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Fróes NBM, Aquino PDS, Soares PRAL, Barbosa LP, Abreu VSM, Nicolau AIO, Jorge HMF, Biazus Dalcin C. Effects of auriculotherapy on nausea and vomiting in pregnant women: A randomized clinical trial. Complement Ther Clin Pract 2024; 55:101847. [PMID: 38498964 DOI: 10.1016/j.ctcp.2024.101847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/06/2024] [Accepted: 03/09/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Pregnancy induces physiological changes, commonly marked by nausea and vomiting in the first trimester, posing risks for both mother and baby. This study evaluates the effects of auriculotherapy on nausea and vomiting during the first trimester of pregnancy. MATERIALS AND METHODS A randomized clinical trial was conducted in two primary health care centers with 56 Brazilian pregnant women who reported nausea or vomiting in the first trimester. The participants were divided into an intervention group (auriculotherapy with seeds) and a placebo group (sham auriculotherapy). The intervention was divided into three moments: pre-intervention with assessment of nausea and vomiting and application of questionnaires, and two follow-ups conducted on the fourth and seventh day of the intervention, with reassessment of nausea and vomiting. RESULTS Both groups experienced a decrease in nausea and vomiting over time, with no statistically significant differences between groups in the within-group analyses at various time points. The intervention group had a greater reduction in symptoms. Within the intervention group, symptoms were more common among ferrous sulfate users and those without reported dietary disturbances. In addition, a higher incidence of nausea and vomiting was associated with the use of analgesics, morning snacks, and low intake of protein, vegetables, and fruits. CONCLUSIONS The intervention did not affect the between-group differences in the incidence of nausea and vomiting and vomiting effort in the first trimester of pregnancy. However, a greater reduction was observed in the intervention group.
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Affiliation(s)
| | - Priscila de Souza Aquino
- Federal University of Ceara, Ceará, Fortaleza, Rua Alexandre Baraúna, 1115, CEP: 60430-160, Brazil
| | | | - Lorena Pinheiro Barbosa
- Federal University of Ceara, Ceará, Fortaleza, Rua Alexandre Baraúna, 1115, CEP: 60430-160, Brazil
| | | | | | | | - Camila Biazus Dalcin
- School of Health Sciences, University of Dundee, Nethergate, Dundee, DD1 4HN, UK.
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Schrager NL, Parker SE, Werler MM. The timing, duration, and severity of nausea and vomiting of pregnancy and adverse birth outcomes among controls without birth defects in the National Birth Defects Prevention Study. Birth Defects Res 2024; 116:e2334. [PMID: 38578229 DOI: 10.1002/bdr2.2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/31/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Nausea and vomiting of pregnancy (NVP) occurs in approximately 70% of pregnant people, with varying severity and duration. Treatments include pharmacologic and herbal/natural medications. The associations between NVP and birth outcomes, including preterm birth, small for gestational age (SGA), and low birth weight are inconclusive. OBJECTIVE To determine whether NVP and reported medications are associated with adverse birth outcomes. METHODS We used data from the population-based, multisite National Birth Defects Prevention Study (1997-2011) to evaluate whether self-reported NVP according to timing, duration, and severity or its specific treatments were associated with preterm birth, SGA, and low birth weight among controls without birth defects. Odds ratios (aOR) and 95% confidence intervals (CI) were adjusted for sociodemographic, reproductive, and medical factors. For any NVP, duration, treatment use, and severity score analyses, the comparison group was participants with no reported NVP. For timing analyses, the comparison group was women with no reported NVP in the same trimester of pregnancy. RESULTS Among 6018 participants, 4339 (72.1%) reported any NVP. Among those with NVP, moderate or severe symptoms were more common than mild symptoms. Any versus no NVP was not associated with any of the outcomes of interest. NVP in months 4-6 (aOR 1.21, 95% CI: 1.00, 1.47) and 7-9 (aOR 1.57, 95% CI: 1.22, 2.01) of pregnancy were associated with an increase in the risk of preterm birth. NVP lasting one trimester in duration was associated with decrease in risk of SGA (aOR: 0.74, 95% CI: 0.58, 0.95), and NVP present in every trimester of pregnancy had a 50% increase in risk of preterm birth (aOR: 1.50, 95% CI: 1.11, 2.05). For NVP in months 7-9 and preterm birth, ORs were elevated for moderate (aOR: 1.82, 95% CI: 1.26, 2.63), and severe (aOR: 1.53, 95% CI: 1.06, 2.19) symptoms. NVP was not significantly associated with low birth weight. Our analyses of medications were limited by small numbers, but none suggested increased risk of adverse outcomes associated with use of the medication. CONCLUSION Mild NVP and NVP limited to early pregnancy appear to have no effect or a small protective effect on birth outcomes. Long-lasting NVP, severe NVP, and NVP later in pregnancy may increase risk of preterm birth and SGA.
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Affiliation(s)
- Nina L Schrager
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Samantha E Parker
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Martha M Werler
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
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Sanati V, Sohouli MH, Dareini H, Esmailzadeh A, Sajadian AS, Raji Lahiji M, Clark CCT, Zarrati M. The Association between Dietary Patterns and Chemotherapy Side Effects in Patients with Breast Cancer (BrCa). Nutr Cancer 2023; 75:948-959. [PMID: 36734527 DOI: 10.1080/01635581.2023.2173552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study aimed to determine the relationship between food pattern and dietary intake before and during chemotherapy with the severity of gastrointestinal side effects, cancer-related fatigue, and chemotherapy-induced pain. This study was performed on 204 patients with breast cancer who were undergoing chemotherapy. Dietary pattern was collected by food frequency questionnaire and dietary intake during chemotherapy using a 24-hour food recall questionnaire. The severity of chemotherapy side effects including nausea, vomiting, constipation, diarrhea, CRF, and pain was also assessed by valid questionnaires. The relationship between dietary pattern and mean score of chemotherapy side effects was calculated using linear regression analysis. Three dietary patterns were extracted from the participants. After adjusting the effect of all possible confounders, no significant relationship was found between the dietary pattern one year before the start of treatment and the mean of chemotherapy side effects severity. Although the mean of daily energy intake with the severity of nausea and vomiting (r = -0.258, P-value <0.01), constipation, fatigue, and pain have a significant inverse relationship. Nutrition education and following a healthy diet are needed to reduce the severity of chemotherapy side effects during this period.
