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Li P, Wang H, Chen G, Feng J, Fan D, Lin D, Rao J, Zhou Z, Liu Z, Guo X. Association Between Nausea and Vomiting During Pregnancy and Sleep Quality: Mediating Effect of Depressive Symptoms. Int J Gen Med 2021; 14:41-49. [PMID: 33447075 PMCID: PMC7802779 DOI: 10.2147/ijgm.s290216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/17/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Nausea and vomiting during pregnancy (NVP) of varying degrees of severity are commonly experienced by pregnant women. This paper explores the association between NVP and poor sleep quality. Patients and Methods A cross-sectional study was conducted in an obstetrics clinic. A total of 2494 pregnant women (representing a response rate of 92.7%) completed a self-administered questionnaire. Results Of the 2494 participants, the mean sleep duration was 7.76 hours, and 54.3% of them report poor sleep quality (ie, a Pittsburgh Sleep Quality Index global score > 5). In this study, 49.1%, 49.3% and 1.6% women reported mild, moderate, and severe NVP, respectively. Compare with women with mild NVP, women with moderate or severe NVP were more likely to report poor sleep quality (χ 2 = 30.16, p < 0.001). After adjusted for demographics and gestational age, moderate and severe NVP were associated with poor sleep quality (adjusted odds ratio (AOR) = 1.66, 95% confidence interval (CI) = 1.40-1.96, and AOR = 2.95, 95% CI = 1.44-6.02, respectively). Moreover, depressive symptoms mediated the association between NVP and poor sleep quality (β = 0.060, p = 0.033, 95% CI = 0.028-0.180). Conclusion Our study suggested that moderate and severe NVP increase the risk of poor sleep quality. Further studies are warranted that focus on the mechanisms of the association between NVP and poor sleep quality.
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Affiliation(s)
- Pengsheng Li
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Haiyan Wang
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Gengdong Chen
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Jinping Feng
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Dazhi Fan
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Dongxin Lin
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Jiaming Rao
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Zixing Zhou
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Zhengping Liu
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China.,Foshan Fetal Medicine Research Institute, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
| | - Xiaoling Guo
- Department of Obstetrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, People's Republic of China
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Caporaso E, Oliver D, Rusher M. A Pregnant Woman with Hyperemesis Gravidarum Admitted to the Psychiatric Ward. Psychiatr Ann 2020. [DOI: 10.3928/00485713-20200903-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Freitas VCAD, Quirino GDS, Giesta RP, Pinheiro AKB. Clinical and obstetric situation of pregnant women who require prehospital emergency care. Rev Bras Enferm 2020; 73 Suppl 4:e20190058. [PMID: 32785472 DOI: 10.1590/0034-7167-2019-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 04/30/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to identify the clinical and obstetric situation of pregnant women who required emergency care, considering the adequacy of their requirement. METHODS this is a cross-sectional study, developed in the headquarters of the Mobile Emergency Care Services from a state in the Brazilian Northeast, through the analysis of 558 reports of obstetric patients attended in 2016. The magnitude of the associations was expressed by odds ratio and confidence intervals, considering a 5% significance level. RESULTS more than half (50.9%) requirements for emergency care were from women who went into labor (non-expulsive), especially among third trimester pregnant women (p < 0.000). Most clinical and obstetric parameters were normal. CONCLUSIONS the inadequate demands for emergency care services reflect the excessive medicalization of the gestational process and shows how important it is to discuss the physiological symptoms that involve pregnancy, so that a more egalitarian and efficient urgency service can be offered.
