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妊娠恶心和呕吐:对生活质量及日常功能的影响。

Nausea and vomiting of pregnancy: Effects on quality of life and day-to-day function.

作者信息

Tan Amelia, Lowe Sandra, Henry Amanda

机构信息

School of Women's and Children's Health, UNSW Medicine, Sydney, NSW, Australia.

Department of Obstetrics, Royal Hospital for Women, Randwick, NSW, Australia.

出版信息

Aust N Z J Obstet Gynaecol. 2018 Jun;58(3):278-290. doi: 10.1111/ajo.12714. Epub 2017 Sep 26.

Abstract

AIMS

To investigate the effect of nausea and vomiting of pregnancy (NVP) on quality of life (QoL) and activities of daily living/socioeconomic function in a contemporary Australian setting.

MATERIALS AND METHODS

Observational, single centre prospective cohort study using validated survey instruments in pregnant women at 9-16 weeks gestation at a tertiary metropolitan women's hospital in Sydney, Australia. QoL measured by the Short-Form Health Survey (SF-12) was compared between those with and without NVP. NVP severity scores were correlated with QoL scores, work patterns and medication use.

RESULTS

Of 116 participants, 72% had NVP, with no baseline (including mental health) differences between women with or without NVP. As classified by modified Pregnancy-Unique-Quantified-Emesis (PUQE) survey, 42% had mild symptoms, 55% moderate and 1% severe. SF-12 Physical Component Summary (PCS) scores were significantly lower for those with NVP (P < 0.001), but not Mental Component Summary (MCS) scores (P = 0.11). Decreasing QoL was associated with increasing NVP severity (P < 0.001), most markedly in the physical domain (P < 0.001). Only 39% of women used any NVP treatment and 15% pharmacotherapy. Most used treatments were vitamin B , ginger, metoclopramide and natural remedies. Significantly more women with NVP required time off work (45% vs 16%, P = 0.003).

CONCLUSIONS

NVP is a physically morbid disease, affecting most pregnancies. NVP has a significant detrimental impact on QoL, especially physical QoL and work function. Despite this, we found low treatment utilisation, even in those with moderate/severe symptoms. Women should be encouraged to seek assistance for NVP and further education is required to improve practitioner awareness and management.

摘要

目的

在当代澳大利亚环境中,研究妊娠恶心和呕吐(NVP)对生活质量(QoL)以及日常生活/社会经济功能的影响。

材料与方法

在澳大利亚悉尼一家三级城市妇女医院,对妊娠9至16周的孕妇使用经过验证的调查工具进行观察性单中心前瞻性队列研究。比较有和没有NVP的孕妇通过简短健康调查(SF - 12)测量的生活质量。NVP严重程度评分与生活质量评分、工作模式和药物使用相关。

结果

116名参与者中,72%有NVP,有或没有NVP的女性在基线(包括心理健康)方面没有差异。根据改良的妊娠特异性量化呕吐(PUQE)调查分类,42%有轻度症状,55%有中度症状,1%有重度症状。有NVP的患者的SF - 12身体成分总结(PCS)评分显著更低(P < 0.001),但心理成分总结(MCS)评分没有差异(P = 0.11)。生活质量下降与NVP严重程度增加相关(P < 0.001),在身体领域最为明显(P < 0.001)。只有39%的女性使用了任何NVP治疗,15%使用了药物治疗。大多数使用的治疗方法是维生素B、生姜、甲氧氯普胺和天然疗法。有NVP需要请假的女性明显更多(45%对16%,P = 0.003)。

结论

NVP是一种身体上的病态疾病,影响大多数妊娠。NVP对生活质量有显著的不利影响,尤其是身体生活质量和工作功能。尽管如此,我们发现治疗利用率较低,即使是在那些有中度/重度症状的患者中。应鼓励女性寻求NVP方面的帮助,并且需要进一步开展教育以提高从业者的认识和管理水平。

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