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Affiliation(s)
- Vahid Sanati
- Department of Nutrition Sciences, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa Dareini
- Cancer Quality of life Department, Breast Cancer Research Center, Motamed Cancer Institute, Academic Center for Education, Culture, and Reaserch (ACECR), Tehran, Iran
| | - Ahmad Esmailzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram-Sadat Sajadian
- Cancer Quality of life Department, Breast Cancer Research Center, Motamed Cancer Institute, Academic Center for Education, Culture, and Reaserch (ACECR), Tehran, Iran
| | - Mahsa Raji Lahiji
- Department of Nutrition Sciences, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Mitra Zarrati
- Department of Nutrition Sciences, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Abbasi M, Maleki A, Ebrahimi L, Molaei B. Effects of supportive counseling using a positive psychology approach on coping patterns among pregnant women with nausea and vomiting. BMC Pregnancy Childbirth 2022; 22:259. [PMID: 35346097 PMCID: PMC8958341 DOI: 10.1186/s12884-022-04603-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pregnancy nausea and vomiting (NVP) are associated with a wide range of physical and mental changes in the mothers and could affect their adaptation to pregnancy. There is a gap of knowledge regarding the effectiveness of a positive psychology approach counselling on improving coping patterns in women with NVP. Objective This study aimed to determine the effect of supportive counselling with a positive psychology approach on improving coping patterns in women with NVP. Method The current study was a randomized controlled trial on 60 pregnant women who experienced nausea and vomiting in Zanjan a province in the northwest of Iran, 2020–2021. Using four-block random sampling, eligible women were randomly assigned to the intervention and control groups. According to the Seligman protocol, the intervention group received supportive counselling in six sessions of 45 min3 times a week. The revised prenatal coping inventory (Nu PCI) was used to collect data and analyzed using Chi-square, repeated measures ANOVA, and MANOVA at a 95% confidence level. Results In the counseling group, the mean (SD) of a total score of coping with pregnancy before the intervention was 6.11 (1.31) which increased to 8.40 (1.03) in 4 weeks after the intervention. Based on the MANOVA test with adjusting the number of pregnancies, the mean total score of coping with pregnancy was statistically significant 4 weeks after the intervention compared with the control group (Adjusted mean difference (AMD) = -1.84, CI95% -2.36, -1.32, p = 0.001). Conclusion The use of positive psychology in supportive counselling improved the coping of mothers suffering from nausea and vomiting during pregnancy. It is recommended that this approach be incorporated into prenatal care to promote the health of pregnant women. Trial registration The study was registered at the Iranian Registry of Clinical Trials website under the code IRCT20150731023423N17. Registration date: 2020–10-31, Expected recruitment start date: 2020–11-01. IRCT Id: IRCT20150731023423N17. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04603-4.
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Hui D, Puac V, Shelal Z, Liu D, Maddi R, Kaseb A, Javle M, Overman M, Yennurajalingam S, Gallagher C, Bruera E. Fixed-Dose Netupitant and Palonosetron for Chronic Nausea in Cancer Patients: A Double-Blind, Placebo Run-in Pilot Randomized Clinical Trial. J Pain Symptom Manage 2021; 62:223-232.e1. [PMID: 33388382 DOI: 10.1016/j.jpainsymman.2020.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/26/2020] [Accepted: 12/29/2020] [Indexed: 11/17/2022]
Abstract
CONTEXT No clinical trials have examined the effect of netupitant/palonosetron (NEPA) on chronic nausea in patients with cancer. OBJECTIVES In this pilot randomized trial, we assessed the efficacy of NEPA and placebo on chronic nausea. METHODS This double-blind, parallel, randomized trial enrolled patients with cancer and chronic nausea for at least 1 month, intensity ≥4/10 and not on moderately or highly emetogenic systemic therapies. Patients started with a placebo run-in period from days 1 to 5; those without a placebo response proceeded to the double-blinded phase between days 6 to 15 (NEPA: placebo 2:1 ratio). The primary outcome was within-group change in average nausea over the 24 hours on a 0-10 numeric rating scale between day 5 and 15. RESULTS Among the 53 enrolled patients, 46 proceeded to placebo run-in and 33 had blinded treatment (22 NEPA and 11 placebo). We observed a statistically significant within-group improvement in nausea numeric rating scale between day 5 and 15 in the NEPA group (mean change, -2.0; 95% CI, -3.1 to -0.8) and the placebo group (mean change, -2.3; 95% CI, -3.9 to -0.7). A complete response was achieved in 8 (38%) patients in the NEPA group and 2 (20%) in the placebo group by day 15. No grade 3-4 toxicities were attributed to NEPA. There were no statistically significant between-group differences for the primary/secondary outcomes. CONCLUSIONS NEPA and placebo were associated with similar magnitude of within-group improvement in chronic nausea without significant between-group differences (Clinicaltrials.gov NCT03040726).
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Affiliation(s)
- David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, Texas, USA.
| | - Veronica Puac
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Zeena Shelal
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Diane Liu
- Department of Biostatistics, MD Anderson Cancer Center, Houston, Texas, USA
| | - Rama Maddi
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Ahmed Kaseb
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Milind Javle
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael Overman
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Sriram Yennurajalingam
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Colleen Gallagher
- Department of Bioethics, MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, Texas, USA
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Tara F, Bahrami-Taghanaki H, Amini Ghalandarabad M, Zand-Kargar Z, Azizi H, Esmaily H, Azizi H. The Effect of Acupressure on the Severity of Nausea, Vomiting, and Retching in Pregnant Women: A Randomized Controlled Trial. Complement Med Res 2020; 27:252-259. [PMID: 32018274 DOI: 10.1159/000505637] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 12/24/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Nausea and vomiting are common problems during pregnancy. Previous studies have shown that stimulation at Neiguan (PC6) acupoint can be effective in controlling pregnancy-induced nausea and vomiting. However, more evidence is required for approving this method on controlling pregnancy-induced nausea and vomiting. The aim of this study was to determine the efficacy of PC6 acupoint pressure stimulation on the severity of nausea, vomiting, and retching in pregnant women. METHOD This randomized, multi-center clinical trial was conducted on pregnant women referring to Health Centers and Ommolbanin Hospital in Mashhad, Iran, during December 2016 to September 2017. Women with first singleton pregnancy and below 12 weeks were included. Patients were randomly allocated into three groups of (1) PC6 pressure (4 times a day, for 10 min), (2) sham acupressure, and (3) medication with vitamin B6 and metoclopramide. Assessment of severity of nausea, vomiting, and retching was done based on the Rhodes Index on the first and fifth day (before and after the intervention). Pearson chi-square test, one-way ANOVA, Kruskal-Wallis, and Wilcoxon tests were used for statistical analysis using SPSS version 18. This clinical trial was registered at the Iranian Registry of Clinical Trials (IRCT) with the code IRCT201512187265N6. RESULTS Ninety patients with a mean age of 26.40 ± 4.73 years were studied in 3 groups of 30. There was no significant difference between the 3 groups in terms of the severity outcomes before the intervention, while, after the intervention, the three groups were significantly different on the fifth day in terms of vomiting frequency, distress from retching, distress from vomiting, duration of nausea, distress from nausea, amount of vomiting, frequency of nausea, and frequency of retching (p < 0.001 for each outcome). According to the linear regression analysis, the correlation between occupation with vomiting frequency (beta coefficient = 0.252) and nausea severity (beta coefficient = -0.213) was statistically significant. CONCLUSION It seems that PC6 acupoint pressure can reduce the severity of nausea, vomiting, and retching in pregnant women.
