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Jansen LAW, Shaw V, Grooten IJ, Koot MH, Dean CR, Painter RC. Diagnostic et traitement de l’hyperémèse gravidique. CMAJ 2024; 196:E734-E743. [PMID: 38830681 PMCID: PMC11142033 DOI: 10.1503/cmaj.221502-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Affiliation(s)
- Larissa A W Jansen
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Victoria Shaw
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Iris J Grooten
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Marjette H Koot
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Caitlin R Dean
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Rebecca C Painter
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
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Rath W, Maul H, Abele H, Pauluschke J. [Hyperemesis Gravidarum - an Interprofessional and Interdisciplinary Challenge - Evidence-Based Review]. Z Geburtshilfe Neonatol 2024; 228:218-231. [PMID: 38065551 DOI: 10.1055/a-2200-9686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Hyperemesis gravidarum (HG) is a multifactorial disease characterized by severe and persisting nausea and vomiting, impairment of oral intake, weight loss of at least 5%, electrolyte abnormalities, and dehydration. The prevalence of HG ranges from 0.3 to 10% worldwide. The diagnosis is made by the patient's prehistory, clinical symptoms, physical examination, and the typical laboratory abnormalities. Therapeutic cornerstones are nutrition advice, consultation of life style, psychological/psychosocial support of the mother as well as the administration of antiemetics in a stepwise approach, depending on the severity of symptoms, and finally admission to hospital in severe cases. Treatment of patients requires close interprofessional and interdisciplinary cooperation.
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Affiliation(s)
- Werner Rath
- Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Holger Maul
- Geburtshilfe und Pränatalmedizin, Asklepios Kliniken Hamburg, Hamburg, Germany
| | - Harald Abele
- Frauenklinik, Universitätklinikum Tübingen, Tübingen, Germany
| | - Jan Pauluschke
- Frauenklinik, Universitätklinikum Tübingen, Tübingen, Germany
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3
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Jansen LAW, Shaw V, Grooten IJ, Koot MH, Dean CR, Painter RC. Diagnosis and treatment of hyperemesis gravidarum. CMAJ 2024; 196:E477-E485. [PMID: 38621783 PMCID: PMC11019608 DOI: 10.1503/cmaj.221502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Affiliation(s)
- Larissa A W Jansen
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Victoria Shaw
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Iris J Grooten
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marjette H Koot
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Caitlin R Dean
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Rebecca C Painter
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
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4
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Zheng H, Wang Q, Chen F. Correlation between serum beta-human chorionic gonadotropin levels and thyroid metabolic function in pregnant women with hyperemesis gravidarum. CHINESE J PHYSIOL 2023; 66:359-364. [PMID: 37929347 DOI: 10.4103/cjop.cjop-d-23-00045] [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] [Indexed: 11/07/2023] Open
Abstract
As previously demonstrated, serum beta-human chorionic gonadotropin (β-hCG) is linked to identifying early gestational abnormalities. This research was aimed at investigating the correlation between serum β-hCG levels and thyroid metabolic function in pregnant women with hyperemesis gravidarum (HG). Ninety-one pregnant women with HG were selected as the study group and divided into early pregnancy (EP), mid-pregnancy (MP), and late pregnancy (LP) groups according to their gestational weeks, while 84 normal pregnant women were selected as the control group. Venous blood was collected from pregnant women in both groups and serum β-hCG levels were measured by chemiluminescent immunoassay. The levels of free thyroxine (FT4), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroid-stimulating hormone receptor antibody (TRAb), and thyroglobulin antibody (TgAb) were tested by chemiluminescent microparticle immunoassay. Visual analog scale (VAS) scores were utilized to assess the degree of HG. Pearson analysis was implemented