Associations between Nausea, Vomiting, Fatigue and Health-Related Quality of Life of Women in Early Pregnancy: The Generation R Study

Abstract

The objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early pregnancy in the Rotterdam area, the Netherlands. The information on nausea, vomiting and fatigue in the previous three months was measured in the questionnaire at enrollment, as well as potential confounders (i.e., maternal/gestational age, ethnic background, educational level, parity, marital status, body mass index, tobacco and alcohol use, chronic/infectious conditions, uro-genital conditions/symptoms, sleep quality, headache, anxiety, and depression). Health-related quality of life was assessed by the 12-item Short Form Health Survey and physical and mental component summary scores were calculated. Multivariate regression models were performed to evaluate the independent associations of the presence of nausea, vomiting and fatigue with health-related quality of life, adjusting for potential confounders. 33.6% of women experienced daily presence of nausea, 9.6% for vomiting and 44.4% for fatigue. Comparing with women who never reported nausea, vomiting and fatigue, women with daily presence of at least one of these symptoms had significantly lower scores of physical component summary and mental component summary, after adjusting for potential confounders. Our study shows how common nausea, vomiting and fatigue are among women in early pregnancy and how much each of these symptoms negatively impact on health-related quality of life. We call for awareness of this issue from health care professionals, pregnant women and their families.

Nausea and vomiting of pregnancy: Effects on quality of life and day‐to‐day function

“…Regarding QoL, our SF‐12 findings are similar to Lacasse et al . and Bai et al . who also found NVP versus no NVP women performed substantially worse in the physical domain (−13% versus −16% in our study), and lower than the corresponding scores by Chan et al .…”

“…Limitations include modest sample size, and convenience sampling of women from a single institution in Sydney's eastern suburbs (advantaged socioeconomic area), potentially not reflecting QoL effects on the wider Australian maternity population. However, overseas evidence suggest the influence of demographics on QoL in NVP is minor compared to the influence of symptom severity, so our findings likely still apply to the broader population.…”

Effect of Nausea and Vomiting on Anxiety and Depression Levels in Early Pregnancy

“…In addition to the physical condition of pregnancy, NVP and HG also negatively affect the mental health, quality of life, and functional capacity of women [6]. In severe cases, fetal development might also be affected.…”

“…Moreover, there is evidence that links this condition to alternation in a variety of hormones, including estrogen, progesterone, placental prostaglandin E2, and thyroid-stimulating hormone [1]. In addition, studies have shown that NVP may also be linked with psychological disturbances, including eating disorders, neurotic tendencies, hysteria, and rejection of pregnancy, as well as anxiety and depression with psychological stress related to poverty and marital conflicts [6,7]. From these psychological disturbances, anxiety and depression exert a special importance, because apart from being a cause, it can also be a consequence of NVP.…”

Positive Emotion and its Changes during Pregnancy: Adjunct Study of Japan Environment and Children’s Study in Miyagi Prefecture

“…Mild morning sickness symptoms in early pregnancy were associated with decreased positive emotion from early to middle pregnancy. Pregnant women with severe nausea and vomiting are known to have lower health-related QOL compared to women not experiencing these symptoms (Bai et al 2016). Moreover, the severity of nausea is associated with lower physical and mental QOL among pregnant women (Lacasse et al 2008;McCarthy et al 2011).…”