Department of Obstetrics and Gynecology, Central Finland Central Hospital, Keskussairaalantie 19, 40620, Jyväskylä, Finland.
University of Turku, Turku, Finland.
BMC Pregnancy Childbirth. 2021 Feb 19;21(1):152. doi: 10.1186/s12884-021-03639-2.
Nausea and vomiting of pregnancy (NVP) deteriorates many aspects of daily lives of women. However, little is known about associations between NVP and sleep quality.
Women attending to routine mid-pregnancy visits in maternity health care clinics in Turku city area and surrounding municipalities, Finland, during 2011-2014, were invited to participate. A cohort of 1203 volunteers (mean age 30 years, mean gestational week 16.6, mean BMI 24.4 kg/m, nulliparous 46%) was recruited. The severity of NVP in the worst 12-h period of current pregnancy was assessed with Pregnancy Unique Quantification of Emesis Questionnaire (PUQE) and categorized accordingly into no/mild/moderate and severe NVP. Sleep disturbances during the past 3 months were assessed with selected questions (difficulty falling asleep, night awakenings, too early morning awakenings and sleepiness during the day) from Basic Nordic Sleep Questionnaire (BNSQ). In addition, general sleep quality, as well as physical and mental quality of life (QoL) were rated with three visual analog scales (VAS). Associations between PUQE categories (severity of NVP) and sleep disturbances, general sleep quality, physical QoL and mental QoL were evaluated with multinomial regression analysis.
According to PUQE, NVP was most frequently moderate (n = 629, 52.3%), followed by mild (n = 361, 30.0%) and severe (n = 77, 6.4%). Only 11.3% had no NVP (n = 136). The most frequent sleep disturbance was night awakenings (69.9%, n = 837), followed by sleepiness during the day (35.7%, n = 427), too early morning awakenings (12.0%, n = 143) and difficulty falling asleep (7.1%, n = 81). In adjusted analysis (age, parity, body mass index, smoking, employment), more severe NVP was associated with night awakenings (AOR 3.9, 95% CI 1.79-8.47, P < 0.0001) and sleepiness during the day (AOR 4.7, 95% CI 2.20-9.94, P < 0.0001). In VAS, women with more severe NVP rated worse general sleep quality and worse physical and mental QoL. However, in multivariable analysis, the association between the severity of NVP and physical and mental QoL was stronger than that of sleep .
More severe NVP is associated with sleep disturbances and in close relation to lower physical and mental QoL. Thus, in comprehensive care of women with NVP, also sleep quality should be evaluated.
妊娠恶心和呕吐（NVP）会恶化女性日常生活的许多方面。然而，目前对于 NVP 与睡眠质量之间的关系知之甚少。
在 2011 年至 2014 年期间，芬兰图尔库市及其周边市镇的产妇保健诊所邀请参加常规中期妊娠检查的妇女参加。招募了 1203 名志愿者（平均年龄 30 岁，平均妊娠周 16.6，平均 BMI 24.4kg/m，初产妇 46%）。当前妊娠期间最严重的 12 小时内恶心呕吐的严重程度使用妊娠特异性呕吐量表（PUQE）进行评估，并相应分为无/轻度/中度和重度 NVP。过去 3 个月的睡眠障碍使用来自基础北欧睡眠问卷（BNSQ）的一些问题（入睡困难、夜间觉醒、过早清晨觉醒和白天嗜睡）进行评估。此外，使用三个视觉模拟量表（VAS）评估总体睡眠质量以及身体和心理健康相关的生活质量（QoL）。使用多项逻辑回归分析评估 PUQE 类别（NVP 严重程度）与睡眠障碍、总体睡眠质量、身体 QoL 和心理 QoL 之间的关系。
根据 PUQE，NVP 最常见的是中度（n=629，52.3%），其次是轻度（n=361，30.0%）和重度（n=77，6.4%）。只有 11.3%的人没有 NVP（n=136）。最常见的睡眠障碍是夜间觉醒（69.9%，n=837），其次是白天嗜睡（35.7%，n=427）、过早清晨觉醒（12.0%，n=143）和入睡困难（7.1%，n=81）。在调整分析（年龄、产次、体重指数、吸烟、就业）中，更严重的 NVP 与夜间觉醒（AOR 3.9，95%CI 1.79-8.47，P<0.0001）和白天嗜睡（AOR 4.7，95%CI 2.20-9.94，P<0.0001）有关。在 VAS 中，NVP 更严重的女性总体睡眠质量和身体及心理健康相关的 QoL 更差。然而，在多变量分析中，NVP 严重程度与身体和心理健康相关的 QoL 之间的关系强于睡眠。
更严重的 NVP 与睡眠障碍相关，并与较低的身体和心理健康相关的 QoL 密切相关。因此，在对 NVP 妇女进行综合护理时，还应评估其睡眠质量。
