The Impact of Nausea and Vomiting of Pregnancy on Quality of Life

Clark, Shannon; Hughes, Barbara; McDonald, Susan

doi:10.1097/ogx.0b013e3182a8784d

Cited by 22 publications

(15 citation statements)

References 24 publications

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“…NVP has been reported to reduce quality of life, impairing a woman's ability to function on a day‐to‐day basis, and negatively affects relationships with her partner and family 110–130 . Women with HG are three to six times more likely than women with NVP to have low quality of life 24 .…”

Section: How Should Women With Nvp and Hg Be Offered Ongoing Antenata...mentioning

confidence: 99%

The Management of Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (Green‐top Guideline No. 69)

Nelson‐Piercy,

Dean,

Shehmar

et al. 2024

BJOG

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Key recommendations An objective and validated index of nausea and vomiting such as the Pregnancy‐Unique Quantification of Emesis (PUQE) and HyperEmesis Level Prediction (HELP) tools can be used to classify the severity of NVP and HG. [Grade C] Ketonuria is not an indicator of dehydration and should not be used to assess severity. [Grade A] There are safety and efficacy data for first line antiemetics such as anti (H1) histamines, phenothiazines and doxylamine/pyridoxine (Xonvea®) and they should be prescribed initially when required for NVP and HG (Appendix III). [Grade A] There is evidence that ondansetron is safe and effective. Its use as a second line antiemetic should not be discouraged if first line antiemetics are ineffective. Women can be reassured regarding a very small increase in the absolute risk of orofacial clefting with ondansetron use in the first trimester, which should be balanced with the risks of poorly managed HG. [Grade B] Metoclopramide is safe and effective and can be used alone or in combination with other antiemetics. [Grade B] Because of the risk of extrapyramidal effects metoclopramide should be used as second‐line therapy. Intravenous doses should be administered by slow bolus injection over at least 3 minutes to help minimise these. [Grade C] Women should be asked about previous adverse reactions to antiemetic therapies. If adverse reactions occur, there should be prompt cessation of the medications. [GPP] Normal saline (0.9% NaCl) with additional potassium chloride in each bag, with administration guided by daily monitoring of electrolytes, is the most appropriate intravenous hydration. [Grade C] Combinations of different drugs should be used in women who do not respond to a single antiemetic. Suggested antiemetics for UK use are given in Appendix III. [GPP] Thiamine supplementation (either oral 100 mg tds or intravenous as part of vitamin B complex (Pabrinex®)) should be given to all women admitted with vomiting, or severely reduced dietary intake, especially before administration of dextrose or parenteral nutrition. [Grade D] All therapeutic measures should have been tried before considering termination of pregnancy. [Grade C]

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Section: How Should Women With Nvp and Hg Be Offered Ongoing Antenata...mentioning

confidence: 99%

The Management of Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (Green‐top Guideline No. 69)

Nelson‐Piercy,

Dean,

Shehmar

et al. 2024

BJOG

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“…Nevertheless, several studies have shown that NVP significantly affect the quality of life and well-being of pregnant women. NVP can have a major impact on the woman’s physical and mental health requiring hospitalization for rehydration and treatment 5 32 . This, in turn, will affect their daily life, including work commitments 7 33 .…”

Section: Impact Of Nvpmentioning

confidence: 99%

“…Furthermore, NVP may influence the willingness of women to conceive again 33 . It is estimated that 30 to 40% of pregnant women experience limitations in participating fully in family and social activities due to NVP 5 23 34 35 36 . A survey of 621 pregnant women revealed that NVP has strongly affected their eating behavior, pleasure, diet, and sleep 5 .…”

Section: Impact Of Nvpmentioning

confidence: 99%

“…According to the National Voice of Pregnancy survey, out of the 621 respondents, 24% never mentioned their NVP symptoms to their HCP, while 37% admitted waiting until their first prenatal visit between weeks 6 to 10. Notably, 51% waited even longer until a later visit 5 . Women with moderate or severe symptoms were more likely to inform their HCP about their NVP.…”

Section: Introductionmentioning

confidence: 99%

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Nausea and Vomiting of Pregnancy and its Management with the Dual-Release Formulation of Doxylamine and Pyridoxine