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Affiliation(s)
- Fatemeh Tara
- Department of Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Bahrami-Taghanaki
- Department of Chinese and Complementary Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | | | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hoda Azizi
- Department of Chinese and Complementary Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,
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Jalili S, Rashtchi V. The Relationship between Menstrual Cycle Phases with Postoperative Nausea and Vomiting after Open Cholecystectomy Surgery. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2018. [DOI: 10.29252/pcnm.8.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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O'Donnell A, McParlin C, Robson SC, Beyer F, Moloney E, Bryant A, Bradley J, Muirhead C, Nelson-Piercy C, Newbury-Birch D, Norman J, Simpson E, Swallow B, Yates L, Vale L. Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment. Health Technol Assess 2018; 20:1-268. [PMID: 27731292 DOI: 10.3310/hta20740] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG. DATA SOURCES MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, PsycINFO, Commonwealth Agricultural Bureaux (CAB) Abstracts, Latin American and Caribbean Health Sciences Literature, Allied and Complementary Medicine Database, British Nursing Index, Science Citation Index, Social Sciences Citation Index, Scopus, Conference Proceedings Index, NHS Economic Evaluation Database, Health Economic Evaluations Database, China National Knowledge Infrastructure, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched from inception to September 2014. References from studies and literature reviews identified were also examined. Obstetric Medicine was hand-searched, as were websites of relevant organisations. Costs came from NHS sources. REVIEW METHODS A systematic review of randomised and non-randomised controlled trials (RCTs) for effectiveness, and population-based case series for adverse events and fetal outcomes. Treatments: vitamins B6 and B12, ginger, acupressure/acupuncture, hypnotherapy, antiemetics, dopamine antagonists, 5-hydroxytryptamine receptor antagonists, intravenous (i.v.) fluids, corticosteroids, enteral and parenteral feeding or other novel treatment. Two reviewers extracted data and quality assessed studies. Results were narratively synthesised; planned meta-analysis was not possible due to heterogeneity and incomplete reporting. A simple economic evaluation considered the implied values of treatments. RESULTS Seventy-three studies (75 reports) met the inclusion criteria. For RCTs, 33 and 11 studies had a low and high risk of bias respectively. For the remainder (n = 20) it was unclear. The non-randomised studies (n = 9) were low quality. There were 33 separate comparators. The most common were acupressure versus placebo (n = 12); steroid versus usual treatment (n = 7); ginger versus placebo (n = 6); ginger versus vitamin B6 (n = 6); and vitamin B6 versus placebo (n = 4). There was evidence that ginger, antihistamines, metoclopramide (mild disease) and vitamin B6 (mild to severe disease) are better than placebo. Diclectin® [Duchesnay Inc.; doxylamine succinate (10 mg) plus pyridoxine hydrochloride (10 mg) slow release tablet] is more effective than placebo and ondansetron is more effective at reducing nausea than pyridoxine plus doxylamine. Diclectin before symptoms of NVP begin for women at high risk of severe NVP recurrence reduces risk of moderate/severe NVP compared with taking Diclectin once symptoms begin. Promethazine is as, and ondansetron is more, effective than metoclopramide for severe NVP/HG. I.v. fluids help correct dehydration and improve symptoms. Dextrose saline may be more effective at reducing nausea than normal saline. Transdermal clonidine patches may be effective for severe HG. Enteral feeding is effective but extreme method treatment for very severe symptoms. Day case management for moderate/severe symptoms is feasible, acceptable and as effective as inpatient care. For all other interventions and comparisons, evidence is unclear. The economic analysis was limited by lack of effectiveness data, but comparison of costs between treatments highlights the implications of different choices. LIMITATIONS The main limitations were the quantity and quality of the data available. CONCLUSION There was evidence of some improvement in symptoms for some treatments, but these data may not be transferable across disease severities. Methodologically sound and larger trials of the main therapies considered within the UK NHS are needed. STUDY REGISTRATION This study is registered as PROSPERO CRD42013006642. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Amy O'Donnell
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine McParlin
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Stephen C Robson
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Beyer
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Eoin Moloney
- Health Economics Group, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Bradley
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Colin Muirhead
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Justine Norman
- North Tyneside Clinical Commissioning Group, Whitley Bay, UK
| | - Emma Simpson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Laura Yates
- UK Teratology Information Service (UKTIS) and Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Health Economics Group, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
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Bø K, Artal R, Barakat R, Brown W, Davies GAL, Dooley M, Evenson KR, Haakstad LAH, Henriksson-Larsen K, Kayser B, Kinnunen TI, Mottola MF, Nygaard I, van Poppel M, Stuge B, Khan KM. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1-exercise in women planning pregnancy and those who are pregnant. Br J Sports Med 2017; 50:571-89. [PMID: 27127296 DOI: 10.1136/bjsports-2016-096218] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2016] [Indexed: 12/16/2022]
Affiliation(s)
- Kari Bø
- Norwegian School of Sport Sciences, Oslo, Norway
| | - Raul Artal
- Department of Obstetrics/Gynecology and Women's Health, Saint Louis University, St Louis, Missouri, USA
| | - Ruben Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Wendy Brown
- Centre for Research on Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Gregory A L Davies
- Department of Maternal-Fetal Medicine, Queens University, Kingston, Ontario, Canada
| | - Michael Dooley
- The Poundbury Clinic Dorchester-The Poundbury Suite, King Edward VII Hospital London, London, UK
| | - Kelly R Evenson
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Lene A H Haakstad
- Department of Sport Sciences, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Bengt Kayser
- Faculty of Biology and Medicine, Institute of Sports Science, University of Lausanne, Lausanne, Switzerland
| | - Tarja I Kinnunen
- University Lecturer, School of Health Sciences, University of Tampere, Tampere, Finland Department of Children, Young People and Families, The National Institute for Health and Welfare, Helsinki, Finland
