International Journal of Reproductive BioMedicine International Journal of Reproductive BioMedicine IJRM Medical Sciences http://ijrm.ir 1 admin 2476-4108 2476-3772 10.29252/ijrm en jalali 1400 9 1 gregorian 2021 12 1 19 12 online 1 fulltext
en دلبستگی مادری-جنینی و اضطراب بارداری در زنان باردار شده از طریق روش های کمک باروری و طبیعی: یک مطالعه طولی Maternal-fetal attachment and anxiety in pregnant women who conceived through assisted reproductive technology: A longitudinal study Pregnancy Health Original Article Original Article <div style="text-align: justify;"><strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">مقدمه: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">بارداری از طریق روش&shy;های کمک باروری (</span></span><span dir="LTR"><span style="font-size:10.0pt;">ART</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) یک تجربه استرس</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">زا است که ممکن است دلبستگی پره</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">ناتال را تحت تأثیر قرار دهد. با این وجود، دلبستگی مادری-جنینی (</span></span><span dir="LTR"><span style="font-size:10.0pt;">MFA</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) و اضطراب در بارداری بعد از </span></span><span dir="LTR"><span style="font-size:10.0pt;">ART</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">کمتر مورد بررسی قرار گرفته است.</span></span><strong><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span></strong><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">هدف: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">هدف این مطالعه، مقایسه تغییرات </span></span><span dir="LTR"><span style="font-size:10.0pt;">MFA</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">و اضطراب بارداری در سه ماهه اول و سوم در زنان باردار شده از طریق روش</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">های کمک باروری و طبیعی بود.</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">مواد و روش &shy;ها: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">یک مطالعه طولی در سال 1398 بر روی 187 زن باردار (بارداری طبیعی</span></span><span style="font-size:10.0pt;">=</span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;"> 144، کمک باروری</span></span><span style="font-size:10.0pt;">=</span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;"> 43) انجام شد. مشارکت&shy;کنندگان با استفاده از نمونه&shy;گیری مستمر از یک کلینیک پره&shy;ناتال در تهران انتخاب شدند. جهت گردآوری داده&shy;ها از مقیاس دلبستگی مادر-جنینی </span></span><span dir="LTR"><span style="font-size:10.0pt;">Cranley</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">و پرسشنامه اضطراب مرتبط با بارداری </span></span><span dir="LTR"><span style="font-size:10.0pt;">Van Den Bergh</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;"> استفاده شد.</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نتایج: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">در زنان </span></span><span dir="LTR"><span style="font-size:10.0pt;">ART</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">، نمره </span></span><span dir="LTR"><span style="font-size:10.0pt;">MFA</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">در هفته 12 بارداری پایین</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">تر از زنان باردار طبیعی بود اما در هفته 36 بارداری، تفاوت معنی</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">داری وجود نداشت. در هر دو گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">MFA</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">در 36 هفته به طور معنی&shy;داری بالاتر از 12 هفته بود (001/0 </span></span><span style="font-size:10.0pt;">&ge; </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">)</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">.</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;"> افزایش در نمره </span></span><span dir="LTR"><span style="font-size:10.0pt;">MFA</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">به طور معنی</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">داری در زنان </span></span><span dir="LTR"><span style="font-size:10.0pt;">ART</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">بالاتر از زنان باردار طبیعی بود (001/0 </span></span><span style="font-size:10.0pt;">&ge; </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">). نمره اضطراب بارداری در دو گروه افت پیدا کرد و تفاوت معنی&shy;داری در تغییرات نمره اضطراب بین دو گروه مشاهده نشد (84/0 </span></span><span style="font-size:10.0pt;">= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">).</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نتیجه&shy; گیری:</span></span></strong> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">دلبستگی به جنین در زنان باردار شده از طریق روش&shy;های کمک باروری در سه ماهه سوم بارداری مشابه سایر زنان بود و آن&shy;ها اضطراب بیشتری را تجربه نکردند. </span></span><strong><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span></strong><br> &nbsp;</div> <div style="text-align: justify;"><strong>Background: </strong>Pregnancy through assisted reproductive technology (ART) is a stressful experience that may affect prenatal attachment. However, maternal-fetal attachment (MFA) and anxiety in pregnancy after ART are understudied in Iran.<br> <strong>Objective:</strong> To compare changes in MFA and pregnancy-related anxiety (PRA) in the first and third trimester of pregnancy in women who conceived through ART compared to those who conceived naturally.<br> <strong>Materials and Methods: </strong>This longitudinal study was conducted in 2019 with 187 pregnant women (ART conception = 43, natural conception = 144). Participants were recruited using the consecutive sampling method from a prenatal clinic in Tehran. The Cranley MFA Scale and the Van Den Bergh PRA Questionnaire were used to collect the data.<br> <strong>Results:</strong> The MFA score in the 12<sup>th</sup> wk of gestation was lower in the women who conceived with ART compared to in the women who conceived naturally, but there were no statistically significant difference between the groups in wk 36. MFA in both groups was significantly higher at gestational wk 36 than wk 12 (p &le; 0.001). The increase in MFA score was significantly higher in the women who conceived with ART than in those who conceived naturally (p &le; 0.001). The anxiety score declined in the two groups and no statistically significant difference was observed in the changes of anxiety scores between the two groups (p = 0.84).<br> <strong>Conclusion: </strong>Pregnant women who conceived through ART were as attached to their fetus in the third trimester of pregnancy as other women and did not experience more PRA.</div> دلبستگی, رابطه مادری-جنینی, روش­های کمک باروری, بارداری, اضطراب. Attachment, Maternal fetal relations, Assisted reproductive technology, Pregnancy, Anxiety. 1075 1084 http://ijrm.ir/browse.php?a_code=A-10-1051-2&slc_lang=en&sid=1 Fahimeh Ranjar fahimeh_ranjbar@yahoo.com 0000-0001-7558-9815 No Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran. J.catja Warmelink catja.warmelink@inholland.nl 0000-0003-1469-4114 No Department of Midwifery Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands. Department of General Practice and Elderly Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands. Midwifery Academy, Academie Verloskunde Amsterdam Groningen (AVAG), the Netherlands. Robab Mousavi rrr.mousavi@gmail.com 0000-0002-7531-8705 No School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Maryam Gharacheh gharacheh.m@gmail.com 0000-0002-7659-0786 Yes Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran.