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 Researchers identified 1,836 woman who were diagnosed during their
first pregnancy with the severe nausea and vomiting, formally known
as hyperemesis gravidarum, and who went on to have at least one more
pregnancy.
Out of an overall 2,267 later pregnancies, the severe morning
sickness recurred in 544, or 24 percent.
The condition, the most common cause of hospitalization in the first
trimester of pregnancy, garnered attention in 2012 when Kate
Middleton, the Duchess of Cambridge and wife of Britain's Prince
William, was hospitalized with hyperemesis gravidarum while
expecting their first child. Kate has since been diagnosed with the
condition in her two subsequent pregnancies.
"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," Miina Nurmi,
lead author of the study, told Reuters Health by email.
Nurmi, from University of Turku and Turku University Hospital, said
the study's findings align with data from other Nordic studies. But
Nurmi also said some women who experienced severe nausea and
vomiting in multiple pregnancies have said the recurrence rate
appeared surprisingly low to them.
Comparison of recurrence rates is complicated by the lack of a
universally accepted definition of hyperemesis gravidarum. As a
result, there is no common understanding of what amounts to a
recurrence of hyperemesis gravidarum, the authors admit.
The current study, published in the American Journal of Obstetrics &
Gynecology, did find that morning sickness was more frequent in
these women than in the general population.
The researchers evaluated data from national registers in Finland
between 2004 and 2011 on women who had at least one pregnancy ending
in delivery following a pregnancy diagnosed with hyperemesis
gravidarum.
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Of the 333 women in the study who had more than one pregnancy after
their first, 11 percent suffered hyperemesis gravidarum every time,
highlighting the need for close follow-up and prompt treatment of
symptoms.
"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 rather expensive, to come as
close to the true recurrence rate as possible," said Nurmi.
The eight-year follow-up period did not necessarily cover the entire
reproductive history of all women, and continuation of follow-up of
the women in the study would be of interest, the authors suggest.
Also, they note, some women with symptoms of hyperemesis gravidarum
may not have sought medical care, so the current study might
underestimate the recurrence rate.
Still, the fact that severe morning sickness does not necessarily
recur may be reassuring when women are considering whether to have
another baby, the authors said.
"Women who have had hyperemesis gravidarum in one pregnancy should
hope for the best, but always prepare for the worst," Dr. Marlena
Fejzo, Associate Researcher at the University of Southern California
and the University of California, Los Angeles, said.
"What is novel is that the study provides evidence against a common
assumption that nausea and vomiting gets worse with each pregnancy,"
Fejzo said by email.
SOURCE: http://bit.ly/2onIbgT American Journal of Obstetrics &
Gynecology, online August 16, 2018.
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