Mode of conception in relation to nausea and vomiting of pregnancy: a nested matched cohort study in Sweden.
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ABSTRACT:
SUBMITTER: Bazargani F
PROVIDER: S-EPMC8079670 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundNausea and vomiting are experienced by most women during pregnancy. The onset is usually related to Last Menstrual Period (LMP) the date of which is often unreliable. This study describes the time to onset of nausea and vomiting symptoms from date of ovulation and compares this to date of last menstrual period METHODS: Prospective cohort of women seeking to become pregnant, recruited from 12 May 2014 to 25 November 2016, in the United Kingdom. Daily diaries of nausea and vomiting were kept by 256 women who were trying to conceive. The main outcome measure is the number of days from last menstrual period (LMP) or luteinising hormone surge until onset of nausea or vomiting.ResultsAlmost all women (88%) had Human Chorionic Gonadotrophin rise within 8 to 10 days of ovulation; the equivalent interval from LMP was 20 to 30 days. Many (67%) women experience symptoms within 11 to 20 days of ovulation.ConclusionsOnset of nausea and vomiting occurs earlier than previously reported and there is a narrow window for onset of symptoms. This indicates that its etiology is associated with a specific developmental stage at the foetal-maternal interface.Trial registrationNCT01577147 . Date of registration 13 April 2012.
| S-EPMC7786982 | biostudies-literature
Project description:BackgroundThe American Society of Anesthesiologists Physical Status Classification System is commonly used for preoperative assessment. Patient physical status before surgery can play an important role in postoperative nausea and vomiting. However, the relationship between the physical status classification and postoperative nausea and vomiting has not been well defined.MethodsAdults aged ≥ 18 years who underwent procedures under anesthesia between 2015 and 2020 were included in the study. We analyzed the relationship of postoperative nausea and vomiting with physical status classification score using propensity score matching and Cox hazard regression. Differences in intraoperative use of vasopressor and inotropes and invasive monitoring were investigated according to the classification.ResultsA total of 163,500 patients were included in the study. After matching, classification 1 versus 2 included 43,400 patients; 1 versus ≤ 3, 13,287 patients; 2 versus ≤ 3, 23,530 patients (absolute standardized difference, 0-0.06). Patients with physical status classification ≤ 3 had a significantly lower postoperative nausea and vomiting risk than those with classification 1-2 (physical status classification 1 vs. ≤ 3, hazard ratio 0.76 [0.71-0.82], P < 0.001; 2 versus ≤ 3, hazard ratio 0.86 [0.82-0.91], P < 0.001). Intraoperative use of vasopressor or inotrope and invasive monitoring were noted more in the high physical status classification than the low physical status classification (absolute standardized difference [0.19-1.25]).ConclusionThere were differences in intraoperative invasive monitoring and use of vasopressor or inotrope among the classifications, and a score of 3 or higher reduced the risk of postoperative nausea and vomiting more than a score of 1-2.
| S-EPMC9446728 | biostudies-literature
Project description:PurposeTo examine whether personal history of nausea or history of nausea and vomiting of pregnancy (NVP) in relatives are risk factors for a woman to suffer from NVP. Further, to evaluate if these factors are associated with the severity of NVP.MethodsCohort study of 2411 pregnant women recruited from maternity health care clinics. The severity of NVP was categorized according to Pregnancy-Unique Quantification of Emesis (PUQE) questionnaire into no/mild/moderate/severe NVP. History of nausea was assessed in connection with motion sickness, seasickness, migraine or other kinds of headache, after anesthesia, related to the use of contraceptives, and other kinds of nausea. History of NVP in relatives was categorized into first-degree (mother/sister) and second-degree relatives (more distant).ResultsIn multivariable analysis including previous personal history of nausea, motion sickness (OR 3.17, 95% CI 1.81-5.56, p < 0.0001) and nausea in migraine (OR 3.18, 95% CI 1.86-5.45, p < 0.0001) were associated with severe NVP. History of nausea in other kinds of headache was associated with moderate NVP (OR 1.91, 95% CI 1.34-2.72, p = 0.001). Women with affected first-degree relatives had higher odds for moderate (OR 3.84, 95% CI 2.72-5.40) and severe (OR 3.19, 95% CI 1.92-5.28) NVP (p < 0.0001). All these results remained significant after adjusting for parity, body mass index, smoking, employment and age.ConclusionWomen with personal history of nausea or family history of NVP have an increased susceptibility of NVP. This information is useful in pre-pregnancy counselling.
