Comparison of Pregnancy Stress Between In Vitro Fertilization/Embryo Transfer and Spontaneous Pregnancy in Women During Early Pregnancy

體外受精與自然受孕婦女於懷孕早期之妊娠壓力比較

石芬芬(Fen-Fen Shih) ； 陳彰惠(Chung-Hey Chen) ； 喬佳宜(Chia-Yi Chiao) ； 李其融(Chi-Rong Li) ； 郭碧照(Pi-Chao Kuo) ； 賴德仁(Te-Jen Lai)

《The Journal of Nursing Research》 23卷4期 (2015/12) Pp. 280-289

https://doi.org/10.1097/jnr.0000000000000089

摘要

背景：文獻顯示體外受精婦女具有複雜的心理壓力，但是不論何種受孕方式其妊娠壓力皆可能影響孕婦健康與胎兒發展成長，而體外受精婦女心理壓力是否與自然懷孕者有所差異尚未有相關文獻報導。目的：探討體外受精與自然懷孕之中台灣婦女，在妊娠期前二十週之心理壓力及其差異。方法：研究設計採前瞻性、縱貫性調查法，於台灣中部某醫學中心立意取樣163 位體外受精及94位自然懷孕婦女為研究對象。研究工具為人口學資料及孕期壓力量表，分別於妊娠第9、12 及20週完成三次自填問卷；並以重複測量、廣義估計方程式與Bonferroni 測驗進行統計分析。結果：體外受精婦女在妊娠期前二十週之心理壓力隨妊娠週數增加而增加（p ＜ .01），自然懷孕婦女則沒有顯著差異。針對妊娠時間與受孕方式進行分析，妊娠週數為主要影響因子，其中妊娠壓力次量表之「認同母親角色」及「身體外型和活動改變」所引發的心理壓力，隨妊娠週數增加而增加（p ＜ .00）；而不同受孕方式在妊娠期前二十週之心理壓力並未達統計差異（p ＞ .05）。結論／實務應用：本結果提供醫護人員了解體外受精妊娠前期心理壓力不會比自然懷孕婦女的高，但兩者壓力的次量表有不同的強度與趨勢。護理人員可評估不同受孕方式之孕婦特殊壓力程度，依妊娠週數提供適切之精神健康照護。

關鍵字

體外受精 ； 妊娠壓力 ； 自然懷孕

並列摘要

Background: Women who undergo in vitro fertilization/embryo transfer (IVF/ET) face complicated psychological stress and negative emotions, which may affect health during pregnancy and the development of the fetus. The current literature does not address the question of whether women who become pregnant spontaneously and women who undergo IVF face similar levels of pregnancy stress. Purpose: This study investigates the differences in pregnancy stress between women with spontaneous pregnancy and women with IVF/ET pregnancy living in central Taiwan during their first 20 weeks of pregnancy. Methods: A prospective, longitudinal design with repeated measures, generalized estimated equations model, Wilks’ λ, and Bonferroni test was used. Purposive samples of 163 women who had undergone IVF/ET and of 94 women who had undergone spontaneous pregnancy were enrolled as participants. Pregnancy stress was measured using the Chinese version of the self-administered Pregnancy Stress Scale at the 9th, 12th, and 20th weeks of pregnancy. Results: The psychological stress experienced by IVF participants significantly increased with gestational week during the first 20 weeks of pregnancy (p G .01) but did not significantly increase in spontaneous-pregnancy participants. Gestational week was the main factor found to influence stress ratings for ＂identifying maternal role.＂ ＂Altering body structure and body function＂ was the main factor found to influence pregnancy stress (p G .00). The method of becoming pregnant had no significant influence on pregnancy stress during the first 20weeks of pregnancy (p 9 .05). Conclusions/Implications for Practice: The results of this study provide clinical evidence that IVF/ET does not cause more stress for women than spontaneous pregnancy. However, the intensity and trend of stresses differed between these two groups. These findings suggest that nurses should consider method of pregnancy when assessing the risk of stress in expectant mothers for each gestational week and when providing appropriate care and support.

並列關鍵字

in vitro fertilization and embryo transfer ； pregnancy stress ； spontaneous pregnancy

參考文獻

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