| | - Michelle F Mottola
- R Samuel McLaughlin Foundation-Exercise and Pregnancy Lab, The University of Western Ontario London, London, Ontario, Canada
| | - Ingrid Nygaard
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
| | | | - Britt Stuge
- Oslo University Hospital, Ullevål, Oslo, Norway
| | - Karim M Khan
- Department of Family Practice & Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada
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10
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Boelig RC, Barton SJ, Saccone G, Kelly AJ, Edwards SJ, Berghella V. Interventions for treating hyperemesis gravidarum. Cochrane Database Syst Rev 2016; 2016:CD010607. [PMID: 27168518 PMCID: PMC10421833 DOI: 10.1002/14651858.cd010607.pub2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Hyperemesis gravidarum is a severe form of nausea and vomiting in pregnancy affecting 0.3% to 1.0% of pregnancies, and is one of the most common indications for hospitalization during pregnancy. While a previous Cochrane review examined interventions for nausea and vomiting in pregnancy, there has not yet been a review examining the interventions for the more severe condition of hyperemesis gravidarum. OBJECTIVES To assess the effectiveness and safety, of all interventions for hyperemesis gravidarum in pregnancy up to 20 weeks' gestation. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Complementary Medicine Field's Trials Register (20 December 2015) and reference lists of retrieved studies. SELECTION CRITERIA Randomized controlled trials of any intervention for hyperemesis gravidarum. Quasi-randomized trials and trials using a cross-over design were not eligible for inclusion.We excluded trials on nausea and vomiting of pregnancy that were not specifically studying the more severe condition of hyperemesis gravidarum. DATA COLLECTION AND ANALYSIS Two review authors independently reviewed the eligibility of trials, extracted data and evaluated the risk of bias. Data were checked for accuracy. MAIN RESULTS Twenty-five trials (involving 2052 women) met the inclusion criteria but the majority of 18 different comparisons described in the review include data from single studies with small numbers of participants. The comparisons covered a range of interventions including acupressure/acupuncture, outpatient care, intravenous fluids, and various pharmaceutical interventions. The methodological quality of included studies was mixed. For selected important comparisons and outcomes, we graded the quality of the evidence and created 'Summary of findings' tables. For most outcomes the evidence was graded as low or very low quality mainly due to the imprecision of effect estimates. Comparisons included in the 'Summary of findings' tables are described below, the remaining comparisons are described in detail in the main text.No primary outcome data were available when acupuncture was compared with placebo, There was no clear evidence of differences between groups for anxiodepressive symptoms (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.73 to 1.40; one study, 36 women, very low-quality evidence), spontaneous abortion (RR 0.48, 95% CI 0.05 to 5.03; one study, 57 women, low-quality evidence), preterm birth (RR 0.12, 95% CI 0.01 to 2.26; one study, 36 women, low-quality evidence), or perinatal death (RR 0.57, 95% CI 0.04 to 8.30; one study, 36 women, low-quality evidence).There was insufficient evidence to identify clear differences between acupuncture and metoclopramide in a study with 81 participants regarding reduction/cessation in nausea or vomiting (RR 1.40, 95% CI 0.79 to 2.49 and RR 1.51, 95% CI 0.92 to 2.48, respectively; very low-quality evidence).In a study with 92 participants, women taking vitamin B6 had a slightly longer hospital stay compared with placebo (mean difference (MD) 0.80 days, 95% CI 0.08 to 1.52, moderate-quality evidence). There was insufficient evidence to demonstrate a difference in other outcomes including mean number of episodes of emesis (MD 0.50, 95% CI -0.40 to 1.40, low-quality evidence) or side effects.A comparison between metoclopramide and ondansetron identified no clear difference in the severity of nausea or vomiting (MD 1.70, 95% CI -0.15 to 3.55, and MD -0.10, 95% CI -1.63 to 1.43; one study, 83 women, respectively, very low-quality evidence). However, more women taking metoclopramide complained of drowsiness and dry mouth (RR 2.40, 95% CI 1.23 to 4.69, and RR 2.38, 95% CI 1.10 to 5.11, respectively; moderate-quality evidence). There were no clear differences between groups for other side effects.In a single study with 146 participants comparing metoclopramide with promethazine, more women taking promethazine reported drowsiness, dizziness, and dystonia (RR 0.70, 95% CI 0.56 to 0.87, RR 0.48, 95% CI 0.34 to 0.69, and RR 0.31, 95% CI 0.11 to 0.90, respectively, moderate-quality evidence). There were no clear differences between groups for other important outcomes including quality of life and other side effects.In a single trial with 30 women, those receiving ondansetron had no difference in duration of hospital admission compared to those receiving promethazine (MD 0.00, 95% CI -1.39 to 1.39, very low-quality evidence), although there was increased sedation with promethazine (RR 0.06, 95% CI 0.00 to 0.94, low-quality evidence) .Regarding corticosteroids, in a study with 110 participants there was no difference in days of hospital admission compared to placebo (MD -0.30, 95% CI -0.70 to 0.10; very low-quality evidence), but there was a decreased readmission rate (RR 0.69, 95% CI 0.50 to 0.94; four studies, 269 women). For other important outcomes including pregnancy complications, spontaneous abortion, stillbirth and congenital abnormalities, there was insufficient evidence to identify differences between groups (very low-quality evidence for all outcomes). In other single studies there were no clear differences between groups for preterm birth or side effects (very low-quality evidence).For hydrocortisone compared with metoclopramide, no data were available for primary outcomes and there was no difference in the readmission rate (RR 0.08, 95% CI 0.00 to 1.28;one study, 40 women).In a study with 80 women, compared to promethazine, those receiving prednisolone had increased nausea at 48 hours (RR 2.00, 95% CI 1.08 to 3.72; low-quality evidence), but not at 17 days (RR 0.81, 95% CI 0.58 to 1.15, very low-quality evidence). There was no clear difference in the number of episodes of emesis or subjective improvement in nausea/vomiting. There was insufficient evidence to identify differences between groups for stillbirth and neonatal death and preterm birth. AUTHORS' CONCLUSIONS On the basis of this review, there is little high-quality and consistent evidence supporting any one intervention, which should be taken into account when making management decisions. There was also very limited reporting on the economic impact of hyperemesis gravidarum and the impact that interventions may have.The limitations in interpreting the results of the included studies highlights the importance of consistency in the definition of hyperemesis gravidarum, the use of validated outcome measures, and the need for larger placebo-controlled trials.
