The psychosocial burden of hyperemesis gravidarum

Poursharif, Borzouyeh; Korst, Lisa M.; Fejzo, Marlena S.; MacGibbon, Kimber; Romero, Roberto; Goodwin, T. Murphy

doi:10.1038/sj.jp.7211906

Cited by 105 publications

(83 citation statements)

References 23 publications

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“…HG is associated with morbidity such as acute kidney injury (Machado et al, 2012), liver dysfunction (Shekhar et al, 2015), pneumomediastinum (Gorbach et al, 1997; Liang et al, 2002), ruptured esophagus (Buchanan et al, 2014), and Wernicke’s encephalopathy (Berdai et al, 2016; Giugale et al, 2015). In addition, a recent case-control study found that psychological distress was a direct consequence of HG (Aksoy et al, 2015), which is in accordance with previous reports of increased risk of cognitive, behavioral, and emotional disorders in this population (Poursharif et al, 2008; Zur, 2013). Even more, the complications associated with HG can result in termination of an otherwise wanted pregnancy (Poursharif et al, 2007; Trogstad et al, 2005).…”

Section: Hyperemesis Gravidarumsupporting

confidence: 89%

Nausea and vomiting of pregnancy - What's new?

Bustos

Venkataramanan²,

Caritis

2017

Autonomic Neuroscience

116

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Nausea and vomiting of pregnancy (NVP) is one of the most common disorders of pregnancy. The symptoms occur predominantly during the first trimester, although in a subgroup of patients they can continue throughout the entire pregnancy and can affect the woman’s quality of life. A small percentage of women develop a severe form of NVP called hyperemesis gravidarum (HG) that if left untreated may lead to significant maternal morbidity and adverse birth outcomes. Overall, the morbidity in pregnant women with NVP is significant, although it tends to be underestimated. The pathogenesis of NVP remains unclear, but there is consensus that the disorder is multifactorial and that various genetic, endocrine and infectious factors may be involved. The treatment of NVP can be challenging as the optimal targets for therapy are not known. Currently, the therapy used depends on the severity of the disorder and it is focused on improving the symptoms while minimizing risks to mother and fetus. Therapies range from dietary changes, pharmacologic treatment or hospitalization with intravenous fluid replacement and nutrition therapy. The aims of this review are 1) to provide an overview of NVP, 2) to present possible links between the most important factors associated with the pathogenesis of NVP and 3) to discuss the effectiveness and safety of the pharmacologic and non-pharmacologic options available to treat this disorder.

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Section: Hyperemesis Gravidarumsupporting

confidence: 89%

Nausea and vomiting of pregnancy - What's new?

Bustos

Venkataramanan²,

Caritis

2017

Autonomic Neuroscience

116

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“…A careful review of the literature indicates that medical complications occurring during pregnancy and/or childbirth have been inconsistently linked to postpartum psychiatric disorders (Blom et al 2010). These include complications of pregnancy such as pre-eclampsia (Steegers et al 2010; Robillard et al 2011; Di Florio et al 2014; Munk-Olsen et al 2014), hyperemesis gravidarum (HG; severe nausea and vomiting) (Poursharif et al 2008; Buyukkayaci Duman et al 2015), gestational diabetes (Nicklas et al 2013; Barakat et al 2014; Ferrara et al 2014; Meltzer-Brody & Stuebe, 2014) and gestational hypertension (Bijlenga et al 2011; Rigó et al 2015), as well as obstetrical complications including postpartum hemorrhage (Sentilhes et al 2011; Thompson et al 2011), Cesarean section (C-section) (Hannah et al 2004; Sword et al 2011; Houston et al 2015) and preterm birth (Grigoriadis et al 2013; Barroso et al 2015; Helle et al 2015). These pregnancy and obstetrical complications occur relatively commonly: The prevalence of pre-eclampsia is 5–8% of all pregnancies (Leffert, 2015), preterm birth is about 10% (Delnord et al 2015; Horgan, 2015) and gestational diabetes is up to 9% (DeSisto et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Obstetrical, pregnancy and socio-economic predictors for new-onset severe postpartum psychiatric disorders in primiparous women