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Fossum S, Næss Ø, Halvorsen S, Tell GS, Vikanes ÅV. Long-term cardiovascular morbidity following hyperemesis gravidarum: A Norwegian nationwide cohort study. PLoS One 2019; 14:e0218051. [PMID: 31188868 PMCID: PMC6561562 DOI: 10.1371/journal.pone.0218051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/24/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To investigate whether exposure to hyperemesis gravidarum (hyperemesis) is associated with subsequent maternal cardiovascular morbidity. DESIGN Nationwide cohort study. SETTING Medical Birth Registry of Norway (1967-2002) linked to the nationwide Cardiovascular Disease in Norway project 1994-2009 (CVDNOR) and the Cause of Death Registry. POPULATION Women in Norway with singleton births from 1967 to 2002, with and without hyperemesis, were followed up with respect to cardiovascular outcomes from 1994 to 2009. METHODS Cox proportional hazards regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI). MAIN OUTCOME MEASURES The first hospitalisation due to nonfatal stroke, myocardial infarction or angina pectoris, or cardiovascular death. RESULTS Among 989 473 women with singleton births, 13 212 (1.3%) suffered from hyperemesis. During follow-up, a total of 43 482 (4.4%) women experienced a cardiovascular event. No association was found between hyperemesis and the risk of a fatal or nonfatal cardiovascular event (adjusted HR 1.08; 95% CI 0.99-1.18). Women with hyperemesis had higher risk of hospitalisation due to angina pectoris (adjusted HR 1.28; 95% CI 1.15-1.44). The risk of cardiovascular death was lower among hyperemetic women in age-adjusted analysis (HR 0.73; 95% CI 0.59-0.91), but the association was no longer significant when adjusting for possible confounders. CONCLUSION Women with a history of hyperemesis did not have increased risk of a cardiovascular event (nonfatal myocardial infarction or stroke, angina pectoris or cardiovascular death) compared to women without.
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Affiliation(s)
- Stine Fossum
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Næss
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Division for Mental and Physical Health, National Institute of Public Health, Oslo, Norway
| | - Sigrun Halvorsen
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Grethe S. Tell
- Division for Mental and Physical Health, National Institute of Public Health, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Åse V. Vikanes
- The Intervention Center, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
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Kondo T, Nakamura M, Kawashima J, Matsumura T, Ohba T, Yamaguchi M, Katabuchi H, Araki E. Hyperemesis gravidarum followed by refeeding syndrome causes electrolyte abnormalities induced rhabdomyolysis and diabetes insipidus. Endocr J 2019; 66:253-258. [PMID: 30700639 DOI: 10.1507/endocrj.ej18-0496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Although hyperemesis gravidarum (HG), an extreme form of morning sickness, is a common complication during pregnancy, HG associated simultaneous onset of rhabdomyolysis and diabetes insipidus due to electrolyte abnormalities are rare. A 34-year-old woman with severe HG at 17 weeks of gestation complicated with appetite loss, weight reduction by 17 kg, general fatigue, myalgia, weakness and polyuria was identified to have simultaneous hypophosphatemia (1.6 mg/dL) and hypokalemia (2.0 mEq/L). Appetite recovery and the improvement of the hypophosphatemia (3.2 mg/dL) were observed prior to the first visit to our department. At the admission, she presented polyuria around 7,000~8,000 mL/day with impaired concentrating activity (U-Osm 185 mOsm/L), and abnormal creatine kinase elevation (4,505 U/L). The electrolyte disturbances and physio-metabolic abnormalities in undernourished state due to HG let us diagnose this case as refeeding syndrome (RFS). In this case, abnormal loss by vomiting, insufficient intake and previous inappropriate fluid infusion as well as the development of RFS may accelerate the severity of hypokalemia due to HG. Thus, as her abnormalities were considered as results of rhabdomyolysis and diabetes insipidus due to severe HG associated hypokalemia based on RFS, oral supplementation of potassium chloride was initiated. After 6 days of potassium supplementation, her symptoms and biochemical abnormalities were completely resolved. Severe HG followed by RFS can be causes of electrolyte abnormalities and subsequent complications, including rhabdomyolysis and renal diabetes insipidus. Appropriate diagnosis and prompt interventions including adequate nutrition are necessary to prevent electrolyte imbalance induced cardiac, neuromuscular and/or renal complications.