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Affiliation(s)
- Rupsa C Boelig
- Thomas Jefferson UniversityDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology833 Chestnut StreetLevel 1PhiladelphiaPennsylvaniaUSAPA 19107
| | | | - Gabriele Saccone
- School of Medicine, University of Naples Federico IIDepartment of Neuroscience, Reproductive Science and Dentistry5 PansiniNaplesItaly80100
| | - Anthony J Kelly
- Brighton and Sussex University Hospitals NHS TrustDepartment of Obstetrics and GynaecologyRoyal Sussex County HospitalEastern RoadBrightonUKBN2 5BE
| | | | - Vincenzo Berghella
- Thomas Jefferson UniversityDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology833 Chestnut StreetLevel 1PhiladelphiaPennsylvaniaUSAPA 19107
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Yilmaz E, Yilmaz Z, Cakmak B, Karsli MF, Gultekin IB, Guneri Dogan N, Kara OF, Kucukozkan T. Nausea and Vomiting in Early Pregnancy of Adolescents: Relationship with Depressive Symptoms. J Pediatr Adolesc Gynecol 2016; 29:65-8. [PMID: 26143555 DOI: 10.1016/j.jpag.2015.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 06/16/2015] [Accepted: 06/22/2015] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVE To determine the relationship between severity of nausea and vomiting during pregnancy (NVP) and depressive symptoms in pregnant adolescents. DESIGN Prospective cross-sectional study. SETTING A maternity research hospital outpatient clinic, Ankara, Turkey. PARTICIPANTS A total of 200 pregnant adolescents. INTERVENTIONS AND MAIN OUTCOME MEASURES Demographic features and obstetric histories of the participants were assessed. The Rhodes test was performed to determine nausea and vomiting severity in a face-to-face interview, and the self-reported Edinburgh Postnatal Depression Scale was administered with supervision. RESULTS The Rhodes test results showed that 52/200 patients (26%) were classified with none, 83/200 patients (41.5%) with mild, 48/200 patients (24.0%) with moderate, and 17/200 patients (8.5%) with severe symptoms. The mean depression score in the severe vomiting group was significantly higher than that in the no NVP and mild NVP groups (P = .028 and .041, respectively). No differences were found between the other groups. CONCLUSION Severe nausea and vomiting was associated with greater depressive symptom severity in pregnant adolescents.
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Affiliation(s)
- Elif Yilmaz
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Zehra Yilmaz
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Bulent Cakmak
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
| | - Mehmet Fatih Karsli
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Ismail Burak Gultekin
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Nihan Guneri Dogan
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Osman Fadil Kara
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Tuncay Kucukozkan
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
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Vomissements incoercibles de la grossesse : mise au point. Presse Med 2015; 44:1226-34. [DOI: 10.1016/j.lpm.2015.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 06/01/2015] [Accepted: 06/03/2015] [Indexed: 12/27/2022] Open
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Matthews A, Haas DM, O'Mathúna DP, Dowswell T. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2015; 2015:CD007575. [PMID: 26348534 PMCID: PMC7196889 DOI: 10.1002/14651858.cd007575.pub4] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Nausea, retching and vomiting are very commonly experienced by women in early pregnancy. There are considerable physical, social and psychological effects on women who experience these symptoms. This is an update of a review of interventions for nausea and vomiting in early pregnancy last published in 2014. OBJECTIVES To assess the effectiveness and safety of all interventions for nausea, vomiting and retching in early pregnancy, up to 20 weeks' gestation. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, the Cochrane Complementary Medicine Field's Trials Register (19 January 2015) and reference lists of retrieved studies. SELECTION CRITERIA All randomised controlled trials of any intervention for nausea, vomiting and retching in early pregnancy. We excluded trials of interventions for hyperemesis gravidarum, which are covered by another Cochrane review. We also excluded quasi-randomised trials and trials using a cross-over design. DATA COLLECTION AND ANALYSIS Four review authors, in pairs, reviewed the eligibility of trials and independently evaluated the risk of bias and extracted the data for included trials. MAIN RESULTS Forty-one trials involving 5449 women, met the inclusion criteria. These trials covered many interventions, including acupressure, acustimulation, acupuncture, ginger, chamomile, lemon oil, mint oil, vitamin B6 and several antiemetic drugs. There were no included studies of dietary and other lifestyle interventions. Evidence regarding the effectiveness of P6 acupressure, auricular (ear) acupressure and acustimulation of the P6 point was limited. Acupuncture (P6 or traditional) showed no significant benefit to women in pregnancy. The use of ginger products may be helpful to women, but the evidence of effectiveness was limited and not consistent, though three recent studies support ginger over placebo. There was only limited evidence from trials to support the use of pharmacological agents including vitamin B6, Doxylamine-pyridoxoine and other anti-emetic drugs to relieve mild or moderate nausea and vomiting. There was little information on maternal and fetal adverse outcomes and on psychological, social or economic outcomes.We were unable to pool findings from studies for most outcomes due to heterogeneity in study participants, interventions, comparison groups, and outcomes measured or reported. The methodological quality of the included studies was mixed. Risk of bias was low related to performance bias, detection bias and attrition bias for most studies. Selection bias risk was unclear for many studies and almost half of the studies did not fully or clearly report all pre-specified outcomes. AUTHORS' CONCLUSIONS Given the high prevalence of nausea and vomiting in early pregnancy, women and health professionals need clear guidance about effective and safe interventions, based on systematically reviewed evidence. There is a lack of high-quality evidence to support any particular intervention. This is not the same as saying that the interventions studied are ineffective, but that there is insufficient strong evidence for any one intervention. The difficulties in interpreting and pooling the results of the studies included in this review highlight the need for specific, consistent and clearly justified outcomes and approaches to measurement in research studies.
