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Open Access 01-12-2016 | Research article

Hyperemesis gravidarum and placental dysfunction disorders

Authors: Heleen M. Koudijs, Ary I. Savitri, Joyce L. Browne, Dwirani Amelia, Mohammad Baharuddin, Diederick E. Grobbee, Cuno S. P. M. Uiterwaal

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

Abstract

Background

Evidence about the consequence of hyperemesis gravidarum (HG) on pregnancy outcomes is still inconclusive. In this study, we evaluated if occurrence of hyperemesis gravidarum is associated with placental dysfunction disorders and neonatal outcomes.

Methods

A prospective cohort study was conducted in a maternal and child health primary care referral center, Budi Kemuliaan Hospital and its branch, in Jakarta, Indonesia. 2252 pregnant women visiting the hospital for regular antenatal care visits from July 2012 until October 2014 were included at their first clinic visit. For women without, with mild and with severe hyperemesis, placental dysfunction disorders (gestational hypertension, preeclampsia (PE), stillbirth, miscarriage), neonatal outcomes (birth weight, small for gestational age (SGA), low birth weight (LBW), Apgar score at 5 min, gestational age at delivery) and placental outcomes (placental weight and placental-weight-to-birth-weight ratio (PW/BW ratio)) were studied.

Results

Compared to newborns of women without hyperemesis, newborns of women with severe hyperemesis had a 172 g lower birth weight in adjusted analysis (95%CI -333.26; -10.18; p = 0.04). There were no statistically significant effects on placental dysfunction disorders or other neonatal outcome measures.

Conclusions

The results of our study suggest that hyperemesis gravidarum does not seem to induce placental dysfunction disorders, but does, if severe lead to lower birth weight.

Niebyl JR. Nausea and vomiting in pregnancy. N Engl J Med. 2010;363:1544–50.CrossRefPubMed

Einarson TR, Piwko C, Koren G. Quantifying the global rates of nausea and vomiting of pregnancy: a meta-analysis. J Popul Ther Clin Pharmacol. 2013;20(2):e171–83.

Vikanes A, Grjibovski AM, Vangen S, Magnus P. Variations in prevalence of hyperemesis gravidarum by country of birth: a study of 900,074 pregnancies in Norway, 1967–2005. Scand J Public Health. 2008;36(2):135–42. doi: 10.1177/1403494807085189.

Jordan V, MacDonald J, Crichton S, Stone P, Ford H. The incidence of hyperemesis gravidarum is increased among Pacific Islanders living in Wellington. N Z Med J. 1995;108(1006):342–4.PubMed

Matsuo K, Ushioda N, Nagamatsu M, Kimura T. Hyperemesis gravidarum in Eastern Asian population. Gynecol Obstet Invest. 2007;64(4):213–6. doi: 10.1159/000106493.

Verberg MFG, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update. 2005;11(5):527–39. doi: 10.1093/humupd/dmi021.

McCarthy FP, Khashan AS, North RA, et al. A prospective cohort study investigating associations between hyperemesis gravidarum and cognitive, behavioural and emotional well-being in pregnancy. PLoS One. 2011;6(11):e27678. doi: 10.1371/journal.pone.0027678.

Munch S, Korst LM, Hernandez GD, Romero R, Goodwin TM. Health-related quality of life in women with nausea and vomiting of pregnancy: the importance of psychosocial context. J Perinatol. 2010;31(1):10–20. doi: 10.1038/jp.2010.54.

Bacak SJ, Callaghan WM, Dietz PM, Crouse C. Pregnancy-associated hospitalizations in the United States, 1999–2000. Am J Obstet Gynecol. 2005;192(2):592–7. doi: 10.1016/j.ajog.2004.10.638.

10.

Gazmararian JA, Petersen R, Jamieson DJ, et al. Hospitalizations during pregnancy among managed care enrollees. Obstet Gynecol. 2002;100(1):94–100.PubMed

11.

Trogstad LIS, Stoltenberg C, Magnus P, Skjærven R, Irgens LM. Recurrence risk in hyperemesis gravidarum. BJOG. 2005;112(12):1641–5. doi: 10.1111/j.1471-0528.2005.00765.x.

12.

Berkowitz R, Ozturk M, Goldstein D, Bernstein M, Hill L, Wands JR. Human chorionic gonadotropin and free subunits’ serum levels in patients with partial and complete hydatidiform moles. Obstet Gynecol. 1989;74(2):212–6.PubMed

13.