| S-EPMC7471164 | biostudies-literature
Project description:BackgroundNausea and vomiting during pregnancy (NVP) is the most common complication of pregnancy. NVP has been associated with improved fetal outcomes, but its association with childhood neurodevelopmental outcomes has rarely been studied.MethodsSubjects were children aged 5-12 years (n = 560) who were controls in a previously conducted case-control study of prenatal risk factors for craniofacial malformations. Information on NVP, including trimester, duration, and treatment, was collected through a maternal interview conducted within 3 years of delivery. Neurocognition was assessed using the Peabody Picture Vocabulary Test (PPVT-III) and the Beery-Buktenica Test of Visual Motor Integration-Fifth Edition (VMI-5). Psychosocial outcomes, including internalising and externalising behaviour problems, were measured by maternal report, using the Child Behavior Checklist (CBCL), and teacher report, using the Teacher Report Form. Linear regression models were used to calculate adjusted mean (adjMD -3.04, 95% confidence interval (CI) -5.02, -1.06) differences (adjMD) and 95% confidence intervals [CI] on test scores for children exposed and unexposed to NVP in utero. Differences based on trimester, duration, and treatment were assessed.ResultsNVP was reported among 63% of women and was most common in early pregnancy. Children exposed to NVP performed worse on the VMI-5 [-3.04, 95% CI: -5.02, -1.06] but exhibited few other differences from unexposed children. Durations of NVP ≥4 months were associated with poorer scores on PPVT-III (adjMD -2.52), VMI-5 (adjMD -5.41), and CBCL [adjMD 3.38 (internalising) and adjMD 4.19 (externalising)].ConclusionsOverall, there were few differences between children exposed and unexposed to NVP. NVP was associated with slightly worse visual motor performance, and prolonged NVP and NVP extending late into pregnancy were associated with poorer scores on several neurodevelopmental measures.
| S-EPMC4232991 | biostudies-literature
Project description:GDF15, a hormone acting on the brainstem, has been implicated in the nausea and vomiting of pregnancy, including its most severe form, hyperemesis gravidarum (HG), but a full mechanistic understanding is lacking1-4. Here we report that fetal production of GDF15 and maternal sensitivity to it both contribute substantially to the risk of HG. We confirmed that higher GDF15 levels in maternal blood are associated with vomiting in pregnancy and HG. Using mass spectrometry to detect a naturally labelled GDF15 variant, we demonstrate that the vast majority of GDF15 in the maternal plasma is derived from the feto-placental unit. By studying carriers of rare and common genetic variants, we found that low levels of GDF15 in the non-pregnant state increase the risk of developing HG. Conversely, women with β-thalassaemia, a condition in which GDF15 levels are chronically high5, report very low levels of nausea and vomiting of pregnancy. In mice, the acute food intake response to a bolus of GDF15 is influenced bi-directionally by prior levels of circulating GDF15 in a manner suggesting that this system is susceptible to desensitization. Our findings support a putative causal role for fetally derived GDF15 in the nausea and vomiting of human pregnancy, with maternal sensitivity, at least partly determined by prepregnancy exposure to the hormone, being a major influence on its severity. They also suggest mechanism-based approaches to the treatment and prevention of HG.
| S-EPMC10808057 | biostudies-literature
Project description:BackgroundNausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite during pregnancy on birth outcomes in rural Nepal.MethodsObservational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011 to 2013. Exposure was defined as nausea, vomiting or poor appetite at any point during pregnancy and by trimester; symptoms were recorded monthly throughout pregnancy. Adverse outcomes were low birth weight (LBW), preterm birth and small for gestational age (SGA). Adjusted relative risks (aRR) with 95% CIs are reported from Poisson regressions with robust variance.ResultsAmong 3,623 pregnant women, the cumulative incidence of nausea, vomiting or poor appetite was 49.5% (n = 1793) throughout pregnancy and 60.6% (n = 731) in the first trimester. Significantly higher aRRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower aRR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29).ConclusionsSymptoms of nausea, vomiting or poor appetite during pregnancy are associated with LBW, SGA and preterm birth in a setting with limited resources, especially beyond the first trimester.Trial registrationProspectively registered at ClinicalTrials.gov on Dec 17, 2009 ( NCT01034254 ).
