Medline ® Abstracts for References 122,147
of 'Treatment and outcome of nausea and vomiting of pregnancy'
Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis.
Veenendaal MV, van Abeelen AF, Painter RC, van der Post JA, Roseboom TJ
BACKGROUND: There is evidence that hyperemesis gravidarum (HG) is associated with a predominance of female fetuses, lower birthweights and shorter gestational ages at birth. As the adverse effects of prematurity and low birthweight on disease risk in later life have become increasingly clear, the repercussions of HG might not be limited to adverse perinatal outcomes.
OBJECTIVES: To summarise the evidence on short- and long-term outcomes of pregnancies with HG.
SEARCH STRATEGY: A literature search was conducted in the electronic databases Medline and Embase.
SELECTION CRITERIA: Studies were included that reported on the fetal, neonatal and long-term outcome of pregnancies complicated by HG.
DATA COLLECTION AND ANALYSIS: Two authors independently selected studies and extracted data. Meta-analysis was performed using review manager.
MAIN RESULTS: Women with HG during pregnancy were more likely to have a female child (OR 1.27; 95% CI 1.21-1.34). They were also more likely to have a baby with low birthweight (LBW,<2500 kg; OR 1.42; 95% CI 1.27-1.58) that was small for gestational age (SGA; OR 1.28; 95% CI 1.02-1.60), and to deliver prematurely (OR 1.32; 95% CI 1.04-1.68). There was no association with Apgar scores, congenital anomalies or perinatal death. One study described an association between HG and testicular cancer in the offspring.
AUTHOR'S CONCLUSIONS: There is evidence that HG is associated with a higher female/male ratio of offspring and a higher incidence of LBW, SGA and premature babies. Little is known about the long-term health effects of babies born to mothers whose pregnancies were complicated by HG.
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands. email@example.com
Hyperemesis gravidarum and birth outcomes-a population-based cohort study of 2.2 million births in the Norwegian Birth Registry.
Vandraas KF, Vikanes AV, Vangen S, Magnus P, Støer NC, Grjibovski AM
OBJECTIVE: To study associations between hyperemesis gravidarum (HG) and birth outcomes.
DESIGN: Population-based cohort study.
SAMPLE: Singleton births in the Norwegian Birth Registry, 1967-2009 (n = 2 270 363).
METHODS: Multiple logistic regression was applied to study associations between HG and dichotomous outcomes; multiple linear regression to study associations between HG, birthweight and gestational length. Generalised estimating equations were applied to obtain valid standard errors. Sub-analysis on data with available information on smoking was conducted (1999-2009).
MAIN OUTCOME MEASURES: Small and large for gestational age (SGA/LGA), Apgar score after 5 minutes, very preterm and preterm birth (VPTB/PTB), perinatal death, stillbirth, neonatal death, birthweight and gestational length.
RESULTS: No associations between HG and adverse pregnancy outcomes were observed in crude analyses, except for VPTB (odds ratio [OR]0.79, 95% CI 0.67-0.93). In adjusted analysis, HG was associated with perinatal death (OR 1.27, 95% CI 1.08-1.48). Inverse associations were observed between HG and VPTB (OR 0.80, 95% CI 0.68-0.94) and LGA (OR 0.95, 95% CI 0.90-0.99). Sub-analyses showed no associations between HG and perinatal death (OR 1.29, 95% CI 0.91-1.83). The inverse associations between HG, VPTB and LGA were strengthened (OR 0.66, 95% CI, 0.48-0.91 and OR 0.86, 95% CI 0.79-0.93, respectively). Exposed babies had reduced birthweight and gestational length compared with unexposed, adjusted difference - 21.4 g and - 0.5 days, respectively. Adjustment for smoking slightly strengthened the impact of HG on birthweight.
CONCLUSIONS: Inverse associations for HG and VPTB and LGA were observed. HG was associated with slight reductions in birthweight and gestational age.
Department of Genes and Environment, Division for Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; Norwegian Resource Centre for Women's Health, Rikshospitalet, Oslo, Norway.