Lepage N, Chitayat D, Kingdom J, Huang T. Association between second-trimester isolated high maternal serum maternal serum human chorionic gonadotropin levels and obstetric complications in singleton and twin pregnancies. Am J Obstet Gynecol. 2003;188(5):1354–9.CrossRefPubMed

14.

Levine MG, Esser D. Total parenteral nutrition for the treatment of severe hyperemesis gravidarum: maternal nutritional effects and fetal outcome. Obstet Gynecol. 1988;72(1):102–7.PubMed

15.

Bolin M, Åkerud H, Cnattingius S, Stephansson O, Wikström AK. Hyperemesis gravidarum and risks of placental dysfunction disorders: a population-based cohort study. BJOG. 2013;120(5):541–7. doi: 10.1111/1471-0528.12132.

16.

Ismail SK, Kenny L. Review on hyperemesis gravidarum. Best Pract Res Clin Gastroenterol. 2007;21(5):755–69. doi: 10.1016/j.bpg.2007.05.008.

17.

Kaufmann P, Black S, Huppertz B. Endovascular trophoblast invasion: implications for the pathogenesis of intrauterine growth retardation and preeclampsia. Biol Reprod. 2003;69(1):1–7. doi: 10.1095/biolreprod.102.014977.

18.

Siddiqui N, Hladunewich M. Understanding the link between the placenta and future cardiovascular disease. Trends Cardiovasc Med. 2011;21(7):188–93. doi: 10.1016/j.tcm.2012.05.008.

19.

Smith GCS, Fretts RC. Stillbirth. Lancet. 2007;370(9600):1715–25. doi: 10.1016/S0140-6736(07)61723-1.

20.

Chen JZJ, Sheehan PM, Brennecke SP, Keogh RJ. Vessel remodelling, pregnancy hormones and extravillous trophoblast function. Mol Cell Endocrinol. 2012;349(2):138–44.CrossRefPubMed

21.

Vandraas KF, Vikanes AV, Vangen S, Magnus P, Stoer NC, Grjibovski AM. Hyperemesis gravidarum and birth outcomes-a population-based cohort study of 2.2 million births in the Norwegian Birth Registry. BJOG. 2013;120(13):1654–60.CrossRefPubMed

22.

Veenendaal MVE, van Abeelen AFM, Painter RC, van der Post JAM, Roseboom T. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis. BJOG. 2011;118(11):1302–13.CrossRefPubMed

23.

Vlachodimitropoulou-Koumoutsea E, Gosh S, Manmatharajah B, Ray A, Igwe-Omoke N, Yoong W. Pregnancy outcomes in severe hyperemesis gravidarum in a multi-ethnic population. J Obstet Gynaecol. 2013;33(5):455–8. doi: 10.3109/01443615.2013.767788.

24.

Hastoy A, Lien Tran P, Lakestani O, Barau G, Gerardin P, Boukerrou M. Hyperemesis gravidarum and pregnancy outcomes. J Gynecol Obs Biol Reprod. 2015;44(2):154–63.CrossRef

25.

Vikanes ÅV, Støer NC, Magnus P, Grjibovski AM. Hyperemesis gravidarum and pregnancy outcomes in the Norwegian Mother and Child Cohort - a cohort study. BMC Pregnancy Childbirth. 2013;13:169.CrossRefPubMedPubMedCentral

26.

Kuru O, Sen S, Akbayır O, et al. Outcomes of pregnancies complicated by hyperemesis gravidarum. Arch Gynecol Obstet. 2012;285(6):1517–21. doi:10.1007/s00404-011-2176-3.

27.

Buyukkayaci Duman N, Ozcan O, Bostanci MO. Hyperemesis gravidarum affects maternal sanity, thyroid hormones and fetal health: a prospective case control study. Arch Gynecol Obstet. 2015;292(2):307–12.CrossRefPubMed

28.

Vandraas KF, Vikanes AV, Støer NC, Vangen S, Magnus P, Grjibovski AM. Is hyperemesis gravidarum associated with placental weight and the placental weight-to-birth weight ratio? a population-based Norwegian cohort study. Placenta. 2013;34(11):990–4. http://dx.doi.org/10.1016/j.placenta.2013.08.001.

29.

Tan PC, Jacob R, Quek KF, Omar SZ. Pregnancy outcome in hyperemesis gravidarum and the effect of laboratory clinical indicators of hyperemesis severity. J Obstet Gynaecol Res. 2007;33(4):457–64.CrossRefPubMed

30.

Niemeijer MN, Grooten IJ, Vos N, et al. Diagnostic markers for hyperemesis gravidarum: a systematic review and metaanalysis. Am J Obstet Gynecol. 2014;211(2):150.e1–15. doi:10.1016/j.ajog.2014.02.012.

