Hyperemesis Gravidarum and Fetal Outcome

Spectrum Health, Grand Rapids, Michigan, United States
Journal of Parenteral and Enteral Nutrition (Impact Factor: 3.15). 03/2005; 29(2):93-6. DOI: 10.1177/014860710502900293
Source: PubMed


Hyperemesis gravidarum (HG) is reported in 0.5-2% of all pregnancies. The purpose of this research was to evaluate the relationship of maternal HG, neonatal birth weight, and birth outcomes.
This is a prospective cohort study of 45 patients diagnosed, by Fairweather's criteria, with HG compared with 306 non-HG control pregnant patients with singleton pregnancies. Sociodemographic and clinical data were obtained from the pregnant patients. Neonatal data were also collected, including indicators of neonatal wellness.
Significantly higher incidences of being nonwhite (33% vs 16%; p < .05) and of attaining post-high school education (60% vs 38%) were noted in the HG group, relative to controls. Mothers in the control group experienced greater gestational weight gain, 14.9 +/- 0.3 kg (mean +/- SEM) relative to mothers in the HG group (10.6 +/- 1.3 kg). Infants from HG pregnancies manifested significantly lower birth weight (3.23 +/- 0.09 kg vs 3.52 +/- 0.03 kg), younger gestational age (38.4 +/- 0.3 weeks vs 39.7 +/- 0.1 weeks), and a greater length of hospital stay (2.9 +/- 0.5 days vs 1.8 +/- 0.1 day), relative to infants from the control group. After undergoing multivariate analysis, HG was a significant predictor of decreased gestational age and increased hospital length of stay.
Infants born of women who had HG are more likely to experience decreased gestational age and increased length of hospital stay. Efficacy of early and aggressive treatment of HG, including nutrition support, in minimizing these outcomes needs to be studied.

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    • "In this perspective, the associations between HG and adverse pregnancy outcomes reported in previous research may be explained by poor maternal weight gain rather than the mother suffering from HG [9,12]. Moreover, an American case–control study found women with HG to gain on average 4.6 kg less during pregnancy, and to deliver babies who weighed on average 291 grams less compared to those born from healthy women [10]. In MoBa women with HG gained on average 2.2 kg less than women without HG, but their babies did not have lower birth weight. "
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    ABSTRACT: Hyperemesis gravidarum (HG) characterized by excessive nausea and vomiting in early pregnancy, is reported to be associated with increased risks for low birthweight (LBW), preterm birth (PTB), small-for-gestational-age (SGA) and perinatal death. Conflicting results in previous studies underline the necessity to study HG's potential effect on pregnancy outcomes using large cohorts with valid data on exposure and outcome measures, as well as potential confounders. This study aims to investigate associations between HG and adverse pregnancy outcomes using the Norwegian Mother and Child Cohort Study (MoBa). All singleton pregnancies in MoBa from 1998 to 2008 were included. Multivariable regression was used to estimate relative risks, approximated by odds ratios, for PTB, LBW, SGA and perinatal death. Linear regression was applied to assess differences in birthweight and gestational age for children born to women with and without HG. Potential confounders were adjusted for. Altogether, 814 out of 71,468 women (or 1.1%) had HG. In MoBa HG was not associated with PTB, LBW or SGA. Babies born to women with HG were born on average 1 day earlier than those born to women without HG; (-0.97 day (95% confidence intervals (CI): -1.80 - -0.15). There was no difference in birthweight when maternal weight gain was adjusted for; (23.42 grams (95% CI: -56.71 - 9.86). Babies born by women with HG had lower risk for having Apgar score < 7 after 1 minute (crude odds ratio was 0.64 (95% CI: 0.43 - 0.95). No differences between the groups for Apgar score < 7 after 5 minutes were observed. Time-point for hospitalisation slightly increased differences in gestational age according to maternal HG status. HG was not associated with adverse pregnancy outcomes. Pregnancies complicated with HG had a slightly shorter gestational length. There was no difference in birth weight according to maternal HG-status. HG was associated with an almost 40% reduced risk for having Apgar score < 7 after 1 minute, but not after 5 minutes. The clinical importance of these statistically significant findings is, however, rather limited.
    BMC Pregnancy and Childbirth 09/2013; 13(1):169. DOI:10.1186/1471-2393-13-169 · 2.19 Impact Factor
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    • "Compared with those among infants born to women without hyperemesis, rates of low birth weight and preterm delivery are substantially higher among infants born to women with hyperemesis and low weight gain (Dodds et al., 2006). There is also a report demonstrating that infants born to women with hyperemesis gravidarum are more likely to demonstrate decreased gestational age and increased length of hospital stay (Paauw et al., 2005). Adverse infant outcomes associated with hyperemesis are a consequence of poor maternal weight gain (Dodds et al., 2006). "

    Prenatal Diagnosis 01/2008; 28(1):59-61. DOI:10.1002/pd.1903 · 3.27 Impact Factor
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    • "These mothers tend to have less gestational weight gain, leading to infants with significantly lower birth weights. These infants are often born at a younger gestational age and have to stay in hospital longer (Paauw et al. 2005). From these and other studies, we can conclude that maternal weight gain strongly correlates with birth weight. "
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    ABSTRACT: Many healthcare professionals and their patients are aware of the importance of proper nutrition during pregnancy, but may not be aware of specific nutritional recommendations on how to achieve a healthy pregnancy outcome. This review article aims to discuss the implications maternal nutritional status and weight gain have in both the short and long terms. Babies born to mothers with inadequate weight gain are more likely to be premature and small for gestational age (SGA). They are also predisposed to obesity and metabolic problems later in life. Women with excessive weight gain during pregnancy are at increased risk for developing type II diabetes later in life. Their offspring also have increased body fat as babies and during childhood. Pregnant women need to be informed about appropriate weight gain and how to achieve this, and should be given specific nutritional recommendations and weight-gain goals.
    Applied Physiology Nutrition and Metabolism 03/2006; 31(1):12-20. DOI:10.1139/h06-001 · 2.34 Impact Factor
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