this area is needed to explore the underlying mechanisms which account for this relationship and to delineate fully the extent to which the relationship is determined by the presence of psychiatric and substance use disorders.
尽管研究已经发现了产妇焦虑/抑郁与血流变化之间的关联，但不同孕期的数据并不一致。因此，我们试图确定所有三个孕期中，焦虑/抑郁指标与子宫血流之间的关系。从产前门诊招募了低风险单胎妊娠的健康妇女。在妊娠 13-14 周（T1）、21-22 周（T2）和 32-33 周（T3）时，用 K10、压力感知量表和 Spielberger 状态-特质焦虑量表的状态子量表评估产妇的焦虑/抑郁状况和子宫多普勒血流速度。状态特质焦虑量表的特质分量表要么在 T1 做，要么在 T2 做。有 30 名妇女在 T1 就诊，79 名妇女在 T2 就诊，59 名妇女在 T3 就诊。在任何时间点，焦虑/抑郁指标与脐动脉搏动指数（PI）或大脑中动脉 PI 之间均无显著相关性。在 T3 时，特质焦虑与子宫动脉 PI 之间存在小的正相关，但在调整酒精和尼古丁使用（任何使用以及酗酒/尼古丁依赖）后，相关性不再显著。在 T3 时，但不在 T1 或 T2 时，K10 得分高于 20（存在轴 I 精神障碍的标准化截断值）的妇女的子宫动脉 PI 高于 K10 得分低于 20 的妇女。在调整酒精和尼古丁使用以及考虑尼古丁依赖后，这一差异具有统计学意义。这项工作突出了增加的焦虑/抑郁指标与胎盘循环变化之间关系的复杂性。需要在这一领域进一步开展工作，以探讨导致这种关系的潜在机制，并充分阐明这种关系在多大程度上是由精神和物质使用障碍的存在决定的。