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Affiliation(s)
- Anne Matthews
- Dublin City UniversitySchool of Nursing and Human SciencesCollins AvenueDublinIreland9
| | - David M Haas
- Indiana University School of MedicineDepartment of Obstetrics and Gynecology1001 West 10th Street, F‐5IndianapolisIndianaUSA46202
| | - Dónal P O'Mathúna
- Dublin City UniversitySchool of Nursing and Human SciencesCollins AvenueDublinIreland9
| | - Therese Dowswell
- The University of LiverpoolCochrane Pregnancy and Childbirth Group, Department of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
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Matthews A, Haas DM, O'Mathúna DP, Dowswell T. Interventions for nausea and vomiting in early pregnancy. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [PMID: 26348534 DOI: 10.1002/14651858.cd007575] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Nausea, retching and vomiting are very commonly experienced by women in early pregnancy. There are considerable physical, social and psychological effects on women who experience these symptoms. This is an update of a review of interventions for nausea and vomiting in early pregnancy last published in 2014. OBJECTIVES To assess the effectiveness and safety of all interventions for nausea, vomiting and retching in early pregnancy, up to 20 weeks' gestation. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, the Cochrane Complementary Medicine Field's Trials Register (19 January 2015) and reference lists of retrieved studies. SELECTION CRITERIA All randomised controlled trials of any intervention for nausea, vomiting and retching in early pregnancy. We excluded trials of interventions for hyperemesis gravidarum, which are covered by another Cochrane review. We also excluded quasi-randomised trials and trials using a cross-over design. DATA COLLECTION AND ANALYSIS Four review authors, in pairs, reviewed the eligibility of trials and independently evaluated the risk of bias and extracted the data for included trials. MAIN RESULTS Forty-one trials involving 5449 women, met the inclusion criteria. These trials covered many interventions, including acupressure, acustimulation, acupuncture, ginger, chamomile, lemon oil, mint oil, vitamin B6 and several antiemetic drugs. There were no included studies of dietary and other lifestyle interventions. Evidence regarding the effectiveness of P6 acupressure, auricular (ear) acupressure and acustimulation of the P6 point was limited. Acupuncture (P6 or traditional) showed no significant benefit to women in pregnancy. The use of ginger products may be helpful to women, but the evidence of effectiveness was limited and not consistent, though three recent studies support ginger over placebo. There was only limited evidence from trials to support the use of pharmacological agents including vitamin B6, Doxylamine-pyridoxoine and other anti-emetic drugs to relieve mild or moderate nausea and vomiting. There was little information on maternal and fetal adverse outcomes and on psychological, social or economic outcomes.We were unable to pool findings from studies for most outcomes due to heterogeneity in study participants, interventions, comparison groups, and outcomes measured or reported. The methodological quality of the included studies was mixed. Risk of bias was low related to performance bias, detection bias and attrition bias for most studies. Selection bias risk was unclear for many studies and almost half of the studies did not fully or clearly report all pre-specified outcomes. AUTHORS' CONCLUSIONS Given the high prevalence of nausea and vomiting in early pregnancy, women and health professionals need clear guidance about effective and safe interventions, based on systematically reviewed evidence. There is a lack of high-quality evidence to support any particular intervention. This is not the same as saying that the interventions studied are ineffective, but that there is insufficient strong evidence for any one intervention. The difficulties in interpreting and pooling the results of the studies included in this review highlight the need for specific, consistent and clearly justified outcomes and approaches to measurement in research studies.
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Affiliation(s)
- Anne Matthews
- School of Nursing and Human Sciences, Dublin City University, Collins Avenue, Dublin, Ireland, 9
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Matthews A, Haas DM, O'Mathúna DPO, Dowswell T, Doyle M. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2014:CD007575. [PMID: 24659261 DOI: 10.1002/14651858.cd007575.pub3] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Nausea, retching and vomiting are very commonly experienced by women in early pregnancy. There are considerable physical, social and psychological effects on women who experience these symptoms. This is an update of a review of interventions for nausea and vomiting in early pregnancy previously published in 2010. OBJECTIVES To assess the effectiveness and safety of all interventions for nausea, vomiting and retching in early pregnancy, up to 20 weeks' gestation. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Complementary Medicine Field's Trials Register (27 April 2013). SELECTION CRITERIA All randomised controlled trials of any intervention for nausea, vomiting and retching in early pregnancy. We excluded trials of interventions for hyperemesis gravidarum, which are covered by another Cochrane review. We also excluded quasi-randomised trials and trials using a cross-over design. DATA COLLECTION AND ANALYSIS Four review authors, in pairs, reviewed the eligibility of trials and independently evaluated the risk of bias and extracted the data for included trials. MAIN RESULTS Thirty-seven trials involving 5049 women, met the inclusion criteria. These trials covered many interventions, including acupressure, acustimulation, acupuncture, ginger, chamomile, lemon oil, mint oil, vitamin B6 and several antiemetic drugs. We identified no studies of dietary or other lifestyle interventions. Evidence regarding the effectiveness of P6 acupressure, auricular (ear) acupressure and acustimulation of the P6 point was limited. Acupuncture (P6 or traditional) showed no significant benefit to women in pregnancy. The use of ginger products may be helpful to women, but the evidence of effectiveness was limited and not consistent, though two recent studies support ginger over placebo. There was only limited evidence from trials to support the use of pharmacological agents including vitamin B6, and anti-emetic drugs to relieve mild or moderate nausea and vomiting. There was little information on maternal and fetal adverse outcomes and on psychological, social or economic outcomes. We were unable to pool findings from studies for most outcomes due to heterogeneity in study participants, interventions, comparison groups, and outcomes measured or reported. The methodological quality of the included studies was mixed. AUTHORS' CONCLUSIONS Given the high prevalence of nausea and vomiting in early pregnancy, women and health professionals need clear guidance about effective and safe interventions, based on systematically reviewed evidence. There is a lack of high-quality evidence to support any particular intervention. This is not the same as saying that the interventions studied are ineffective, but that there is insufficient strong evidence for any one intervention. The difficulties in interpreting and pooling the results of the studies included in this review highlight the need for specific, consistent and clearly justified outcomes and approaches to measurement in research studies.
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Affiliation(s)
- Anne Matthews
- School of Nursing and Human Sciences, Dublin City University, Collins Avenue, Dublin, Ireland, 9
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16
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Odom-Forren J. Measurement of Postdischarge Nausea and Vomiting for Ambulatory Surgery Patients: A Critical Review and Analysis. J Perianesth Nurs 2011; 26:372-83. [DOI: 10.1016/j.jopan.2011.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 08/19/2011] [Accepted: 09/14/2011] [Indexed: 02/08/2023]
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17
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Murphey C, Fowles E. Dental Health, Acidogenic Meal, and Snack Patterns Among Low‐Income Women During Early Pregnancy: A Pilot Study. J Midwifery Womens Health 2011; 55:587-92. [DOI: 10.1016/j.jmwh.2010.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 02/17/2010] [Accepted: 02/17/2010] [Indexed: 10/18/2022]
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Fowles ER, Murphey C. Nutrition and Mental Health in Early Pregnancy: A Pilot Study. J Midwifery Womens Health 2010; 54:73-7. [DOI: 10.1016/j.jmwh.2008.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Revised: 07/18/2008] [Accepted: 07/18/2008] [Indexed: 10/21/2022]
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Fowles ER, Timmerman GM, Bryant M, Kim S. Eating at fast-food restaurants and dietary quality in low-income pregnant women. West J Nurs Res 2010; 33:630-51. [PMID: 21131508 DOI: 10.1177/0193945910389083] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Little is known about how fast-food consumption affects dietary quality in women during the first trimester of pregnancy, which may adversely affect pregnancy outcomes. An observational design compared high versus low frequency of fast-food consumption in low-income pregnant women (N = 50) during the first trimester. Although high-frequency fast-food consumers ate significantly more vegetables, they also consumed more gravies, less fruit, and more daily calories, with a higher percentage of total calories from fats. Those with high-frequency fast-food consumption were more likely to be obese, depressed, and stressed and they skipped more meals. In addition, the combination of depression, stress, and emotional eating depression and anxiety subscale scores explained 45% of the variance in dietary quality. High frequency of fast-food consumption contributed to poor dietary quality and excessive caloric intake, which may lead to excessive gestational weight gain.
