The Effect of Hyperemesis Gravidarum on Pregnancy Outcomes

Year 2021, Volume: 11 Issue: 4, 428 - 432, 31.07.2021

Zekiye Soykan Sert

https://doi.org/10.16899/jcm.870631

Abstract

Objective: We evaluated the clinical characteristics of the patients followed with the diagnosis of hyperemesis gravidarum (HG). We aimed to determine the effects of HG on pregnancy outcomes in these patients.
Materials and Methods: This retrospective study was conducted in the department of obstetrics of our hospital between the years 2018–2020. The study group consisted of pregnant women who were diagnosed with HG before the 20th gestational week and were treated and delivered at our hospital. The patients were divided into two groups based on the presence of HG. Both groups were compared in terms of placental dysfunction and newborn outcomes. The severity of the HG was assessed and classified. A sub-analysis of the HG group comparing mild and severe cases was performed.
Results: The study included 213 patients diagnosed with HG and 218 healthy pregnant women without HG diagnosis. Preterm birth (p=0.034) and small for gestational age (SGA) (p=0.016) were significantly higher in the HG group compared to the control group. 78.8% of the pregnant women diagnosed with HG were mild and 21.1% were severe HG. When women in the severe HG group and mild HG group were compared, we found that severe HG is associated with a higher chance of SGA (p=0.042), preterm birth (p=0.001) and admission to Neonatal Intensive Care Unit (p=0.031).
Conclusions: Babies born from hyperemetic pregnant women are at a significant risk for SGA and preterm birth compared to babies born from healthy pregnant women. This risk increases especially in pregnant women with severe HG.

Keywords

Hyperemesis gravidarum, pregnancy outcomes, small for gestational age

Hiperemezis Gravidarumun Gebelik Sonuçlarına Etkisi

Abstract

Amaç: Hiperemezis gravidarum (HG) tanısı ile takip edilen hastaların klinik özelliklerini değerlendirdik. Bu hastalarda HG'nin gebelik sonuçları üzerindeki etkilerini belirlemeyi amaçladık.
Gereç ve Yöntemler: Bu retrospektif çalışma 2018-2020 yılları arasında hastanemiz kadın hastalıkları bölümünde gerçekleştirildi. Çalışma grubu, 20. gebelik haftasından önce HG tanısı alan ve hastanemizde tedavi edilerek doğum yapılan gebelerden oluşturuldu. Hastalar HG varlığına göre iki gruba ayrıldı. Her iki grup plasental disfonksiyon ve yenidoğan sonuçları açısından karşılaştırıldı. HG'nin şiddeti değerlendirildi ve sınıflandırıldı. Hafif ve ağır vakaları karşılaştıran HG grubunun bir alt analizi yapıldı.
Bulgular: Çalışmaya HG tanısı almış 213 hasta ve HG tanısı olmayan 218 sağlıklı gebe dahil edildi. Preterm doğum (p = 0.034) ve gestasyonel yaşa göre küçük (SGA) (p = 0.016) HG grubunda kontrol grubuna göre anlamlı olarak yüksek bulundu. HG tanısı alan gebelerin % 78,8'i hafif,% 21,1'i ağır HG idi. Ağır HG grubundaki kadınlar ile hafif HG grubundaki kadınlar karşılaştırıldığında, şiddetli HG'nin daha yüksek SGA (p = 0,042), erken doğum (p = 0,001) ve Yenidoğan Yoğun Bakım Ünitesine yatış (p = 0,031) ile ilişkili olduğunu bulduk.
Sonuçlar: Hiperemetik hamile kadınlardan doğan bebekler, sağlıklı hamile kadınlardan doğan bebeklere kıyasla SGA ve erken doğum için önemli bir risk altındadır. Özellikle ağır HG'li gebelerde bu risk artar.