| S-EPMC7499900 | biostudies-literature
Project description:Nausea and vomiting in pregnancy (NVP) is a pervasive and debilitating phenomenon in humans. Several adaptive explanations for NVP occurrence have been recently proposed, the two most prominent of which predict associations with nutritional intake or specific dietary components. Here we extend previous cross-cultural analyses by analysing associations between NVP prevalence in 56 studies (21 countries) and quantitative estimates of per capita intake across major dietary categories, measured for the year of study by the Food and Agriculture Organisation (FAO). Rates of nausea and vomiting in pregnancy were correlated with high intake of macronutrients (kilocalories, protein, fat, carbohydrate), as well as sugars, stimulants, meat, milk and eggs, and with low intake of cereals and pulses. Restricting analyses to studies from North America and Europe caused relationships between macronutrient intake and NVP to disappear, suggesting that they might be influenced by non-dietary confounds associated with geographical region of study. However, factor analysis of dietary components revealed one factor significantly associated with NVP rate, which was characterized by low cereal consumption and high intake of sugars, oilcrops, alcohol and meat. The results provide further evidence for an association between diet and NVP prevalence across populations, and support for the idea that NVP serves an adaptive prophylactic function against potentially harmful foodstuffs.
| S-EPMC1635459 | biostudies-literature
Project description:Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP.We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of "nausea and vomiting in pregnancy" or "hyperemesis gravidarum." Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses.There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6%) had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06-1.61]), high parity (OR 1.50 95% CI [1.12-2.00]), and early gestational age (OR 0.74 95% CI [0.60-0.90]) were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59-0.91]) was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002).NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition.
| S-EPMC5017843 | biostudies-other
Project description:Experiences of nausea and/or vomiting in pregnancy (NVP) vary greatly, but the paucity of studies with pre-pregnancy dietary data mean that little is known about the effects of NVP on diet. Using an administered food frequency questionnaire, diet was assessed before pregnancy and at 11 and 34 weeks' gestation in 2270 participants in a UK birth cohort study (Southampton Women's Survey). Experience of NVP in early pregnancy was graded as none, mild, moderate, or severe. Participants reported their level of food consumption as more, the same, or less than before pregnancy. "Prudent" diet scores (derived using principal component analysis) were used to describe participants' diet quality before, in early and late pregnancy. In early pregnancy, 89% of women were nauseous, although most commonly, the NVP experienced was mild (48%) or moderate (30%); 11% had severe NVP. A total of 39% of women reported an increase in their level of food intake in early pregnancy; 34% reported a reduction. Increasing severity of nausea was associated with changes in intake of a range of foods, most notably reduced consumption of vegetables, tea/coffee, rice/pasta, breakfast cereals, beans/pulses and citrus fruits/fruit juices and increased consumption of white bread, and soft drinks. Increasing severity of nausea was also associated with decreasing prudent diet score from before to early pregnancy, such that women with severe nausea had prudent diet scores 0.29 SDs lower than those with no nausea (P < 0.001). However, this was transient as NVP was not related to change in diet quality from before to late pregnancy.
| S-EPMC5400073 | biostudies-literature
Project description:Nausea and vomiting of pregnancy (NVP) is a common problem for pregnant women. Researchers have recently paid special attention to complementary medicine methods for the treatment of NVP. Regarding the high prevalence of NVP as well as maternal and fetal adverse effects of chemical drugs, the present study, focusing on clinical trials carried out in Iran, was conducted to assess safety and efficacy of different nonpharmacological methods in relieving NVP. This systematic review focused on randomized controlled trials (RCTs) and assessed complementary medicine on NVP for which databases including MedLib, Magiran, Iran Medex, SID, PubMed, Scopus, and Google Scholar search engines from 2000 to 2015 were searched. Those articles that gained score 3 or higher, according to Jadad criteria, were recruited for the study. In this study, 31 clinical trials assessing NVP were conducted on Iranian pregnant women. After removing ten articles, 21 articles with scores 3 and higher, according to Jedad criteria, were assessed. Out of 21 papers, 10 papers were about ginger, one was about cardamom, one was about lemon, two were about peppermint aromatherapy, six were about pericardium 6 (P6) acupressure, and one article about KID21 acupressure. Most studies have demonstrated a positive effect on reducing NVP; however, no adverse effect was reported. According to the results of this review, the majority of methods employed were effective in reducing the incidence of NVP, among which ginger and P6 acupressure can be recommended with more reliability.
| S-EPMC6177529 | biostudies-other