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Abstract
BACKGROUND Nausea, retching and vomiting are very commonly experienced by women in early pregnancy. There are considerable physical and psychological effects on women who experience these symptoms. This is an update of a review of interventions for nausea and vomiting in early pregnancy previously published in 2003. OBJECTIVES To assess the effectiveness and safety of all interventions for nausea, vomiting and retching in early pregnancy, up to 20 weeks' gestation. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 May 2010). SELECTION CRITERIA All randomised controlled trials of any intervention for nausea, vomiting and retching in early pregnancy. We excluded trials of interventions for hyperemesis gravidarum which are covered by another review. We also excluded quasi-randomised trials and trials using a crossover design. DATA COLLECTION AND ANALYSIS Four review authors, in pairs, reviewed the eligibility of trials and independently evaluated the risk of bias and extracted the data for included trials. MAIN RESULTS Twenty-seven trials, with 4041 women, met the inclusion criteria. These trials covered many interventions, including acupressure, acustimulation, acupuncture, ginger, vitamin B6 and several antiemetic drugs. We identified no studies of dietary or other lifestyle interventions. Evidence regarding the effectiveness of P6 acupressure, auricular (ear) acupressure and acustimulation of the P6 point was limited. Acupuncture (P6 or traditional) showed no significant benefit to women in pregnancy. The use of ginger products may be helpful to women, but the evidence of effectiveness was limited and not consistent. There was only limited evidence from trials to support the use of pharmacological agents including vitamin B6, and anti-emetic drugs to relieve mild or moderate nausea and vomiting. There was little information on maternal and fetal adverse outcomes and on psychological, social or economic outcomes. We were unable to pool findings from studies for most outcomes due to heterogeneity in study participants, interventions, comparison groups, and outcomes measured or reported. The methodological quality of the included studies was mixed. AUTHORS' CONCLUSIONS Given the high prevalence of nausea and vomiting in early pregnancy, health professionals need to provide clear guidance to women, based on systematically reviewed evidence. There is a lack of high-quality evidence to support that advice. The difficulties in interpreting the results of the studies included in this review highlight the need for specific, consistent and clearly justified outcomes and approaches to measurement in research studies.
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Affiliation(s)
- Anne Matthews
- School of Nursing, Dublin City University, Dublin, Ireland
| | - Therese Dowswell
- Cochrane Pregnancy and Childbirth Group, School of Reproductive and Developmental Medicine, Division of Perinatal and Reproductive Medicine, The University of Liverpool, Liverpool, UK
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mary Doyle
- Mid-Western Regional Maternity Hospital, Limerick, Ireland
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Chan OK, Sahota DS, Leung TY, Chan LW, Fung TY, Lau TK. Nausea and vomiting in health-related quality of life among Chinese pregnant women. Aust N Z J Obstet Gynaecol 2010; 50:512-8. [PMID: 21133860 DOI: 10.1111/j.1479-828x.2010.01216.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nausea and vomiting in pregnancy (NVP) is the most common pregnancy complication affecting women during the first trimester of pregnancy. The cause of NVP remains unknown and factors associated with the occurrence of NVP are contradictory. There is currently little information on its effects of NVP in general and specifically in the Chinese population. AIMS To assess the prevalence of NVP with different degree of severity and identify their relationship with health-related quality of life (HRQoL) and to determine its association with the sociodemographic and obstetric factors. METHODS In a prospective cross-sectional study, 396 women who attended the antenatal clinic between 10 and 14 weeks of gestation were invited to complete a structured questionnaire covering maternal characteristics, severity of NVP and their HRQoL. The status of NVP and HRQoL was measured by the frequency of symptoms and the Medical Outcomes Study Short-Form-36 (SF-36) respectively. Logistic regression analysis was performed to delineate the factors associated with NVP. RESULTS The prevalence of NVP was 90.9%. Almost all domains and dimensions of SF-36 were affected by the presence of NVP and its severity. Factors associated with the presence and severity of NVP were non-smoking, younger age and history of NVP in previous pregnancy. CONCLUSIONS The various degrees of severity of NVP significantly impair both physical and mental HRQoL in Hong Kong Chinese women. Awareness and care should be given to women with symptoms of nausea or retching alone, as well as vomiting.
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Affiliation(s)
- Oi Ka Chan
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.
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Fowles ER, Murphey C, Ruiz RJ. Exploring Relationships Among Psychosocial Status, Dietary Quality, and Measures of Placental Development During the First Trimester in Low-Income Women. Biol Res Nurs 2010; 13:70-9. [DOI: 10.1177/1099800410378733] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To examine the relationships between maternal psychosocial factors and dietary quality and explore the relationships among dietary quality and selected biomarkers of nutrition and placental development. Method: A cross-sectional design in 18 low-income, pregnant women. Results: Partner support was positively related to vegetable intake (r = .54) and negatively related to intake of iron (r = -.68) and grains (r = -.67). Emotional eating in response to anger was negatively related to intake of iron-(r /it> = -.53) and folate-rich (r = -.75) foods, and emotional eating in response to anxiety was negatively related to intake of folate-rich foods (r = -.51). Depressed women had an increased intake of calcium-rich foods (r = .60). Levels of vascular endothelial growth factor (VEGF) were negatively related to depression (r = -.56) and intake of foods high in calcium (r = -.53) and iron (r = -.34) but positively related to serum calcium levels (r = .60). VEGF was negatively relationship to soluble fms-like tyrosine kinase 1 (sFlt-1; r = -.56). Placental growth factor had a negative relationship with maternal serum levels of albumin (r = -.61) and calcium (r = -.65). Conclusions: Low-income pregnant women who eat to cope with anger and anxiety may have an inadequate intake of nutrients that contribute to positive pregnancy outcomes. Placental development in the early weeks of pregnancy may be influenced by maternal psychosocial and nutritional status. More research is needed to explore the relationship of dietary quality and placental development in the first trimester of pregnancy.
