Dataset Information

Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and nausea) identifies patients with hyperemesis gravidarum and poor nutritional intake: a prospective cohort validation study.

ABSTRACT: OBJECTIVE:The English questionnaire Pregnancy-Unique Quantification of Emesis and nausea (PUQE) identifies women with severe Hyperemesis Gravidarum. Our aim was to investigate whether scores from the translated Norwegian version; SUKK (SvangerskapsUtløst Kvalme Kvantifisering) was associated with severity of hyperemesis and nutritional intake. DESIGN:A prospective cohort validation study. SETTING:Hospital cohort of Hyperemesis Gravidarum (HG) patients from western Norway and healthy pregnant women from Bergen, Norway. SAMPLE:38 women hospitalized due to HG and 31 healthy pregnant controls attending routine antenatal check-up at health centers. METHODS:Data were collected May 2013-January 2014. The study participants answered the Norwegian PUQE-questionnaire (scores ranging from 3 to 15) and registered prospectively 24-hours nutritional intake by a food list form. MAIN OUTCOME MEASURES:Differences of PUQE-scores, QOL-score and nutritional intake between hyperemesis patients and controls. RESULTS:Hyperemesis patients had shorter gestational age compared to controls (median 9.7 weeks; 95% CI 8.6-10.6 versus 11.9; 95% CI 10.1-12.9, p=0.004), and larger weight-change from pre-pregnant weight (loss of median 3 kg; 95% CI 3-4 versus gain of 2 kg; 95% CI 0.5-2, p<0.001) otherwise groups were similar regarding pre-pregnant BMI, age, gravidity, and inclusion weight. Compared to controls, hyperemesis patients had significant higher PUQE-score (median 13; 95% CI 11-14 vs. 7; 95% CI 4-8), lower QOL (median score 3; 95% CI 2-4 vs. 6; 95% CI 4.5-8) and lower nutritional intake (energy intake median 990 kcal/24 hours; 95% CI 709-1233 vs. 1652; 95% CI 1558-1880 all p<0.001). PUQE-score was inversely correlated to nutritional intake (-0.5, p<0.001). At discharge PUQE-score had fallen to median 6 (95% CI 5-8) and QOL score risen to 7 (95% CI 6-8) in the HG group, (both p<0.001 compared to admission values). CONCLUSION:PUQE-scoring has been validated as a robust indicator of severe hyperemesis gravidarum and insufficient nutritional intake in a Norwegian setting.

SUBMITTER: Birkeland E

PROVIDER: S-EPMC4382206 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and nausea) identifies patients with hyperemesis gravidarum and poor nutritional intake: a prospective cohort validation study.

Birkeland Elisabeth E Stokke Guro G Tangvik Randi J RJ Torkildsen Erik A EA Boateng Jane J Wollen Anne L AL Albrechtsen Susanne S Flaatten Hans H Trovik Jone J

PloS one 20150401 4

<h4>Objective</h4>The English questionnaire Pregnancy-Unique Quantification of Emesis and nausea (PUQE) identifies women with severe Hyperemesis Gravidarum. Our aim was to investigate whether scores from the translated Norwegian version; SUKK (SvangerskapsUtløst Kvalme Kvantifisering) was associated with severity of hyperemesis and nutritional intake.<h4>Design</h4>A prospective cohort validation study.<h4>Setting</h4>Hospital cohort of Hyperemesis Gravidarum (HG) patients from western Norway an ...[more]

PMID: 25830549

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Project description:BACKGROUND:Nausea and vomiting occur 50-90% during the first trimester of pregnancy. However, patients with hyperemesis gravidarum (HG) may be hospitalized at an incidence rate of 0.8-2% before the 20th week of gestational age. The symptoms generally start during the 5-6th gestational weeks, reaching the highest degree during the 9th week, and decline after the 16-20th weeks of gestation. Clinical findings are proportional to the severity of the disease and severe HG is characterized with dehydration, electrolyte imbalance, and nutritional deficiency as a result of vomiting. METHODS:The study population consisted of two groups of pregnant volunteers at 5-12?weeks of gestation: a severe HG group and a control group. The HG severity was scored using the Pregnancy-Unique Quantification of Emesis (and nausea) (PUQE).The serum levels of the maternal Ca, parathyroid hormone (PTH), Na, K, blood urea nitrogen(BUN), creatinine, vitamin D(25OHD3), and the maternal urine NTx levels were compared between the groups. RESULTS:In total, 40 volunteers were enrolled in this study: 20 healthy pregnant volunteers and 20 with severe HG. There were no statistically significant differences between the maternal characteristics. The first trimester weight loss of ?5?kg was significantly higher in the severe HG group (p?<?0.001), while the control group had a significantly higher sunlight exposure ratio than the severe HG group (p?=?0.021). The urine NTx levels were significantly higher in the severe HG group (39.22?±?11.68NTx/Cre) than in the control group(32.89?±?8.33NTx/Cre) (p?=?0.028).The serum Ca, PTH, Na, K, BUN, and creatinine levels were similar between the groups (p?=?0.738, p?=?0.886, p?=?0.841, p?=?0.957, p?=?0.892, and p?=?0.824, respectively). In the severe HG group, the serum 25OHD3 levels were significantly lower than in the control group (p?<?0.001). CONCLUSIONS:The data from this study indicated that severe HG is associated with increased urine NTx levels. However, large-scale studies are required to understand the clinical significance of this finding, as well as the long-term consequences of elevated urine NTx levels and the underlying mechanisms. TRIAL REGISTRATION:NCT02862496 Date of registration: 21/07/2016.

Dataset Information

Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and nausea) identifies patients with hyperemesis gravidarum and poor nutritional intake: a prospective cohort validation study.

Publications

Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and nausea) identifies patients with hyperemesis gravidarum and poor nutritional intake: a prospective cohort validation study.

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