to measure the correlations between serum β-hCG levels and serum FT3, FT4, TSH, TPOAb, TRAb, TgAb, as well as VAS scores and the correlations between β-hCG, FT3, FT4, TSH, TPOAb, TRAb, TgAb, as well as VAS scores and gestation period. The receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic values of thyroid hormones, thyroid-related antibodies, and β-hCG levels for HG. Versus those in the control group, β-hCG, FT3, FT4, TPOAb, TRAb, TgAb levels, and VAS scores were higher and TSH levels were lower in the study group. Versus those in the EP group, β-hCG, FT3, FT4, TPOAb, TRAb, TgAb levels, and VAS scores of pregnant women in the MP and LP groups were decreased, and TSH levels were increased. Serum β-hCG levels of pregnant women with HG were positively correlated with FT3, FT4, TPOAb, TRAb, TgAb, and VAS scores and negatively correlated with TSH levels. Serum β-hCG, FT3, FT4, TPOAb, TRAb, TgAb levels, and VAS scores of pregnant women with HG had a negative correlation with the gestation period, while TSH levels had a positive correlation with the gestation period. The ROC curve analysis showed that β-hCG and thyroid function-related indicators were of high clinical values in the diagnosis of HG. Collectively, our article suggests that serum β-hCG expression of pregnant women with HG is abnormally elevated and closely related to the degree of HG and hyperthyroidism. In addition, β-hCG and thyroid function-related indicators have certain diagnostic efficacy for HG.
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Affiliation(s)
- Haiyan Zheng
- Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Qian Wang
- Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Feng Chen
- Department of Traditional Chinese Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
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Jansen LAW, Nijsten K, Limpens J, van Eekelen R, Koot MH, Grooten IJ, Roseboom TJ, Painter RC. Perinatal outcomes of infants born to mothers with hyperemesis gravidarum: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2023; 284:30-51. [PMID: 36924660 DOI: 10.1016/j.ejogrb.2023.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND Hyperemesis gravidarum is the severe form of nausea and vomiting during pregnancy and can lead to undernutrition and low maternal weight gain. Previous epidemiologic and animal studies have shown that undernutrition and low maternal weight gain in pregnancy can increase the risk of unfavorable perinatal outcomes, like shorter gestational age, small for gestational age and lower weight at birth. OBJECTIVE To evaluate the effect of hyperemesis gravidarum on perinatal outcomes. SEARCH STRATEGY OVID Medline and Embase were searched from inception to February 9th, 2022. STUDY ELIGIBILITY Studies reporting on perinatal outcomes of infants born to mothers with hyperemesis gravidarum or severe nausea and vomiting in pregnancy were included. Case reports, case series, animal studies, reviews, editorials and conference abstracts were excluded. DATA COLLECTION AND ANALYSIS Two reviewers independently selected and extracted data. Risk of bias was assessed by the Newcastle-Ottawa Quality Assessment Scale. We conducted meta-analyses where possible. RESULTS Our search yielded 1387 unique papers, of which 61 studies (n = 20,532,671 participants) were included in our systematic review. Meta-analyses showed that hyperemesis gravidarum was associated with preterm birth < 34 weeks (2 studies n = 2,882: OR 2.81, 95 %CI: 1.69-4.67), birth weight < 1500 g (2 studies, n = 489,141: OR 1.43, 95 %CI: 1.02-1.99), neonatal resuscitation (2 studies, n = 4,289,344: OR 1.07, 95 %CI: 1.05-1.10), neonatal intensive care unit admission (7 studies, n = 6,509,702: OR 1.20, 95 %CI: 1.14-1.26) and placental abruption (6 studies, n = 9,368,360: OR 1.15, 95 %CI: 1.05-1.25). Hyperemesis gravidarum was associated with reductions in birthweight > 4000 g (2 studies, n = 5,503,120: OR 0.74, 95 %CI: 0.72-0.76) and stillbirth (9 studies, n = 3,973,154: OR 0.92, 95 %CI: 0.85-0.99). Meta-analyses revealed no association between hyperemesis gravidarum and Apgar scores < 7 at 1 and 5 min; fetal loss, perinatal deaths and neonatal deaths. CONCLUSION Hyperemesis gravidarum is associated with several adverse perinatal outcomes including low birth weight and preterm birth. We also found that pregnancies complicated by hyperemesis gravidarum less frequently were complicated by macrosomia and stillbirth. We were unable to investigate underlying mechanisms.