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Affiliation(s)
- Eileen R. Fowles
- School of Nursing, University of Texas at Austin, Austin, TX, USA,
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Ingersoll GL, Wasilewski A, Haller M, Pandya K, Bennett J, He H, Hoffmire C, Berry C. Effect of Concord Grape Juice on Chemotherapy-Induced Nausea and Vomiting: Results of a Pilot Study. Oncol Nurs Forum 2010; 37:213-21. [DOI: 10.1188/10.onf.213-221] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kim TH, Choi BM, Chin JH, Lee MS, Kim DH, Noh GJ. The Reliability and Validity of the Rhodes Index of Nausea, Vomiting and Retching in Postoperative Nausea and Vomiting. Korean J Anesthesiol 2007. [DOI: 10.4097/kjae.2007.52.6.s59] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Tae Hee Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byung Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Hyun Chin
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Moo Song Lee
- Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hee Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheonan, Korea
| | - Gyu Jeong Noh
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Abstract
Nausea and vomiting in pregnancy (NVP) is a common condition in early pregnancy. The purpose of this study was to clarify the characteristics of Japanese women's NVP and to determine the relationship between NVP and quality of life. The NVP was measured using the Rhodes' Index and quality of life was measured by the SF-36. Nausea and retching at 4-7 and 12-15 weeks was significantly more severe than at 16-19 weeks, whereas there was no difference in vomiting. A decrease in physical well-being was correlated with the severity of nausea and retching at 8-11 and 12-15 weeks, but not with that of vomiting at any gestational period. Although the symptom of vomiting tended to be noticed more frequently, nausea and retching was more important in the care and treatment of NVP in Japanese women than vomiting, suggesting that professionals should carefully measure NVP symptoms using reliable instruments.
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Affiliation(s)
- Tomoko Kugahara
- Area of Nursing Science, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
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Heazell A, Thorneycroft J, Walton V, Etherington I. Acupressure for the in-patient treatment of nausea and vomiting in early pregnancy: a randomized control trial. Am J Obstet Gynecol 2006; 194:815-20. [PMID: 16522418 DOI: 10.1016/j.ajog.2005.08.042] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Revised: 07/21/2005] [Accepted: 08/18/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the efficacy of acupressure at the P6 point for the in-patient treatment of severe nausea and vomiting in early pregnancy. STUDY DESIGN This was a prospective single-blind randomized control trial that involved 80 patients with nausea and vomiting plus ketonuria before 14 weeks of gestation. RESULTS There was no difference between length of stay, amount of medication, or fluid required between the acupressure and placebo groups, although acupressure reduced the number of patients who stayed > or =4 nights in the hospital. Acupressure was well tolerated and not associated with an increase in perinatal morbidity or death. CONCLUSION The use of acupressure at the P6 point does not reduce the amount of antiemetic medication that is required, the requirement for intravenous fluid, and median duration of in-patient stay more than the use of placebo. A small reduction was seen in the number of women who required > or =4 days in the hospital.
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Affiliation(s)
- Alexander Heazell
- Maternal and Fetal Health Research Centre, St. Mary's Hospital, Manchester, UK.
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Fetzer SJ, Hand MC, Bouchard PA, Smith H, Jenkins MB. Evaluation of the Rhodes Index of Nausea and Vomiting for ambulatory surgery patients. J Adv Nurs 2004; 47:74-80. [PMID: 15186470 DOI: 10.1111/j.1365-2648.2004.03067.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The Index of Nausea and Vomiting (INV), developed by Rhodes and others in 1984, measures three dimensions of upper gastrointestinal distress: nausea, vomiting and retching (NVR). While the revised version has been tested with a variety of high-risk populations, there are no data suggesting that it can be used to assess upper gastrointestinal distress among the growing numbers of ambulatory or day surgery patients. AIM The aim of this study was to evaluate a modified version of the INV for use with ambulatory surgery patients. METHODS A secondary analysis was conducted using data obtained from a descriptive study designed to identify risk factors for postdischarge nausea and vomiting (PDNV) among adult ambulatory surgery patients. Patients who reported PDNV (n = 190) participated via phone interview 24 hours after discharge by completing a modified Rhodes INV. FINDINGS Reliability analysis (alpha = 0.897) indicated that the modified Rhodes INV measured upper gastrointestinal distress as a single concept in the postdischarge ambulatory surgical sample. One item of the 8-item scale was dropped. Principal component analysis extracted one factor that accounted for 67% of the variance with all items loading. CONCLUSIONS Upper gastrointestinal distress following ambulatory surgery discharge comprises a different symptom mix than during other high-risk events such as pregnancy or chemotherapy. Further research on the differences in assessing NVR among different populations is indicated.
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Affiliation(s)
- Susan J Fetzer
- University of New Hampshire, Nursing, Durham, New Hampshire 03824, USA.
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Abstract
BACKGROUND Although there has been some research to identify the dimensions on which individualized care should be measured, the indicators that constitute individualized care remain unclear. OBJECTIVES To describe briefly the maintenance of individualized care and to test a hypothetical model of individualized care in a sample of surgical patients. DESIGN AND METHODS A correlational survey design was used. Data were collected with questionnaires from adult patients (n = 454) discharged from surgical wards in one Finnish hospital district (response rate 91%). Structural equation modelling LISREL SIMPLIS using maximum likelihood estimation was used to estimate and test the parameters of the hypothesized model derived deductively from the previous literature. RESULTS The goodness-of-fit statistics supported the basic solution of the Individualized Care Model, although two additional paths indicating error covariances between the sub-concepts were identified in the revised model. In this model individualized care is defined in terms of patients' views of nursing activities aimed at supporting individuality in care and in terms of perceptions of individuality in their own care. CONCLUSIONS The model has been found to capture attributes that characterize individualized care. It can be used as a basis for evaluation in clinical nursing practice from patients' point of view. The study highlights the importance of patients' clinical situation, personal life situation and decisional control as predictors of individualized care. The results also confirm the construct validity of the previously developed Individualized Care Scale.
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Affiliation(s)
- Riitta Suhonen
- Forssa Hospital, Health Care District of Forssa, Forssa Department of Nursing Science, University of Turku, Turku, Finland.
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