Makino I, Matsuda Y, Yoneyama M, Hirasawa K, Takagi K, Ohta H, Konishi Y
Department of Obstetrics and Gynaecology, Tokyo Women's Medical University, Medical Centre East, Tokyo, Japan.
J Int Med Res. 2009 Nov-Dec;37(6):1780-8. doi: 10.1177/147323000903700614.
This study was designed to determine whether maternal stress levels, state and trait anxiety levels, and stress hormones affect fetal heart rate (FHR) patterns after vibroacoustic stimulation (VAS) at 30 weeks of gestation. A total of 24 healthy pregnant women with a single fetus pregnancy were enrolled. Corticotropin releasing hormone (CRH) and adrenocorticotropic hormone in maternal plasma and cortisol, and chromogranin A in saliva were measured. The FHR patterns after VAS were divided into three types: type I, a long period of acceleration or one acceleration lasting > 1 min or at least two accelerations lasting > 15 s; type II, a biphasic response with acceleration followed by deceleration; and type III, no response or prolonged deceleration. In the high trait anxiety group, CRH levels were significantly higher than in the low trait anxiety group, and FHR patterns after VAS showed mostly a type II response pattern. These findings suggest that stress in pregnant women with high trait anxiety may influence FHR patterns after VAS.
本研究旨在确定妊娠30周时,母体应激水平、状态焦虑和特质焦虑水平以及应激激素是否会影响经声振刺激(VAS)后的胎儿心率(FHR)模式。总共招募了24名单胎妊娠的健康孕妇。测量了母体血浆中的促肾上腺皮质激素释放激素(CRH)和促肾上腺皮质激素以及皮质醇,以及唾液中的嗜铬粒蛋白A。VAS后的FHR模式分为三种类型:I型,长时间加速或一次加速持续>1分钟或至少两次加速持续>15秒;II型,双相反应,先加速后减速;III型,无反应或延长减速。在高特质焦虑组中,CRH水平显著高于低特质焦虑组,VAS后的FHR模式大多表现为II型反应模式。这些发现表明,高特质焦虑孕妇的应激可能会影响VAS后的FHR模式。