Schleußner,

Jäkel,

Keck

et al. 2024

Geburtshilfe Frauenheilkd

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Nausea and vomiting of pregnancy (NVP) is among the most common conditions that pregnant women encounter in the early stages of pregnancy. It can affect up to 85% of pregnant women, thus representing a significant public health concern. NVP results in substantial negative physical, emotional, and financial consequences. Despite its prevalence, the pathogenesis remains elusive. Few guidelines have been published; however, several interventions exist for the symptomatic treatment of NVP.The aim of this review is to provide an overview of modern treatment strategies of NVP with a special focus on the recently approved dual-release formulation of the doxylamine and pyridoxine combination. This combination was approved by the Food and Drug Administration (FDA) in November 2016 for the treatment of NVP when conservative management fails, and it has been introduced to the American market in April 2018.The maximum plasma concentration (Tmax) of doxylamine and pyridoxal-5-phosphate is reached 3.5 h and 15 h, respectively, after administration of one tablet twice daily, or 4.5 h and 0.5 h, respectively, when one tablet is administered just once daily.In addition, the delayed-release combination allows sufficient levels of doxylamine and the active metabolite pyridoxal-5-phosphate in the systemic circulation, providing symptoms relief in the subsequent morning.Hence, the dual-release formulation can improve the quality of life of pregnant women suffering from NVP. Additionally, large epidemiological trials have shown no increased risk of adverse effects to newborns, demonstrating that its use is not teratogenic.

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“…In recent years, it has been revealed that NVP not only affects the physical quality of a pregnant woman's life, but it also affects their mental health, social and occupational life, and family environment (Bai et al, 2016; Hirose et al, 2020). Even in cases with mild symptoms, NVP has a negative effect on a woman's daily life, such as childcare, relationship with her partner, productivity at work, and the intention to have further pregnancies (Clark et al, 2013; Heitmann et al, 2017; Mazzotta et al, 2000; Tsuchiya et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Modification of the association between nausea and vomiting of pregnancy and anxiety by personality trait during early pregnancy: A longitudinal study of Japanese pregnant women

Maruya,

Tamakoshi,

Hirose

et al. 2023

Japan Journal Nursing Sci

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AimThis study aimed to elucidate whether personality traits modify the relationship between nausea and vomiting of pregnancy (NVP) and anxiety, stratified by three pregnancy periods: 5–8 weeks, 9–12 weeks, and 13–20 weeks.MethodsThis longitudinal study was conducted from August 2018 to February 2019 at a perinatal outpatient unit in a general hospital. We included 153 pregnant women aged ≥20 years and under 20 weeks of gestation at their first prenatal visit. They completed the Index of Nausea, Vomiting, and Retching, and the State–Trait Anxiety Inventory (STAI) to measure anxiety in terms of both trait (STAI‐T) and state anxiety (STAI‐S), and retook them at follow‐up checkups for a maximum of three times.ResultsUsing longitudinal data until 20 weeks' gestation, changes in NVP and trait anxiety were significantly associated with changes in state anxiety independently, with trait anxiety being more strongly involved than the change in NVP. This tendency was pronounced in the high‐trait anxiety group with STAI‐T scores of ≥45. Cross‐sectional analyses by gestational week showed similar results in the low‐trait anxiety group (STAI‐T < 45). In the high‐trait anxiety group, only trait anxiety was significantly associated with state anxiety up to 12 weeks gestation. However, only NVP was significantly associated with state anxiety after 13 weeks.ConclusionsPregnant women who tend to be anxious temperamentally may have other factors that cause anxiety besides nausea immediately after the discovery of pregnancy. Understanding personality traits may help reduce anxiety in pregnant women.

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The Impact of Nausea and Vomiting of Pregnancy on Quality of Life

Cited by 22 publications

References 24 publications

The Management of Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (Green‐top Guideline No. 69)

The Management of Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (Green‐top Guideline No. 69)

Nausea and Vomiting of Pregnancy and its Management with the Dual-Release Formulation of Doxylamine and Pyridoxine

Modification of the association between nausea and vomiting of pregnancy and anxiety by personality trait during early pregnancy: A longitudinal study of Japanese pregnant women

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