31.

Lumey LH. Reproductive outcomes in women prenatally exposed to undernutrition: a review of findings from the Dutch famine birth cohort. Proc Nutr Soc. 1998;57(1):129–35.CrossRefPubMed

32.

Roseboom TJ, Painter RC, De Rooij SR, et al. Effects of famine on placental size and efficiency. Placenta. 2011;32(5):395–9. doi:10.1016/j.placenta.2011.03.001.CrossRefPubMed

33.

Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Heal. 2014;2(6):323–33. doi: 10.1016/S2214-109X(14)70227-X.

34.

Gross S, Librach C, Cecutti A. Maternal weight loss associated with hyperemesis gravidarum: a predictor of fetal outcome. Am J Obstet Gynecol. 1989;160(4):906–9.CrossRefPubMed

35.

Tranquilli A, Dekker G, Magee L, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Pregnancy Hypertens. 2014;4(2):97–104. doi: 10.1016/j.preghy.2014.02.001.

36.

Magee L, Pels A, Helewa M, Rey E, von Dadelszen P. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obs Gynaecol Can. 2014;36(5):416–38.

37.

Tuffnell DJ, Shennan AH, FRCOG, Waugh JJS, Walker JJ. The Management of severe eclampsia/preeclampsia. Royal College of Obstetricians and Gynaecologists. 2006;10(A):1-11

38.

ACOG Practice Bulletin No. 125: Chronic hypertension in pregnancy.American College of Obstetricians and Gynecologists. Obstet Gynecol. 2012;119(2 Pt 1):396-407. doi: 10.1097/AOG.0b013e318249ff06.

39.

WHO Regional Strategy on Sexual and Reproductive Health. Definitions and Indicators in Family Planning Maternal and Child Health and Reproductive Health. Geneva: World Health Organization; 2001.

40.

Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol. 1996;87(2):163–8. doi: 10.1016/0029-7844(95)00386-X.

41.

Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65(5):663–737.PubMedPubMedCentral

42.

Score TA. ACOG Committee Opinion. Number 333, May 2006 (replaces No. 174, July 1996): The Apgar score. Obstet Gynecol. 2006;107(5):1209–12.CrossRef

43.

Zhang J, Cai WW. Severe vomiting during pregnancy: antenatal correlates and fetal outcomes. Epidemiology. 1991;2(6):454–7.CrossRefPubMed

44.

Dodds L, Fell DB, Joseph KS, Allen VM, Butler B. Outcomes of pregnancies complicated by hyperemesis gravidarum. Obstet Gynecol. 2006;107(2 Pt 1):285–92. doi: 10.107/2/285.

45.

Kuru O, Sen S, Akbayir O, et al. Outcomes of pregnancies complicated by hyperemesis gravidarum. Arch Gynecol Obstet. 2012;285(6):1517–21.CrossRefPubMed

46.

Roseboom TJ, Ravelli AC, van der Post JA, Painter RC. Maternal characteristics largely explain poor pregnancy outcome after hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol. 2011;156(1):56–9. doi: 10.1016/j.ejogrb.2011.01.010.

47.

Källén B. Hyperemesis during pregnancy and delivery outcome: a registry study. Eur J Obstet Gynecol Reprod Biol. 1987;26(4):291–302. doi: 10.1016/0028-2243(87)90127-4.

48.

Chin RK, Lao TT. Low birth weight and hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol. 1988;28(3):179–83.

49.

Paauw JD, Bierling S, Cook CR, Davis AT. Hyperemesis gravidarum and fetal outcome. J Parenter Enter Nutr. 2005;29(2):93–6. doi: 10.1177/014860710502900293.

50.

Vikanes AV, Stoer NC, Magnus P, Grjibovski AM. Hyperemesis gravidarum and pregnancy outcomes in the Norwegian Mother and Child Cohort - a cohort study. BMC Pregnancy Childbirth. 2013;13:169. doi: 10.1186/1471-2393-13-169.

51.

Perry IJ, Beevers DG, Whincup PH, Bareford D. Predictors of ratio of placental weight to fetal weight in multiethnic community. BMJ. 1995;310(6977):436–9. doi: 10.2307/29726370.

Title: Hyperemesis gravidarum and placental dysfunction disorders
Authors: Heleen M. Koudijs
Ary I. Savitri
Joyce L. Browne
Dwirani Amelia
Mohammad Baharuddin
Diederick E. Grobbee
Cuno S. P. M. Uiterwaal
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-016-1174-7

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Hyperemesis gravidarum and placental dysfunction disorders

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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