et al. 2017

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Background Childbirth is a potent trigger for the onset of psychiatric illness in women including postpartum depression (PPD) and postpartum psychosis (PP). Medical complications occurring during pregnancy and/or childbirth have been linked to postpartum psychiatric illness and sociodemographic factors. We evaluated if pregnancy and obstetrical predictors have similar effects on different types of postpartum psychiatric disorders. Method A population-based cohort study using Danish registers was conducted in 392 458 primiparous women with a singleton delivery between 1995 and 2012 and no previous psychiatric history. The main outcome was first-onset postpartum psychiatric episodes. Incidence rate ratios (IRRs) were calculated for any psychiatric contact in four quarters for the first year postpartum. Results PPD and postpartum acute stress reactions were associated with pregnancy and obstetrical complications. For PPD, hyperemesis gravidarum [IRR 2.69, 95% confidence interval (CI) 1.93–3.73], gestational hypertension (IRR 1.84, 95% CI 1.33–2.55), pre-eclampsia (IRR 1.45, 95% CI 1.14–1.84) and Cesarean section (C-section) (IRR 1.32, 95% CI 1.13–1.53) were associated with increased risk. For postpartum acute stress, hyperemesis gravidarum (IRR 1.93, 95% CI 1.38–2.71), preterm birth (IRR 1.51, 95% CI 1.30–1.75), gestational diabetes (IRR 1.42, 95% CI 1.03–1.97) and C-section (IRR 1.36, 95% CI 1.20–1.55) were associated with increased risk. In contrast, risk of PP was not associated with pregnancy or obstetrical complications. Conclusions Pregnancy and obstetrical complications can increase the risk for PPD and acute stress reactions but not PP. Identification of postpartum women requiring secondary care is needed to develop targeted approaches for screening and treatment. Future work should focus on understanding the contributions of psychological stressors and underlying biology on the development of postpartum psychiatric illness.

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“…Although, HG is today considered a disease of unclear pathophysiology (Grooten et al 2015), clinical practice still includes evaluation of hyperemetic women for psychiatric disease (Kim et al 2009). Women with HG report lack of support from their healthcare providers (Heitmann et al 2016; Poursharif et al 2008), which may have severe consequences such as termination of pregnancy and psychological sequelae (Poursharif et al 2008; Poursharif et al 2007). …”

Section: Introductionmentioning

confidence: 99%

History of depression and risk of hyperemesis gravidarum: a population-based cohort study

Kjeldgaard

Eberhard‐Gran

Benth

et al. 2017

Arch Womens Ment Health

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Hyperemesis gravidarum (HG) is a pregnancy condition characterised by debilitating nausea and vomiting. HG has been associated with depression during pregnancy but the direction of the association remains unclear. The aim of this study was to assess whether previous depression is associated with HG. This is a population-based pregnancy cohort study using data from The Norwegian Mother and Child Cohort Study. The study reviewed 731 pregnancies with HG and 81,055 pregnancies without. Logistic regression analyses were performed to examine the association between a lifetime history of depression and hyperemesis gravidarum. Odds ratios were adjusted for symptoms of current depression, maternal age, parity, body mass index, smoking, sex of the child, education and pelvic girdle pain. A lifetime history of depression was associated with higher odds for hyperemesis gravidarum (aOR = 1.49, 95% CI (1.23; 1.79)). Two thirds of women with hyperemesis gravidarum had neither a history of depression nor symptoms of current depression, and 1.2% of women with a history of depression developed HG. A lifetime history of depression increased the risk of HG. However, given the fact that only 1.2% of women with a history of depression developed HG and that the majority of women with HG had no symptoms of depression, depression does not seem to be a main driver in the aetiology of HG.

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The psychosocial burden of hyperemesis gravidarum

Cited by 105 publications

References 23 publications

Nausea and vomiting of pregnancy - What's new?

Nausea and vomiting of pregnancy - What's new?

Obstetrical, pregnancy and socio-economic predictors for new-onset severe postpartum psychiatric disorders in primiparous women

History of depression and risk of hyperemesis gravidarum: a population-based cohort study

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