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Affiliation(s)
- Larissa A W Jansen
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands; Department of Obstetrics and Gynecology, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
| | - Kelly Nijsten
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Obstetrics and Gynecology, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Jacqueline Limpens
- Medical Library, Research Support - Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Rik van Eekelen
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands
| | - Marjette H Koot
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Iris J Grooten
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Obstetrics and Gynecology, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands; Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands
| | - Rebecca C Painter
- Department of Obstetrics and Gynecology, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
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6
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Farshbaf-Khalili A, Salehi-Pourmehr H, Najafipour F, Alamdari NM, Pourzeinali S, Ainehchi N. Is hyperemesis gravidarum associated with transient hyperthyroidism? A systematic review and meta-analysis. Taiwan J Obstet Gynecol 2023; 62:205-225. [PMID: 36965888 DOI: 10.1016/j.tjog.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 03/27/2023] Open
Abstract
Emerging evidence suggests an association of hyperemesis gravidarum (HG) with transient hyperthyroidism and high HCG levels. For synthesizing the current evidence to determine the association between HG with hormones related to thyroid function, a comprehensive systematic search was performed in the electronic databases comprised Medline, Web of Science, Scopus, Embase, ProQuest, and Cochrane Library up to December 2021. All published observational studies that evaluated the association of hyperemesis gravidarum with transient hyperthyroidism were investigated considering the PICO method. The standardized Joanna Briggs Institute Meta-Analysis of Statistics, Assessment, and Review Instrument were applied to appraise the included studies. Twenty-nine studies consisted of 6525 women included in the systematic review. Among them, 28 studies with 2446 participants were included in the meta-analysis. There were significant associations of HG with fT3 (MD: 1.31 pg/mL, 95% CI: 0.61 to 2.01), fT4 (MD: 1.95 ng/dL, 95% CI: 1.17 to 2.73), TSH (MD: -1.22μIU/mL, 95% CI: -1.75 to -0.68), TT4 (MD: 0.56 nmol/L, 95% CI:-0.43 to 1.24), and HCG (MD: 1.90IU/L, 95% CI: 0.497 to 3.301). In conclusion, the serum levels of fT3, fT4, and TT4 increased but TSH decreased significantly in women with compared without HG, indicating the significant association of HG with GTT.
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Affiliation(s)
- Azizeh Farshbaf-Khalili
- Physical Medicine and Rehabilitation Research Centre, Aging Research Institute, Tabriz University of Medical Sciences Tabriz, Iran
| | - Hanieh Salehi-Pourmehr
- Research Center for Evidence-based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzad Najafipour
- Endocrinology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Samira Pourzeinali
- Amiralmomenin Hospital of Charoimagh, Vice Chancellor for Treatment, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Nava Ainehchi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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7
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Nijsten K, van der Minnen LM, Dean C, Bais JMJ, Ris-Stalpers C, van Eekelen R, Bremer HA, van der Ham DP, Heidema WM, Huisjes A, Kleiverda G, Kuppens SM, van Laar JOEH, Langenveld J, van der Made F, Papatsonis D, Pelinck MJ, Pernet PJ, van Rheenen-Flach L, Rijnders RJ, Scheepers HCJ, Vogelvang T, Mol BW, Olff M, Roseboom TJ, Koot MH, Grooten IJ, Painter RC. Depression, anxiety, and post-traumatic stress disorder symptoms after hyperemesis gravidarum: a prospective cohort study. J Matern Fetal Neonatal Med 2022; 35:10055-10063. [PMID: 35726837 DOI: 10.1080/14767058.2022.2089550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To determine the prevalence of depression, anxiety, and posttraumatic stress disorder (PTSD) years