Nausea and vomiting in pregnancy: associations with maternal gestational diet and lifestyle factors in the Norwegian Mother and Child Cohort Study

Abstract

Objective To investigate primarily the dietary intake, as well as demographics and selected lifestyle factors, of women experiencing nausea and vomiting in pregnancy, nausea only, or women who are symptom free.Design Prospective cohort study.Setting The Norwegian Mother and Child Cohort Study, a population-based pregnancy cohort.Sample Analyses were based on 51 675 Norwegian pregnancies.Methods Dietary intake was assessed by a self-reported food frequency questionnaire answered in the first trimester of pregnancy, as were data regarding nausea and vomiting. Chi-squared tests, one-way analysis of variance, and multiple linear regression were used.Main outcome measures Nausea and vomiting in pregnancy (NVP), gestational weight gain (GWG), and dietary intake.Results We found that 17 070 (33%) women experienced NVP, 20 371 (39%) experienced only nausea, and 14 234 (28%) were symptom free. Women with NVP were younger and heavier at pregnancy onset, with the lowest GWG and highest energy intake during pregnancy, primarily from carbohydrates and added sugars, compared with the other groups (P < 0.001). In multiple linear regression analysis of GWG and group adjusted for body mass index (BMI), gestational length, smoking during pregnancy, and energy intake, a significant interaction was found between BMI and group (P < 0.001). A significant effect of group (P < 0.001) was found in all BMI strata, except among underweight women (P = 0.65).Conclusions Our study suggests that women with NVP are characterised by high intakes of carbohydrates and added sugar, primarily from sugar-containing soft drinks. Whether higher intakes of carbohydrates are a response aimed to alleviate symptoms, or are actually provoking the condition, is not known.

Nausea and vomiting in early pregnancy: Effects on food intake and diet quality

“…Three previous studies examined the effects of NVP on food intake using cross‐sectional data, two in Scandinavia (Latva‐Pukkila et al, 2010; Chortatos et al, 2013) and one ecological study based on international data (Pepper & Craig Roberts, 2006). There is little consistency in the findings.…”

“…The limited cross‐sectional evidence comparing NVP and reported dietary intakes reveals inconsistent associations. In a recent Norwegian study (Chortatos et al, 2013), women with NVP had slightly higher intakes of fruit and vegetables and more noticeably higher intakes of sugar‐containing soft drinks than other pregnant women. In a smaller Finnish study (Latva‐Pukkila, Isolauri, & Laitinen, 2010) women with NVP ate less meat and somewhat fewer vegetables than other pregnant women, whereas an ecological study across 21 countries (Pepper & Craig Roberts, 2006) suggested that high rates of NVP are associated with high intakes of meat, milk and eggs, and low intakes of cereals and pulses.…”

Morning sickness in pregnancy: mini review of possible causes with proposal for monitoring by diagnostic methods

“…6,11 Hormones associated with pregnancy and possibly NVP and HG include hCG, thyroxine, progesterone and oestrogen but psychological, genetic and external risk factors such as smoking, age, infection and diet are also implicated. 2,16,[17][18][19][20][21][22] Discretionally, these implicated causes are hereby briefly reviewed under five basic points:…”

“…37 Young women appear to have increased severity and incidence of NVP. 2 Weigel and Weigel, reported that women over 35 years had comparatively low rates of NVP while pregnant adolescents had high rates of NVP. 38 It has been postulated that adolescent women had a stronger anabolic drive hence a poorer outcome of pregnancy than older women.…”

“…Morning sickness is nausea and vomiting in pregnancy (NVP) with global incidence in up to 80% of pregnancies 1,2 and can be debilitating and affect daily functioning such as child care, social interactions, house chores, or employment. 1,3,4 Morning sickness occurs at any time but is common in the morning 5 and several theories exist on the causes and these include infections, hormonal control 6 and vitamin deficiency.…”