College of Medical and Health Science, Fooyin University, Kaohsiung, Taiwan.
Biol Res Nurs. 2010 Jul;12(1):20-7. doi: 10.1177/1099800410361534. Epub 2010 May 7.
The purposes of this prospective, longitudinal study were to examine the relationships between leptin, human chorionic gonadotropin (hCG), cortisol, and psychosocial stress and nausea and vomiting (NV) in women with mild-to-moderate NV throughout pregnancy. Participants comprised 91 pregnant women recruited from prenatal clinics in southern Taiwan. Data analysis using one-way analysis of variance (ANOVA) indicated that leptin, hCG, cortisol levels, and Index of Nausea, Vomiting, and Retching (INVR) scores, but not stress (measured with the Visual Analog Scale, VAS) scores, were significantly different among the three trimesters. The average INVR score and hCG level decreased from the first to third trimesters (p < .0001 for both). The average leptin and cortisol levels increased from the first to third trimesters (p = .001 and p < .0001, respectively). Analysis using mixed models indicated that the INVR scores decreased significantly in a progressive manner through the stages of pregnancy and were significantly lower in the second and third trimesters. Findings reveal that stress/VAS and hCG may both be significantly and independently associated with INVR scores. Future research should examine psychosocial reactions in addition to exploring other biochemical markers related to NV and stress.
本前瞻性纵向研究旨在探讨瘦素、人绒毛膜促性腺激素（hCG）、皮质醇与心理社会应激与轻至中度妊娠恶心呕吐（NV）之间的关系。研究对象为来自中国台湾南部产前门诊的 91 名孕妇。采用单因素方差分析（ANOVA）进行数据分析，结果表明，瘦素、hCG、皮质醇水平和恶心、呕吐和干呕指数（INVR）评分，而非应激（采用视觉模拟量表，VAS 测量）评分，在三个孕期之间存在显著差异。INVR 评分和 hCG 水平从第一孕期到第三孕期逐渐降低（两者均 p <.0001）。瘦素和皮质醇水平从第一孕期到第三孕期逐渐升高（p =.001 和 p <.0001）。混合模型分析表明，INVR 评分随着妊娠阶段的进展呈显著下降趋势，在第二和第三孕期明显较低。研究结果表明，应激/VAS 和 hCG 均与 INVR 评分显著相关且独立相关。未来的研究除了探讨与 NV 和应激相关的其他生化标志物外，还应研究心理社会反应。
