Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, USA.
J Psychosom Obstet Gynaecol. 2011 Sep;32(3):113-8. doi: 10.3109/0167482X.2011.576790. Epub 2011 May 19.
The study objective is to compare the prevalence of nausea and vomiting of pregnancy (NVP) in singleton and twin gestations conceived via in vitro fertilization (IVF), and to analyze the impact of associated psychological factors. A cohort study on 45 singleton and 12 twin gestations was conducted at an academic practice. Three validated questionnaires assessing anxiety; depression; and NVP at baseline, 10-12 weeks, and 20-22 weeks gestation were used. The prevalence of NVP was compared between twins and singletons and its association with depression and anxiety was determined. Significantly more subjects with twin pregnancies reported NVP at 10-12 weeks of gestation. NVP was not associated with baseline depression or anxiety scores. There were no differences in depression scores between the groups at any time. A trend toward higher anxiety scores among twin gestations at 10-12 weeks was significant at 20-22 weeks. Within the twin group, anxiety scores remained stable, but scores for singletons decreased significantly from 10-12 weeks to 20-22 weeks. NVP is more common in the first trimester in twins compared with singletons following IVF. In IVF pregnancies, anxiety scores, but not depression scores, are higher in women with twin gestations. Women undergoing infertility treatment should be counseled accordingly when discussing the risks associated with multiple gestations.
本研究旨在比较体外受精(IVF)受孕的单胎和双胎妊娠恶心和呕吐(NVP)的发生率,并分析相关心理因素的影响。在一家学术实践中,对 45 例单胎妊娠和 12 例双胎妊娠进行了队列研究。使用了三个经过验证的评估焦虑、抑郁和妊娠 10-12 周和 20-22 周基线、10-12 周和 20-22 周 NVP 的问卷。比较了双胞胎和单胎妊娠的 NVP 发生率,并确定了其与抑郁和焦虑的关系。在妊娠 10-12 周时,更多的双胎妊娠患者报告有 NVP。NVP 与基线抑郁或焦虑评分无关。在任何时间点,两组的抑郁评分均无差异。在妊娠 10-12 周时,双胎妊娠的焦虑评分呈上升趋势,在妊娠 20-22 周时具有显著意义。在双胎组中,焦虑评分保持稳定,但单胎组的评分从妊娠 10-12 周显著下降至妊娠 20-22 周。与 IVF 后的单胎妊娠相比,NVP 在双胎妊娠的早期更为常见。在 IVF 妊娠中,双胎妊娠的焦虑评分高于抑郁评分。在讨论多胎妊娠相关风险时,应相应地为接受不孕治疗的妇女提供咨询。