Hyperemesis gravidarum is associated with increased rates of termination of pregnancy and suicidal ideation: results from a survey completed by >5000 participants

Abstract

Hyperemesis gravidarum (HG) has a detrimental effect on physical and mental health. Termination of pregnancy (TOP) is reported in approximately 10%, 1 and qualitative research studies report an association with suicidal ideation. 2 We aimed to determine the consequences of HG on TOP and suicidal ideation, with particular reference to disease severity, functional status, and perception of care. STUDY DESIGN:This national cross-sectional study utilized a 14-item anonymous online survey distributed across the United Kingdom, incorporating demographic details, self-reported disease severity, consequence on functional status, mental health, details of the care experience, and opportunity for open box feedback.

Recurrence, postponing pregnancy, and termination rates after hyperemesis gravidarum: Follow up of the MOTHER study

“…Previous surveys have identified a termination rate for HG between 3% and 15%. 3 , 11 , 26 Poursharif et al 3 reported that 6% (49/808 women) underwent multiple terminations for HG and an additional 13% “almost” terminated their pregnancy due to HG. Although in our study only one woman terminated a pregnancy due to developing HG again, we found that 23% of women considered terminating a pregnancy, which is consistent with a rate of 26.7% (56/210 women) reported in a Scandinavian population.…”

“…reporting on the effect of HG on women's lives and is recognized by our Patient and Public Involvement representatives.Previous surveys have identified a termination rate for HG between 3% and 15% 3,11,26. Poursharif et al3 reported that 6% (49/808 Baseline characteristics of women included in this follow-up study…”

“…Both overestimating and underestimating the recurrence rate can have substantial impacts on people’s lives. There are reports of families curtailing future pregnancies believing HG is unavoidable as well as reports of women deciding to terminate on the assumption that their risk in a future pregnancy is that of the general population 3,10,11 …”

Hyperemesis gravidarum in the primary care setting: cross-sectional study of GPs

“…Maternal complications include electrolyte disturbance (15-28%), Wernicke's encephalopathy (secondary to thiamine deficiency) (<1%), and susceptibility to thrombus 5,6 . Mental health complications include increased rates of anxiety (46%), depression (47.8%) and suicidal ideation (6.6%) [7][8][9][10][11][12][13] . Effects on the fetus include a four-fold increased risk of low birthweight and preterm birth and three-fold increased odds of neurodevelopmental delay 14,15 .…”

“…In a recent survey of >5000 women with HG, 40% perceived their experience in primary care to be poor or extremely poor in terms of HG management 13 . These women were more likely to terminate a wanted pregnancy as a consequence of HG or experience suicidal ideation.…”