孕期恶心和呕吐的负担：对生活质量、日常生活功能及再次怀孕意愿的严重影响——一项横断面研究的结果
The burden of nausea and vomiting during pregnancy: severe impacts on quality of life, daily life functioning and willingness to become pregnant again - results from a cross-sectional study.
作者信息
Heitmann Kristine, Nordeng Hedvig, Havnen Gro C, Solheimsnes Anja, Holst Lone
机构信息
PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway.
Department of Global Public Health and Primary Care, University of Bergen, P-Box 7804, N-5020, Bergen, Norway.
出版信息
BMC Pregnancy Childbirth. 2017 Feb 28;17(1):75. doi: 10.1186/s12884-017-1249-0.
BACKGROUND
Though nausea and vomiting is very common during pregnancy, no studies have investigated the impact of this condition on the women's daily lives in a Scandinavian population. The aim of this study was to describe the burden of nausea and vomiting during pregnancy (NVP) on global quality of life, daily life functioning and willingness to become pregnant again according to the severity of NVP symptoms.
METHODS
This study is a cross-sectional population-based study conducted in Norway. Pregnant women and mothers with children <1 year of age with current or prior NVP were eligible to participate. Data were collected through an anonymous on-line questionnaire accessible from November 10, 2014 to January 31, 2015. Severity of NVP was measured using the 24-h Pregnancy Unique Quantification of Emesis Scale (PUQE). Associations between severity of NVP, daily life functioning and willingness to become pregnant again were tested using chi-square tests. Associations with global quality of life measured in terms of the Quality of Life Scale (QOLS) were estimated using generalized linear models and reported as unstandardized regression coefficients (β) with 95% confidence intervals (CI).
RESULTS
712 women with NVP were included in the study. NVP was significantly associated with several characteristics, including daily life functioning, quality of life and willingness to become pregnant again. The negative impact was greater the more severe the symptoms were, although considerable adverse effects were also seen among women with mild and moderate NVP symptoms. Over one fourth of the women with severe NVP considered terminating the pregnancy due to NVP, and three in four considered not to get pregnant again. Severity of NVP remained significantly associated with reduced global quality of life when adjusting for maternal characteristics and illnesses with β (95% CI) = -10.9 (-16.9, -4.9) for severe versus mild NVP.
CONCLUSIONS
NVP as measured by PUQE had a major impact on various aspects of the women's lives, including global quality of life and willingness to become pregnant again.
背景
尽管恶心和呕吐在孕期非常常见，但尚无研究调查这种情况对斯堪的纳维亚人群中女性日常生活的影响。本研究的目的是根据恶心和呕吐（NVP）症状的严重程度，描述孕期恶心和呕吐对总体生活质量、日常生活功能以及再次怀孕意愿的影响。
方法
本研究是在挪威进行的一项基于人群的横断面研究。有当前或既往NVP的孕妇以及孩子<1岁的母亲有资格参与。数据通过一份匿名在线问卷收集，该问卷于2014年11月10日至2015年1月31日期间可获取。使用24小时妊娠呕吐独特量化量表（PUQE）测量NVP的严重程度。使用卡方检验测试NVP严重程度、日常生活功能和再次怀孕意愿之间的关联。使用广义线性模型估计与生活质量量表（QOLS）所衡量的总体生活质量的关联，并以未标准化回归系数（β）及95%置信区间（CI）报告。
结果
712名有NVP的女性被纳入研究。NVP与多个特征显著相关，包括日常生活功能、生活质量和再次怀孕意愿。症状越严重，负面影响越大，不过在有轻度和中度NVP症状的女性中也观察到了相当大的不良影响。超过四分之一有严重NVP的女性因NVP考虑终止妊娠，四分之三的女性考虑不再怀孕。在调整了母亲特征和疾病后，NVP严重程度与总体生活质量降低仍显著相关，严重NVP与轻度NVP相比，β（95%CI）=-10.9（-16.9，-4.9）。
结论
通过PUQE测量的NVP对女性生活的各个方面有重大影响，包括总体生活质量和再次怀孕意愿。
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