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Affiliation(s)
- Tatsuya Kondo
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Miwa Nakamura
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Junji Kawashima
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Takeshi Matsumura
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Takashi Ohba
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Munekage Yamaguchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Hidetaka Katabuchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
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Fossum S, Halvorsen S, Vikanes ÅV, Roseboom TJ, Ariansen I, Næss Ø. Cardiovascular risk profile at the age of 40-45 in women with previous hyperemesis gravidarum or hypertensive disorders in pregnancy: A population-based study. Pregnancy Hypertens 2018; 12:129-135. [PMID: 29858105 DOI: 10.1016/j.preghy.2018.04.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 02/16/2018] [Accepted: 04/11/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To assess midlife cardiovascular risk profiles in women with a history of hyperemesis or hypertensive disorders in pregnancy compared to women with none of the studied pregnancy complications. STUDY DESIGN Population-based study. Cardiovascular risk factors at the age of 40-45 among women with previous singleton births only were studied through linkage of the Norwegian Birth Registry and a Norwegian screening program (the Age 40 Program). MAIN OUTCOME MEASURES Family history of coronary heart disease, body mass index, smoking, physical activity, systolic and diastolic blood pressure, heart rate, cholesterol, triglycerides, antihypertensive treatment and diabetes. RESULTS Among 178,231 women participating in the Age 40 Program with previous singleton births; 2140 (1.2%) had experienced hyperemesis and 13,348 (7.5%) hypertensive disorders in pregnancy. Women who had suffered from hyperemesis were less physically active. The differences in mean systolic blood pressure and body mass index were probably clinically irrelevant. In women with a history of hypertensive disorders in pregnancy, systolic and diastolic blood pressure and body mass index were higher, and they were more likely to report diabetes in midlife. Women who had suffered from hyperemesis or hypertensive disorders in pregnancy were less likely to be daily smokers. CONCLUSION Women with hypertensive disorders in pregnancy seemed to have an unfavorable cardiovascular risk profile in midlife compared to women with uncomplicated pregnancies. In contrast there was no consistent evidence of increased risk subsequent to hyperemesis gravidarum. The proportion of daily smokers was lower in women with either of the two pregnancy complications.
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Affiliation(s)
- Stine Fossum
- Department of Cardiology, Oslo University Hospital, 0424 Oslo, Norway; Division for Mental and Physical Health, National Institute of Public Health, 0403 Oslo, Norway; Faculty of Medicine, University of Oslo, 0316 Oslo, Norway.
| | - Sigrun Halvorsen
- Department of Cardiology, Oslo University Hospital, 0424 Oslo, Norway; Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
| | - Åse V Vikanes
- The Intervention Center, Oslo University Hospital, 0424 Oslo, Norway; Division for Health Data and Digitalisation, National Institute of Public Health, 0403 Oslo, Norway
| | - Tessa J Roseboom
- Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Inger Ariansen
- Division for Mental and Physical Health, National Institute of Public Health, 0403 Oslo, Norway
| | - Øyvind Næss
- Division for Mental and Physical Health, National Institute of Public Health, 0403 Oslo, Norway; Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
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Varela PLR, Oliveira RRD, Melo EC, Mathias TADF. Pregnancy complications in Brazilian puerperal women treated in the public and private health systems. Rev Lat Am Enfermagem 2018; 25:e2949. [PMID: 29319740 PMCID: PMC5768206 DOI: 10.1590/1518-8345.2156.2949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 06/07/2017] [Indexed: 11/22/2022] Open
Abstract
Objective: to analyze the prevalence of pregnancy complications and sociodemographic profile
of puerperal patients with complications, according to the form of financing of
the childbirth service. Method: cross-sectional study with interview of 928 puerperal women whose childbirth was
financed by the Unified Health System, health plans and private sources (other
sources than the Unified Health System). The sample was calculated based on the
births registered in the Information System on Live Births, stratified by hospital
and form of financing of the childbirth service. Data were analyzed using the
chi-square and Fisher’s exact tests. Results: the prevalence was 87.8% for all puerperal women, with an average of 2.4
complications per woman. In the case of deliveries covered by the Unified Health
System, urinary tract infection (38.2%), anemia (26.0%) and leucorrhea (23.5%)
were more frequent. In turn, vaginal bleeding (26.4%), urinary tract infection
(23.9%) and leucorrhoea (23.7%) were prevalent in deliveries that were not covered
by the Unified Health System. Puerperal women that had their delivery covered by
the Unified Health System reported a greater number of intercurrences related to
infectious diseases, while women who used health plans and private sources
reported intercurrences related to chronic diseases. A higher frequency of
puerperal adolescents, non-white women, and women without partner among those
assisted in the Unified Health System (p < 0.001). Conclusion: the high prevalence of complications indicates the need for monitoring and
preventing diseases during pregnancy, especially in the case of pregnant women
with unfavorable sociodemographic characteristics.
