بررسی عوامل مرتبط با شدت تهوع و استفراغ در دوران بارداری و نحوه کنترل آن توسط زنان باردار در شهر همدان سال 1393

نوع مقاله: اصیل پژوهشی

نویسندگان

1 استادیار گروه بهداشت باروری، مرکز تحقیقات مراقبتهای مادر و کودک، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران.

2 استاد گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی همدان، همدان، ایران.

3 کارشناس مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران.

چکیده

مقدمه: تهوع و استفراغ می‌تواند موجب کاهش کیفیت زندگی در زنان باردار شود. شناخت عوامل مرتبط و نحوه تسکین آن می‌تواند در مراقبت از زنان باردار نقش مهمی ایفا کند، لذا مطالعه حاضر با هدف تعیین عوامل مؤثر بر شدت تهوع و استفراغ در دوران بارداری و نحوه کنترل آن توسط مادران انجام شد.
روش‌کار: این مطالعه توصیفی در سال 1393 بر روی 160 زن باردار با سن بارداری 20-6 هفته و حاملگی تک‌قلو مراجعه‌کننده به مراکز بهداشتی ‌درمانی شهر همدان انجام شد. داده‌ها با استفاده از پرسشنامه­ محقق ساخته با سؤالاتی در مورد مشخصات فردی، باروری و نحوه کنترل تهوع و استفراغ و پرسشنامه بررسی تهوع و استفراغ بارداری جمع‌آوری شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) و آزمون دقیق فیشر انجام شد. میزان  pکمتر از 05/0 معنی­دار در نظر گرفته شد.
یافته‌ها: بر اساس نتایج مطالعه،شدت تهوع و استفراغ در 79 نفر (4/49%) خفیف، در 75 نفر (9/46%) متوسط و در 6 نفر (7/3%) شدید بود. سن مادر، شغل مادر، سن بارداری و اوقات شبانه‌روز با شدت تهوع و استفراغ ارتباط معناداری داشتند (05/0p<). 89 نفر (2/56%) از واحدهای پژوهش به دنبال راه چاره برای تخفیف شدت بیماری با استفاده از دارو و ترکیبات گیاهی بودند. ویتامین B6 و عرق نعنا بیشترین مصرف را داشتند. 80 نفر (50%) از زنان به‌دلیل نگرانی از آسیب به جنین از هیچ دارویی استفاده نکرده بودند.
نتیجه‌گیری: متغیرهایی مانند سن مادر، شغل مادر، سن بارداری و زمان وقوع تهوع و استفراغ در طول روز، با شدت تهوع و استفراغ ارتباط دارند. ویتامین B6 و عرق نعنا، بیشترین مصرف را برای تسکین تهوع و استفراغ دوران بارداری داشتند.

کلیدواژه‌ها


عنوان مقاله [English]

Investigating the factors related to severity of nausea and vomiting during Pregnancy and how it is controlled by pregnant Women in Hamadan, 2014

نویسندگان [English]

  • Soodabeh Aghababaei 1
  • Ali Reza Soltanian 2
  • Shokoufeh Sharifi 3
  • Elnaz Torkzaban 3
  • Mansoureh Refaei 1
1 Assistant professor, Department of Reproductive Health, Mother and Child Care Research Center, School of Nursing & Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
2 Professor, Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
3 B.Sc. of Midwifery, School of Nursing & Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
چکیده [English]

Introduction: Nausea and vomiting can reduce the quality of life of pregnant women. Identifying the related factors and how we can relieve them can play an important role in the care of pregnant women. Therefore, the present study was conducted with aim to determine the factors affecting the severity of nausea and vomiting during pregnancy and how it is controlled by mothers.
Methods: This descriptive study was performed on 160 pregnant women with gestational age of 6-20 weeks and single pregnancy who had referred to Hamadan health centers in 2014. Data were collected by using the researcher-made questionnaire including the questions about demographic characteristics, fertility, how to control nausea and vomiting, and the questionnaire of assessing nausea and vomiting in pregnancy. Data were analyzed by SPSS software (version 16) and Fisher Exact test. P < 0.05 was considered significant.
Results: According to the results of the study, the severity of nausea and vomiting was mild in 79 cases (49.4%), moderate in 75(46.9%) and severe in 6 (3.7%). Maternal age, mother's occupation, gestational age and time of day were associated with severity of nausea and vomiting (P<0.05). 89 (56.2%) of the research units were looking for a remedy for their problem by using of herbal compounds and medicine. Vitamin B6 and mint extract were most used. 80 (50%) of women did not use any medicines due to their fear of injury to the fetus.
Conclusion: Variables such as maternal age, mother's occupation, gestational age and time of occurrence of nausea and vomiting during the day were related to the severity of nausea and vomiting. Vitamin B6 and Mint extract had the most intake for relieving nausea and vomiting during pregnancy.

