Title Povezanost polimorfizma gena serotoninskoga transportera i doživljaja boli u porodu Title (english) Association polymorphism serotonin transporter gene and pain experience during childbirth Author Lidija Fumić Dunkić305606044 Mentor Krunoslav Kuna (mentor)Mentor Gorka Vuletić (komentor)Committee member Vanja Bašić Kes (predsjednik povjerenstva)Committee member Vesnica Košec (član povjerenstva)Committee member Jasenka Markeljević (član povjerenstva)Committee member Dalibor Karlović (član povjerenstva)Committee member Nada Božina (član povjerenstva)Granter University of Zagreb Defense date and country 2019-10-02, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 618 - Gynaecology. Obstetrics Abstract Uvod: Porod se smatra najintenzivnijim bolnim doživljajem u životu žene koji je karakteriziran interindividualnom varijabilnosti. Za razliku od akutne i kronične boli, bol u porodu nije povezana s patologijom, već je posljedica fiziološkog procesa.
Cilj istraživanja: Cilj ovog rada bio je istražiti povezanost između polimorfizma gena serotoninskog transportera, emocionalnog stanja rodilje te individualne percepcije boli u porodu u odnosu na izbor obezboljenog poroda, odnosno epiduralnu analgeziju.
Metode: Istraživanjem su obuhvaćene rodilje podijeljene u dvije skupine - one koje su izabrale porod s epiduralnom analgezijom i one bez epiduralne analgezije. Za procjenu boli korištene su jednodimenzionalne i multidimenzionalne ljestvice. Za procjenu intenziteta boli korištena je jednodimenzionalna ljestvica, VAS skala, te Melzack-McGillov upitnik o boli koji daje informacije o kvalitativnom aspektu boli. Za procjenu anksioznosti kao osobine korištena je ljestvica anksioznosti kao osobine ličnosti (STAI-X), čime se procjenjuju razmjerno stabilne individualne razlike u sklonosti anksioznosti. Analiza polimorfizama serotoninskog transportera, promotorske regije SERTPR L/S i introna 2 SERTin2, provodila se molekularnom analitičkom metodom koja se temelji na polimeraznoj lančanoj reakciji (PCR), dok se analiza OPRM1 A118G provodila metodom PCR u stvarnom vremenu.
Rezultati: Utvrđena je značajna razlika u doživljenom intenzitetu boli između dviju skupina ispitanica prema traženju epiduralne analgezije, s većim intenzitetom boli u skupini koja je tražila obezboljen porod. U skupini rodilja koje nisu tražile epiduralnu analgeziju ukupna anksioznost značajno je pozitivno povezana s ukupnim doživljajem boli, i to tako da je značajno povezana samo s afektivnom komponentom boli. Nadalje, utvrđeno je da rodilje s visokom anksioznošću imaju značajno jače izraženu afektivnu komponentu boli u odnosu na ispitanice s umjerenom i niskom anksioznošću. Nije utvrđena statistički značajna razlika s obzirom na procjenu boli niti u odnosu na stupanj anksioznosti u korelaciji s polimorfizmimom gena serotoninskog transportera niti u odnosu na kombinaciju alela OPRM1 A118G.
Zaključak: Pokazalo se da su psihičko stanje i osobine rodilje povezani s doživljajem boli u porodu te da je subjektivni doživljaj intenziteta boli povezan s odlukom o traženju epiduralne analgezije u porodu.
Abstract (english) Introduction: The experience of childbirth is a complex, subjective, multidimensional response to sensory stimulation. Birth is considered the most intense painful experience in a woman's life that is characterized by inter-individual pertinence. Unlike acute and chronic pain, the birth pain is not related to pathology but is a consequence of the physiological process.
Aim: The aim of this study was to investigate the correlation between serotonin transporter gene polymorphism, the emotional state of a woman, and the individual perception of birth pain in relation to the choice of painless delivery, e.i. epidural analgesia.
Methods: The study included 124 women, divided into two groups, 55 had delivery with epidural analgesia and 69 without epidural analgesia. One-dimensional and multidimensional scale was used to evaluate pain. For assessing pain intensity, a one-dimensional scale was used, the VAS scales of pain estimates ranging from 0 to 10, while the Melzack-McGill pain questionnaire was used to measure the qualitative aspect of pain. This multidimensional questionnaire provides information on the sensory component, affective component of the pain, and evaluates the component of total pain. STAI-X questionnaire was used to assess anxiety as a trait, thus estimating relatively stable individual personality differences in anxiety. Serotonin transporter polymorphisms, SERTPR L / S promoter regions (long and short and long alleles) and intron 2 The SERTin2-VNTR (variable number of tandem repeats) was performed using a molecular analytical method based on polymerase chain reaction (PCR), while assay for alleles of OPRM1 A118G.
Results: Significant difference in the observed intensity of pain between the groups according to the request for epidural analgesia was found with higher pain intensity in the group that requested painless delivery. In the non-epidural analgesic group, total anxiety is significantly connected with the overall pain experience in a way that is significantly associated only with the affective component of pain. Furthermore, it has been proven that high anxiety women have a significant increase in the affective component of pain compared to moderate and low anxiety subjects, while subjects with low and moderate anxiety do not statistically significantly differ in the average affect factor affecting the patient.
Given the expression of polymorphisms of the serotonin transporter gene, there was no statistically significant difference in relation to the assessment of pain in either one component or overall pain as compared to the degree of anxiety. There was also no significant correlation between the frequency of combination of alleles OPRM1 A118G and pain or anxiety experiences.
Conclusion: No significant correlation of serotonin gene transporter gene polymorphism and pain experience was found in this study, which can be partly attributed to a small sample size. It has been shown that the women's psychological characteristics are related to the experience of birth pain and that the subjective experience of pain intensity is related to the decision to seek epidural analgesia in childbirth.
Keywords
bol u porodu
epiduralna analgezija
anksioznost
polimorfizam gena serotoninskog transportera
Keywords (english)
birth pain
epidural analgesia
anxiety
serotonin transporter gene polymorphism
Language croatian URN:NBN urn:nbn:hr:127:453568 Study programme Title: dental medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-01-24 12:00:34
