Hyperemesis gravidarum: Associations with personal and family history of nausea

Abstract

IntroductionThe pathogenesis and risk factors for hyperemesis gravidarum, excessive nausea and vomiting of pregnancy, are not adequately recognized. In our previous study, we found that women with a personal history of nausea in different situations and a family history of nausea and vomiting of pregnancy (NVP) were more likely to have severe NVP. The present study focuses on these themes in association with hyperemesis gravidarum in a hospital setting.Material and methodsWomen with hyperemesis gravidarum (n = 102) were recruited from among patients hospitalized due to hyperemesis gravidarum in Turku University Hospital, Finland. Our control group (Non‐NVP group, n = 138) consisted of pregnant women with no NVP. Personal history of nausea in different situations was inquired about in relation to “motion sickness”, “seasickness”, “migraine”, “other kind of headache”, “after anesthesia”, “during the use of contraception”, and “other kinds of nausea”. Relatives with NVP were divided into first‐degree (mother and sisters) and second‐degree (more distant) relatives.ResultsIn univariate analysis, a personal history of motion sickness, seasickness, nausea related to migraine, nausea with other headache and nausea in other situations were associated with hyperemesis gravidarum. After adjusting for age, parity, pre‐pregnancy body mass index, marital status, and smoking, motion sickness (adjusted odds ratio [aOR] 5.24, 95% confidence interval [CI] 2.67–10.31, p < 0.0001), seasickness (aOR 4.82, 95% CI 2.32–10.03, p < 0.0001), nausea related to migraine (aOR 3.00, 95% CI 1.58–5.70, p < 0.001), and nausea in other situations (aOR 2.65, 95% CI 1.13–6.20, p = 0.025) remained significant. In multivariable analysis with all history of nausea variables, motion sickness (OR 2.76, 95% CI 1.29–5.89, p = 0.009) and nausea related to migraine (OR 3.10, 95% CI 1.40–6.86, p = 0.005) were associated with hyperemesis gravidarum. Having any affected relative (OR 3.51, 95%CI 1.84–6.73, p = 0.0002), especially a first‐degree relative (OR 3.06, 95% CI 1.62–5.79, p = 0.0006), was also associated with hyperemesis gravidarum. Adjustment did not change the results.ConclusionsWomen with a personal history of nausea or a family history of NVP are more likely to suffer from hyperemesis gravidarum. These results are beneficial to better identify and help women at risk for hyperemesis gravidarum.

The role of systemic inflammatory indices in predicting nausea and vomiting in pregnancy and the need for hospitalization

“…In line with the literature, the results of our study showed a higher BMI, higher gravidity and higher parity in patients who did not have NVP. Higher BMI is associated with lower NVP rates, and since previous NVP is a signi cant risk factor for recurrence of NVP, it is not surprising that women who have experienced NVP and HG are less likely to want to become pregnant again [39,40]. Main ndings of the present study were: (1) SII and PIV were signi cantly higher in the NVP group than in the control group.…”

Inpatient Management of Hyperemesis Gravidarum

“…13 A recent study found that participants with a personal history of motion sickness and nausea associated with migraine were at increased risk for hyperemesis gravidarum. 14 In addition, a nationwide study in the United Kingdom of more than 8 million pregnancies demonstrated that certain comorbid medical conditions, such as type 1 diabetes mellitus, thyroid dysfunction, and hypercholesterolemia, are associated with hyperemesis gravidarum. 15…”

“…Immediate goals of inpatient treatment are stabilization through rehydration and electrolyte repletion. 11 3.2 (1.6-6.4) Nulliparity 15 0.9 (0.89-0.91) for parity 1 or more Young maternal age 70 1.94 (1.77-2.12) for age younger than 20 y; 1.44 (1.38-1.52) for age 21-25 y Female fetus 15 1.23 (1.22-1.25) Multiple gestation 15 2.41 (2.24-2.59) Personal history of motion sickness 14 5.24 (2.67-10.31) Maternal comorbid medical conditions Parathyroid dysfunction 15 3.83 (2.28-6.44) Thyroid disorders 15 1.85 (1.74-1.96) Type 1 diabetes 15 1.95 (1.82-2.09) Hypercholesterolemia 15 2.54 (1.88-3.44) Helicobacter pylori infection 71 3.32 (2.25-4.90) Migraine headaches with nausea 14 3.00 (1.58-5.70) Use of ART 70 2.19 (1.81-2.64) BMI 72 2.36 (1.43-3.88) for underweight; 1.48 (1.00-2.20) for overweight…”