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Severe nausea and vomiting in early pregnancy linked to preterm birth

Robin Wulffson MD's picture
hyperemesis gravidarum, morning sickness, preterm birth, Princess Kate

The recent hospitalization of Prince William’s wife, Catherine, the Duchess of Cambridge has brought hyperemesis gravidarum, or severe morning sickness, to the forefront of public attention. The goal of the hospitalization is to get the condition under control and allow Kate to go on with her pregnancy. A new study has reported that, after the hyperemesis is resolved, other risks prevail. The findings were presented last week at the Society for Maternal-Fetal Medicine's annual meeting in Dallas, Texas.

A research team led by Dr. Gary Stanziano, of Alere Health, a company that produces health care products and offers a program to treat morning sickness, found that women who reported nausea and vomiting in pregnancy that interfered with their ability to live normally were 23%t more likely to deliver their infant before 34 weeks of gestation, and 31% more likely to have high blood pressure or preeclampsia, compared with women who said their morning sickness did not substantially affected their lives.

Dr. Stanziano noted that the findings underscore the importance of recognizing morning sickness and managing it effectively. He explained that about 50-60% of pregnant women experience some type of morning sickness during pregnancy; of those, about 1% suffer from hyperemesis gravidarum, which can lead to dehydration and malnutrition.

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The researchers noted that, while the immediate effects on mothers are easy to observe, few studies have investigated the impact of nausea and vomiting on the later stages of pregnancy, and delivery. Therefore, they analyzed information from 81,486 women enrolled in an Alere maternity education program who delivered between 2004 and 2011. After delivery, the women were asked whether they had experienced nausea and vomiting during their pregnancy that affected their ability to do their job or their daily activities. Approximately 5,200 women (6.4%) of the women surveyed, reported nausea and vomiting that affected their quality of life. Approximately 1,800 of them said they did not require any interventions, while about 3,300 required hydration or pharmacological (drug) treatments.

Among the women who said the nausea and vomiting affected their quality of life, 23% had low weight gain for their pregnancy, compared with 13.7% of women who did not have the problem. Furthermore, approximately 10% of the women who had hyperemesis gravidarum had infants who were small for their gestational age when they were born, compared with 8.4% of those who did not have nausea and vomiting severe enough to affect their daily routine.

The researchers were unable to determine why women with hyperemesis gravidarum experienced this higher complication rate; however, Dr. Stanziano noted that poor nutrition and inadequate weight gain in pregnancy may be contributing factors.

Reference: Society for Maternal-Fetal Medicine's annual meeting in Dallas, Texas

See also:
Princess Kate’s hospitalization for severe nausea and vomiting might be due to twins
Herbal remedies during pregnancy: are they safe and/or effective?