Nausea and Vomiting in Pregnancy – A Contribution to Its Epidemiology

Abstract

Nausea in pregnancy is very common but it is astonishing that so little data are available concerning the cause and course of this disorder. A questionnaire was mailed to all women who had given birth to at least 3 children, the last delivered in 1980 or 1981 in our department. 244 (75%) responded, mean age 33 years, range 23–45. A total of 948 pregnancies resulted in 855 children, 56 spontaneous and 25 legal abortions, 8 twins and 4 ectopics. 70% of all pregnancies were associated with nausea and 52% of the patients always experienced nausea during their pregnancies, while 17% never and 31 % only occasionally felt sick. For 91 % of the cases, the onset of nausea was during the first 3 months. There was no difference concerning intensity, ‘peak nausea’ or onset, whereas duration decreased with subsequent pregnancies. 7 of 8 women with twin pregnancies complained of nausea, contrasting to 50% with spontaneous and 80% with legal abortions. Age, smoking or ‘pregnancy complications’ did not correlate with nausea. There were, however, correlations (p < 0.05) between nausea and gallbladder disease, gastritis and allergy. All patients with gallbladder disease had nausea and so had 90% of those with allergy and gastritis. There was also a strong correlation (p < 0.001) between nausea in pregnancy and ‘intolerance’ of oral contraceptives, as 98% of these women experienced nausea. The data obtained do not support a correlation between HCG and emesis gravidarum, but rather suggest an association with steroidal hormones and liver function.

Human chorionic gonadotropin regulates gastric emptying in ovariectomized rats

“…Pregnant women often complain of nausea, vomiting, and abdominal distension, especially during the first trimester (Jarnfelt-Samsioe et al 1983). hCG is secreted by the placental trophoblast and its concentrations rise rapidly during the first trimester and peak between 10 and 14 weeks of gestation (Soules et al 1980).…”

Übelkeit und Erbrechen als evolutionäre Mechanismen der vielschichtigen Anpassungsreaktion an die Schwangerschaft

“…1 ). Dem entsprechend belegen publizierte Untersuchungen das seltenere Vorkommen von NVP bei Raucherinnen [3,5,18,38] . Gem ä ß dieser Einteilung k ö nnte NVP als dynamische r Anpassungsvorgang, der abh ä ngig von ver ä nderlichen Einfl ussfaktoren der Umgebung ist, verstanden werden.…”

“…Erstaunlich erscheint der etablierte Zusammenhang mit einer besseren fetalen Prognose im Vergleich zum Normalkollektiv, einschlie ß lich einer geringeren Abortneigung, intrauterinen Wachstumsretardierung und Fr ü hgeburtlichkeit, weshalb man NVP trotz oft leidvoll erlebter Symptomatik sicher nicht eindeutig zu den Pathologien rechnen kann [2, 4 -9] . Eine funktionale Betrachtung von NVP liegt auch durch den bekannten engen zeitlichen Zusammenhang mit der Embryogenese, der Phase h ö chster Vulnerabilit ä t und Plastizit ä t, nahe [3] . Vor diesem Hintergrund erscheint es viel versprechend, durch ein funktionales Konzept aus dem Bereich der Evolutionsbiologie bzw.…”

“…diff erierte auff ä llig von der subjektiven Einsch ä tzung der Probandinnen ( • ▶ Abb 3. ).M ö glicherweise erkl ä rt sich dieser Zusammenhang aus dem bekannten Problem der retrospektiven Ü berbewertung von NVP durch den PUQE-Score[20] oder k ö nnte im funktionalen Sinn als Quantifi zierung von NVP, PUQE versus subjektive Klassifi zierung.…”

The nutritional consequences of pregnancy sickness

“…Studies suggest endocrine factors may be the most important element in the pathogenesis of NVP (Jarnfelt-Samsioe et al 1983, 1986a, 1986bO'Connor et al 1998;Soules et al 1980). Although many women experience some nausea and vomiting while taking oral contraceptives (JarnfeltSamsioe et al 1983(JarnfeltSamsioe et al , 1985, the evidence for elevated estrogen and progesterone being the triggering mechanism is weak (Masson et al 1985;O'Connor et al 1998).…”