after hyperemesis gravidarum (HG) and its association with HG severity. MATERIAL AND METHODS This prospective cohort study consisted of a follow-up of 215 women admitted for HG, who were eligible to participate in a randomized controlled trial and either declined or agreed to be randomized between 2013 and 2016 in 19 hospitals in the Netherlands. Participants completed the Hospital Anxiety and Depression Scale (HADS) six weeks postpartum and during follow-up and the PTSD checklist for DSM-5 (PCL-5) during follow-up. An anxiety or depression score ≥8 is indicative of an anxiety or depression disorder and a PCL-5 ≥ 31 indicative of PTSD. Measures of HG severity were symptom severity (PUQE-24: Pregnancy Unique Quantification of Emesis), weight change, duration of admissions, readmissions, and admissions after the first trimester. RESULTS About 54/215 participants completed the HADS six weeks postpartum and 73/215 participants completed the follow-up questionnaire, on average 4.5 years later. Six weeks postpartum, 13 participants (24.1%) had an anxiety score ≥8 and 11 participants (20.4%) a depression score ≥8. During follow-up, 29 participants (39.7%) had an anxiety score ≥8, 20 participants (27.4%) a depression score ≥8, and 16 participants (21.9%) a PCL-5 ≥ 31.Multivariable logistic regression analysis showed that for every additional point of the mean PUQE-24 three weeks after inclusion, the likelihood of having an anxiety score ≥8 and PCL-5 ≥ 31 at follow-up increased with OR 1.41 (95% CI: 1.10;1.79) and OR 1.49 (95% CI: 1.06;2.10) respectively. CONCLUSION Depression, anxiety, and PTSD symptoms are common years after HG occurred.
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Affiliation(s)
- Kelly Nijsten
- Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Loïs M van der Minnen
- Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - Caitlin Dean
- Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands.,Pregnancy Sickness Support, Bodmin, UK
| | - Joke M J Bais
- Department of Obstetrics and Gynecology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - Carrie Ris-Stalpers
- Laboratory of Reproductive Biology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Rik van Eekelen
- Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - Henk A Bremer
- Department of Obstetrics and Gynecology, Reinier de Graaf Hospital, Delft, The Netherlands
| | - David P van der Ham
- Department of Obstetrics and Gynecology, Martini Hospital, Groningen, The Netherlands
| | - Wieteke M Heidema
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anjoke Huisjes
- Department of Obstetrics and Gynecology, Gelre Hospital, Apeldoorn, The Netherlands
| | - Gunilla Kleiverda
- Department of Obstetrics and Gynecology, Flevo Hospital, Almere, The Netherlands
| | - Simone M Kuppens
- Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands
| | - Judith O E H van Laar
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands
| | - Josje Langenveld
- Department of Obstetrics and Gynecology, Zuyderland Hospital, Heerlen, The Netherlands
| | - Flip van der Made
- Department of Obstetrics and Gynecology, Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Dimitri Papatsonis
- Department of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands
| | - Marie-José Pelinck
- Department of Obstetrics and Gynecology, Scheper Hospital, Emmen, The Netherlands
| | - Paula J Pernet
- Department of Obstetrics and Gynecology, Spaarne Gasthuis, Haarlem, The Netherlands
| | | | - Robbert J Rijnders
- Department of Obstetrics and Gynecology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Hubertina C J Scheepers
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tatjana Vogelvang
- Department of Obstetrics and Gynecology, Diakonessenhuis, Utrecht, The Netherlands
| | - Ben W Mol
- Department of Obstetrics and Gynecology, Monash University, Clayton, Australia
| | - Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Tessa J Roseboom
- Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjette H Koot
- Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - Iris J Grooten
- Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - Rebecca C Painter
- Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
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