Keywords

Hiperemezis gravidarum, gebelik sonuçları, gebelik yaşına göre küçük

References

• 1. Gazmararian JA, Petersen R, Jamieson DJ et al. Hospitalizations during pregnancy among managed care enrollees. Obstet Gynecol.2002;100:94–100.
• 2. Jarvis S, Nelson-Piercy C. Management of nausea and vomiting in pregnancy. BMJ.2011;342:d3606.
• 3. Dodds L, Fell DB, Joseph KS, Allen VM, Butler B. Outcomes of pregnancies complicated by hyperemesis gravidarum. ObstetGynecol.2006;107:285–92.
• 4. Kuru O, Sen S, Akbayır O et al. Outcomes of pregnancies complicated by hyperemesis gravidarum. Arch Gynecol Obstet. 2012;285(6):1517- 21.
• 5. Lacasse A, Lagoutte A, Ferreira E, Berard A. Metoclopramide and diphenhydramine in the treatment of hyperemesis gravidarum: effectiveness and predictors of rehospitalisation. Eur J Obstet Gynecol Reprod Biol 2009;143(1):43-9.
• 6. Vilming B, Nesheim BI . Hyperemesis gravidarum in a contemporary population in Oslo. Acta Obstet Gynecol Scand.2000;79(8):640-3.
• 7. Sonkusare S. The clinical management of hyperemesis gravidarum. Archives of Gynecology and Obstetrics volume 283, pages 1183–1192(2011).
• 8. Fejzo MS, Poursharif B, Korst LM et al. Symptoms and pregnancy outcomes associated with extreme weight loss among women with hyperemesis gravidarum. J Womens Health (Larchmt).2009;18(12):1981-7.
• 9. Poon LC, Karagiannis G, Staboulidou I, Shafiei A, Nicolaides KH . Reference range of birth weight with gestation and first-trimester prediction of small-for-gestation neonates. Prenat Diagn.2011;31(1):58-65.
• 10. Vlachodimitropoulou KE, Gosh S, Manmatharajah B, Ray A, Igwe-Omoke N, Yoong W. Pregnancy outcomes in severe hyperemesis gravidarum in a multi-ethnic population. J Obstet Gynaecol.2013;33(5):455-8.
• 11. WHO Regional Strategy on Sexual and Reproductive Health. Definitions and Indicators in Family Planning Maternal and Child Health and Reproductive Health. Geneva: World Health Organization; 2001.
• 12. Vandraas KF, Vikanes AV, Vangen S, Magnus P, Stoer NC, Grjibovski AM. Hyperemesis gravidarum and birth outcomes-a population-based cohort study of 2.2 million births in the Norwegian Birth Registry. BJOG.2013;120(13):1654–60.
• 13. Vikanes AV, Stoer NC, Magnus P, Grjibovski AM. Hyperemesis gravidarum and pregnancy outcomes in the Norwegian Motherand Child Cohort - a cohort study. BMC Pregnancy Childbirth.2013;13:169.
• 14. Veenendaal MVE, vanAbeelen AFM, Painter RC, van der Post JAM, Roseboom T. Consequences of hyperemesis gravidarum for off spring: a systematic review and meta-analysis. BJOG.2011;118(11):1302–13.
• 15. Bailit JL. Hyperemesis gravidarium: Epidemiologic findings from a large cohort. Am J Obstet Gynecol.2005;193(3 Pt 1):811-4.
• 16. Peled Y, Melamed N, Hiersch L, Pardo J, Wiznitzer A, Yogev Y. The impact of total parenteral nutrition support on pregnancy outcome in women with hyperemesis gravidarum. .J Matern Fetal Neonatal Med.2014;27(11):1146-50.
• 17. Paauw JD, Bierling S, Cook CR, Davis AT. Hyperemesis gravidarum and fetal outcome. JPEN J Parenter Enteral Nutr.2005;29:93-6.
• 18. Roseboom TJ, Ravelli AC, van der Post JA, Painter RC. Maternal characteristics largely explain poor pregnancy outcome after hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol.2011;156(1):56-9.
• 19. Fiaschi L, Nelson-Piercy C, Gibson J, Szatkowski L, Tata LJ. Adverse Maternal and Birth Outcomes in Women Admitted to Hospital for Hyperemesis Gravidarum: a Population-Based Cohort Study. Paediatr Perinat Epidemiol.2018;32(1):40-51.
• 20. Bolin M, Akerud H, Cnattingius S, Stephansson O, Wikström AK. Hyperemesis gravidarum and risks of placental dysfunction disorders: a population-based cohort study. BJOG.2013;120(5):541-7.
• 21. Ahkam GK, Budak A. Effects of hyperemesis gravidarum on birth and neonatal outcomes. Tepecik Eğit. ve Araşt. Hast. Dergisi.2018;28(3):151-15.
• 22. Koudijs HM, Savitri AI, Browne JL et al. Hyperemesis gravidarum and placental dysfunction disorders. BMC Pregnancy Childbirth.2016;16(1):374.