کلیدواژه‌ها [English]

  • Control
  • Nausea
  • pregnancy
  • vomiting
  1. Matthews A, Haas DM, O'Mathúna DP, Dowswell T, Doyle M. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Sys Rev 2014; 3:CD007575.
  2. Clark SM, Costantine MM, Hankins GD. Review of NVP and HG and early pharmacotherapeutic intervention. Obstet Gynecol Int 2012; 2012:252676.
  3. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams’s obstetrics. 24th ed. New York: McGrawHill; 2014.
  4. Herrell HE. Nausea and vomiting of pregnancy. Am Fam Physician 2014; 89(12):965-70.
  5. Soltani A, Kajuri MD, Safavi S, Hosseini F. Frequency and severity of nausea and vomiting in pregnancy and the related factors among pregnant women. Iran J Nurs 2007; 19(48):95-102.
  6. Refuerzo JS, Smith JS, Ramin SM. Clinical features and evaluation of nausea and vomiting of pregnancy. Uptodate Clin Features 2013; 2012:26.
  7. Chan RL, Olshan AF, Savitz DA, Herring AH, Daniels JL, Peterson HB, et al. Maternal influences on nausea and vomiting in early pregnancy. Matern Child Health J 2011; 15(1):122-7.
  8. Chortatos A, Haugen M, Iversen P, Vikanes Å, Magnus P, Veierød M. Nausea and vomiting in pregnancy: associations with maternal gestational diet and lifestyle factors in the Norwegian Mother and Child Cohort Study. BJOG 2013; 120(13):1642-53.
  9. Kramer J, Bowen A, Stewart N, Muhajarine N. Nausea and vomiting of pregnancy: prevalence, severity and relation to psychosocial health. Am J Matern Child Nurs 2013; 38(1):21-7.
  10. Lacasse A, Rey E, Ferreira E, Morin C, Bérard A. Epidemiology of nausea and vomiting of pregnancy: prevalence, severity, determinants, and the importance of race/ethnicity. BMC Pregnancy Childbirth 2009; 9(1):26.
  11. Faramarzi M, Ranjbar A, Zakariaii Z, Naeimirad M. Role of psycho-social factors in pregnant women with nausea and vomiting. Daneshvar Med 2015; 23(119):73-80. (Persian).
  12. Munch S, Korst LM, Hernandez GD, Romero R, Goodwin TM. Health-related quality of life in women with nausea and vomiting of pregnancy: the importance of psychosocial context. J Perinatol 2011; 31(1):10-20.
  13. Taghizadeh Z, Cheraghi MA, Kazemnejad A, Pooralajal J, Aghababaei S. Difference in perception of pregnancy risk in two maternal age groups. J Clin Diagn Res 2017; 11(5):QC09-12.
  14. Golmakani N, Soltani M, Ghayour Mobarhan M, Mazloom SR. The relationship between nausea and vomiting in pregnant women with social support and marital satisfaction. J Torbat Heydariyeh Univ Med Sci 2015; 3(4):25-31. (Persian).
  15. Shafti V, Zakerihamidi M. Relationship between nausea and pregnancy vomiting and fetus gender. J Neyshabur Univ Med Sci 2017; 5(1):66-72. (Persian).
  16. Tan A, Lowe S, Henry A. Nausea and vomiting of pregnancy: effects on quality of life and day‐to‐day function. Aust N Z J Obstet Gynaecol 2018; 58(3):278-90.
  17. Zahra Karimi F, Dadgar S, Abdollahi M, Yousefi S, Tolyat M, Khosravi Anbaran Z. The relationship between minor ailments of pregnancy and quality of life in pregnant women. Iran J Obstet Gynecol Infertil 2017; 20(6):8-21. (Persian).
  18. Temming L, Franco A, Istwan N, Rhea D, Desch C, Stanziano G, et al. Adverse pregnancy outcomes in women with nausea and vomiting of pregnancy. J Matern Fetal Neonatal Med 2014; 27(1):84-8.
  19. Veenendaal MV, van Abeelen AF, Painter RC, van der Post JA, Roseboom TJ. Consequences of hyperemesis gravidarum for offspring: a systematic review and metanalysis. BJOG 2011; 118(11):1302-13.
  20. Smith J, Refuerzo J, Ramin S. Treatment and outcome of nausea and vomiting of pregnancy. Waltham, MA: UpToDate; 2014.
  21. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Sys Rev 2003; 4:CD000145.
  22. Soltani M, Golmakani N, Mazloom SR. The effect of an educational intervention based on Ottawa Guideline on nausea and vomiting at first trimester of pregnancy. Payesh 2017; 16(2):219-29. (Persian).
