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妊娠恶心和呕吐:与个人恶心史和受影响亲属的关联。

Nausea and vomiting of pregnancy: associations with personal history of nausea and affected relatives.

机构信息

Department of Obstetrics and Gynecology, Central Finland Central Hospital, Keskussairaalantie 19, 40620, Jyväskylä, Finland.

University of Turku, Turku, Finland.

出版信息

Arch Gynecol Obstet. 2020 Oct;302(4):947-955. doi: 10.1007/s00404-020-05683-3. Epub 2020 Jul 11.

Abstract

PURPOSE

To examine whether personal history of nausea or history of nausea and vomiting of pregnancy (NVP) in relatives are risk factors for a woman to suffer from NVP. Further, to evaluate if these factors are associated with the severity of NVP.

METHODS

Cohort study of 2411 pregnant women recruited from maternity health care clinics. The severity of NVP was categorized according to Pregnancy-Unique Quantification of Emesis (PUQE) questionnaire into no/mild/moderate/severe NVP. History of nausea was assessed in connection with motion sickness, seasickness, migraine or other kinds of headache, after anesthesia, related to the use of contraceptives, and other kinds of nausea. History of NVP in relatives was categorized into first-degree (mother/sister) and second-degree relatives (more distant).

RESULTS

In multivariable analysis including previous personal history of nausea, motion sickness (OR 3.17, 95% CI 1.81-5.56, p < 0.0001) and nausea in migraine (OR 3.18, 95% CI 1.86-5.45, p < 0.0001) were associated with severe NVP. History of nausea in other kinds of headache was associated with moderate NVP (OR 1.91, 95% CI 1.34-2.72, p = 0.001). Women with affected first-degree relatives had higher odds for moderate (OR 3.84, 95% CI 2.72-5.40) and severe (OR 3.19, 95% CI 1.92-5.28) NVP (p < 0.0001). All these results remained significant after adjusting for parity, body mass index, smoking, employment and age.

CONCLUSION

Women with personal history of nausea or family history of NVP have an increased susceptibility of NVP. This information is useful in pre-pregnancy counselling.

摘要

目的

探讨女性个人史恶心或恶心和呕吐史(NVP)与亲属史是否为其患 NVP 的危险因素,进一步评估这些因素是否与 NVP 的严重程度相关。

方法

对来自产科保健诊所的 2411 名孕妇进行队列研究。根据妊娠专用恶心呕吐评分(PUQE)问卷,将 NVP 的严重程度分为无/轻度/中度/重度 NVP。恶心史与晕动病、晕船、偏头痛或其他头痛、麻醉后、与避孕药使用相关以及其他类型的恶心相关进行评估。亲属 NVP 史分为一级亲属(母亲/姐妹)和二级亲属(更远)。

结果

多变量分析包括既往个人恶心史、晕动病(OR 3.17,95%CI 1.81-5.56,p<0.0001)和偏头痛伴恶心(OR 3.18,95%CI 1.86-5.45,p<0.0001)与重度 NVP 相关。其他类型头痛的恶心史与中度 NVP 相关(OR 1.91,95%CI 1.34-2.72,p=0.001)。一级亲属受累的女性发生中度(OR 3.84,95%CI 2.72-5.40)和重度(OR 3.19,95%CI 1.92-5.28)NVP 的几率更高(p<0.0001)。在调整了产次、体重指数、吸烟、就业和年龄后,所有这些结果仍然具有统计学意义。

结论

有个人恶心史或 NVP 家族史的女性患 NVP 的易感性增加。这些信息对孕前咨询有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4838/7471164/3ba8859a000c/404_2020_5683_Fig1_HTML.jpg

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