Women who have suffered from Hyperemesis gravidarum can now be reassured that severe morning sickness does not necessarily recur in each pregnancy according to the results of the study published August 16 in the American Journal of Obstetrics & Gynecology.
The Finnish study provides evidence that 3 out of 4 women who suffered from hyperemesis gravidarum will not experience it in the subsequent pregnancy. The incidence of hyperemesis is 0.5-2.0% and is the most common cause of first-trimester hospital admissions.
The exact etiology of hyperemesis is still unknown, and both maternal and paternal genetics, family history and environmental causes have all been implicated in its causation. Hyperemesis recently hit the headlines when Kate Middleton, the Duchess of Cambridge and wife of Britain's Prince William, was hospitalized with hyperemesis gravidarum during her first pregnancy.
Finnish researchers identified 1836 women over a period of 7 years who were diagnosed with hyperemesis during their first pregnancy and who had at least one more subsequent delivery. The first pregnancy with hyperemesis was considered as an index pregnancy, and the recurrence rate was calculated based on the incidence of hyperemesis and the total number of subsequent pregnancies.
There were 2,267 later pregnancies, of whom hyperemesis occurred in 544 or 24% of pregnancies, while in 1723 pregnancies no morning sickness was noted. In case of more than 1 subsequent pregnancy, 333 (11%) of women suffered from hyperemesis in all of their pregnancies.
Women who were second para during the index pregnancy were 33% more likely to suffer from hyperemesis as compared to those who were para one (adjusted odds ratio, 1.33, P = .046).
Being overweight and smokers were at decreased odds of recurrence of hyperemesis in subsequent pregnancy. Women with female fetuses were also at 29% increased odds of recurring hyperemesis (adjusted odds ratio, 1.29, P = .012).
Miina Nurmi, lead author of the study, told Reuters Health by email, “It is good to know that hyperemesis gravidarum (HG) is not a ‘lifelong sentence’ to everyone - sometimes HG patients have been told that HG would be with them in every pregnancy.”
“It is reassuring to know that hyperemesis does not appear to become more likely with each pregnancy and that after 1 pregnancy with hyperemesis, the following pregnancy may be different,” the authors concluded, admitting that comparison of recurrence is difficult given the lack of universal definition of hyperemesis gravidarum.
The authors further suggested that "Large prospective studies concentrating on HG patients' future pregnancies, studied with both symptom diaries and medical records, would be an ideal way, though slow and somewhat expensive, to come as close to the actual recurrence rate as possible."
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