Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, 1-1-1 Hondo, Akita-shi, 010-8543, Japan.
Graduate School of Nursing, Hyogo University, Kobe, Japan.
Arch Womens Ment Health. 2022 Oct;25(5):995-1004. doi: 10.1007/s00737-022-01262-4. Epub 2022 Aug 30.
The purpose of this study was to elucidate psychological factors that may influence nausea and vomiting during pregnancy (NVP) progression in early pregnancy based on longitudinal observations. Fifty-nine pregnant women completed the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) and General Health Questionnaire-28 (GHQ-28), and recorded their resting heart rate with photoplethysmography for 5 min to determine heart rate variability (HRV) indexes at 7-9 weeks and 11-13 weeks of gestation with a 4-week interval. GHQ-28 scores (total and subclasses) and HRV indexes at 7-9 weeks were compared among groups classified according to the presence of severe NVP (RINVR ≥ 9 points) at the two measurement points. Among women without severe NVP at 7-9 weeks, women who developed severe NVP at 11-13 weeks had significantly higher levels of anxiety/insomnia in the GHQ-28 subclasses (p = 0.018). The cross-lagged relationship from anxiety/insomnia at 7-9 weeks to RINVR at 11-13 weeks was significant (β = 0.367, p < 0.001). Among women with severe NVP at 7-9 weeks, women whose severe symptoms subsided at 11-13 weeks had significantly higher high-frequency (HF) power (p = 0.010), and women with relatively higher HF power demonstrated a significant reduction in RINVR (interaction effect, p = 0.035). During early pregnancy, women with strong anxiety/insomnia symptoms tend to have NVP symptoms that become more severe as the pregnancy progresses. The higher HF power in women whose severe NVP subsided within 4 weeks suggests a contribution of emotion regulation to early amelioration of NVP.
本研究旨在基于纵向观察，阐明可能影响早孕期妊娠恶心和呕吐（NVP）进展的心理因素。59 名孕妇完成了 Rhodes 恶心、呕吐和干呕指数（RINVR）和一般健康问卷-28（GHQ-28），并用光体积描记法记录了 5 分钟的静息心率，以确定妊娠 7-9 周和 11-13 周时的心率变异性（HRV）指数，两次测量间隔为 4 周。根据两次测量时是否存在严重 NVP（RINVR≥9 分），将 GHQ-28 评分（总分和亚类）和 HRV 指数在 7-9 周时进行分组比较。在没有严重 NVP 的孕妇中，在 11-13 周时出现严重 NVP 的孕妇在 GHQ-28 亚类中焦虑/失眠水平显著较高（p=0.018）。7-9 周时的焦虑/失眠与 11-13 周时的 RINVR 之间的交叉滞后关系具有统计学意义（β=0.367，p<0.001）。在 7-9 周时存在严重 NVP 的孕妇中，严重症状在 11-13 周时缓解的孕妇高频（HF）功率显著较高（p=0.010），HF 功率较高的孕妇 RINVR 显著降低（交互效应，p=0.035）。在孕早期，有强烈焦虑/失眠症状的孕妇往往会出现随着妊娠进展而加重的 NVP 症状。在 4 周内严重 NVP 缓解的孕妇中 HF 功率较高，这表明情绪调节对 NVP 的早期改善有一定贡献。