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Affiliation(s)
| | - Rosana Rosseto de Oliveira
- Post-doctoral fellow, Departamento de Enfermagem, Universidade Estadual de Maringá, Maringá, PR, Brazil. Scholarship holder at Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Emiliana Cristina Melo
- PhD, Adjunct Professor, Departamento de Enfermagem, Universidade Estadual do Norte do Paraná, Bandeirantes, PR, Brazil
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Koren G. Safety considerations surrounding use of treatment options for nausea and vomiting in pregnancy. Expert Opin Drug Saf 2017; 16:1227-1234. [DOI: 10.1080/14740338.2017.1361403] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Gideon Koren
- Western University Canada, Tel Aviv University Israel
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Fossum S, Vikanes ÅV, Næss Ø, Vos L, Grotmol T, Halvorsen S. Hyperemesis gravidarum and long-term mortality: a population-based cohort study. BJOG 2017; 124:1080-1087. [PMID: 27981734 PMCID: PMC5484313 DOI: 10.1111/1471-0528.14454] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To investigate whether exposure to hyperemesis gravidarum (HG) is associated with increased maternal long-term mortality. DESIGN Population-based cohort study. SETTING Medical Birth Registry of Norway (1967-2002) linked to the Cause of Death Registry. POPULATION Women in Norway with singleton births in the period 1967-2002, with and without HG. Women were followed until 2009 or death. METHODS Cox proportional hazard regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI). MAIN OUTCOME MEASURES The primary outcome was all-cause mortality during follow up. Secondary outcomes were cause-specific mortality (cardiovascular mortality, deaths due to cancer, external causes or mental and behavioural disorders). RESULTS Of 999 161 women with singleton births, 13 397 (1.3%) experienced HG. During a median follow up of 26 years (25 902 036 person-years), 43 470 women died (4.4%). Women exposed to HG had a lower risk of long-term all-cause mortality compared with women without HG (crude HR 0.82; 95% CI 0.75-0.90). When adjusting for confounders, this reduction was no longer significant (adjusted HR 0.92; 95% CI 0.84-1.01). Women exposed to HG had a similar risk of cardiovascular death as women not exposed (adjusted HR 1.04; 95% CI 0.83-1.29), but a lower long-term risk of death from cancer (adjusted HR 0.86; 95% CI 0.75-0.98). CONCLUSION In this large population-based cohort study, HG was not associated with an increased risk of long-term all-cause mortality. Women exposed to HG had no increase in mortality due to cardiovascular disease, but had a reduced risk of death from cancer. TWEETABLE ABSTRACT Population-based cohort study: Hyperemesis was not associated with an increased risk of long-term mortality.
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Affiliation(s)
- S Fossum
- Department of CardiologyOslo University Hospital UllevalOsloNorway
- Epidemiological DivisionNational Institute of Public HealthOsloNorway
| | - ÅV Vikanes
- The Intervention CenterOslo University HospitalOsloNorway
| | - Ø Næss
- University of OsloOsloNorway
- Epidemiological DivisionNational Institute of Public HealthOsloNorway
| | - L Vos
- Cancer Registry of NorwayOsloNorway
| | | | - S Halvorsen
- Department of CardiologyOslo University Hospital UllevalOsloNorway
- University of OsloOsloNorway
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