  23. Bustos M, Venkataramanan R, Caritis S. Nausea and vomiting of pregnancy-What's new? Auton Neurosci 2017; 202:62-72.
  24. Refaei M, Aghababaei S, Pourreza A, Masoumi SZ. Socioeconomic and reproductive health outcomes of female genital mutilation. Arch Iran Med 2016; 19(11):805-11.
  25. Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A. Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol 2002; 186(5):S228-31.
  26. Choi HJ, Bae YJ, Choi JS, Ahn HK, An HS, Hong DS, et al. Evaluation of nausea and vomiting in pregnancy using the Pregnancy-Unique Quantification of Emesis and Nausea scale in Korea. Obstet Gynecol Sci 2018; 61(1):30-7.
  27. Louik C, Hernandez‐Diaz S, Werler MM, Mitchell AA. Nausea and vomiting in pregnancy: maternal characteristics and risk factors. Paediatr Perinat Epidemiol 2006; 20(4):270-8.
  28. Eliakim R, Abulafia O, Sherer DM. Hyperemesis gravidarum: a current review. Am J Perinatol 2000; 17(4):207-18.
  29. Kallen B, Lundberg G, Åberg A. Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy. Acta Obstet Gynecol Scand 2003; 82(10):916-20.
  30. Goodwin TM, Ramin SM. Practice bulletin summary No. 153: Nausea and vomiting of pregnancy. Obstet Gynecol 2015; 126(3):687-8.
  31. Niebyl JR. Clinical practice. Nausea and vomiting in pregnancy. N Engl J Med 2010; 363(16):1544-50.
  32. Chou FH, Chen CH, Kuo SH, Tzeng YL. Experience of Taiwanese women living with nausea and vomiting during pregnancy. J Midwifery Womens Health 2006; 51(5):370-5.
  33. Locock L, Alexander J, Rozmovits L. Women's responses to nausea and vomiting in pregnancy. Midwifery 2008; 24(2):143-52.
  34. Davis M. Nausea and vomiting of pregnancy: an evidence-based review. J Perinat Neonatal Nurs 2004; 18(4):312-28.
  35. Khresheh R. How women manage nausea and vomiting during pregnancy: a Jordanian study. Midwifery 2011; 27(1):42-5.
  36. Taylor T. Treatment of nausea and vomiting in pregnancy. Aust Prescr 2014; 37(2):42-5.
  37. Firouzbakht M, Nikpour M, Jamali B, Omidvar S. Comparison of ginger with vitamin B6 in relieving nausea and vomiting during pregnancy. Ayu 2014; 35(3):289-93.
  38. Pakniat H, Memarzadeh MR, Azh N, Mafi M, Ranjkesh F. Comparison of the effect of chamomile, ginger and vitamin B6 on treatment of nausea and vomiting in pregnancy: a randomized clinical trial. Iran J Obstet Gynecol Infertil 2018; 21(8):47-54. (Persian).
  39. Firozbakht M, Nikpour M, Omidvar S, Kiapour A. Comparative study of effects of ginger with vit. B6 in treatment nausea and vomiting during pregnancy. J Fam Health 2013; 1(3):8-13.
  40. Joulaeerad N, Ozgoli G, Hajimehdipoor H, Ghasemi E, Salehimoghaddam F. Effect of aromatherapy with peppermint oil on the severity of nausea and vomiting in pregnancy: a single-blind, randomized, placebo-controlled trial. J Reprod Infertil 2018; 19(1):32. (Persian).
  41. Ozgoli G, Saei Ghare Naz M. Effects of complementary medicine on nausea and vomiting in pregnancy: a systematic review. Int J Prev Med 2018; 9(1):75.
  42. Sharifzadeh F, Kashanian M, Koohpayehzadeh J, Rezaian F, Sheikhansari N, Eshraghi N. A comparison between the effects of ginger, pyridoxine (vitamin B6) and placebo for the treatment of the first trimester nausea and vomiting of pregnancy (NVP). J Matern Fetal Neonatal Med 2018; 31(19):2509-14.
  43. Pasha H, Behmanesh F, Mohsenzadeh F, Hajahmadi M, Moghadamnia AA. Study of the effect of mint oil on nausea and vomiting during pregnancy. Iran Red Crescent Med J 2012; 14(11):727-30.
  44. Yeh HY, Chen YC, Chen FP, Chou LF, Chen TJ, Hwang SJ. Use of traditional Chinese medicine among pregnant women in Taiwan. Int J Gynecol Obstet 2009; 107(2):147-50.
  45. Liu MC, Kuo SH, Lin CP, Yang YM, Chou FH, Yang YH. Effects of professional support on nausea, vomiting, and quality of life during early pregnancy. Biol Res Nurs 2014; 16(4):378-86.