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Hyperemesis Gravidarum and Fetal Outcome

James D. Paauw, MD, PhD, Sandra Bierling, MD, Curtis R. Cook, MD and Alan T. Davis, PhD

From the Spectrum Health Nutrition Support Service, Grand Rapids, Michigan; Spectrum Health, Grand Rapids, Michigan; and the Departments of Surgery, Michigan State University and Spectrum Health, Grand Rapids, Michigan

Correspondence: Alan T. Davis, PhD, Clinical Nutrition Laboratory, 515 Michigan Avenue, NE, Suite 102, Grand Rapids, MI 49503. Electronic mail may be sent to davisa{at}msu.edu.

Background: Hyperemesis gravidarum (HG) is reported in 0.5–2% of all pregnancies. The purpose of this research was to evaluate the relationship of maternal HG, neonatal birth weight, and birth outcomes. Methods: This is a prospective cohort study of 45 patients diagnosed, by Fairweather's criteria, with HG compared with 306 non-HG control pregnant patients with singleton pregnancies. Sociodemographic and clinical data were obtained from the pregnant patients. Neonatal data were also collected, including indicators of neonatal wellness. Results: Significantly higher incidences of being nonwhite (33% vs 16%; p < .05) and of attaining post–high school education (60% vs 38%) were noted in the HG group, relative to controls. Mothers in the control group experienced greater gestational weight gain, 14.9 ± 0.3 kg (mean ± SEM) relative to mothers in the HG group (10.6 ± 1.3 kg). Infants from HG pregnancies manifested significantly lower birth weight (3.23 ± 0.09 kg vs 3.52 ± 0.03 kg), younger gestational age (38.4 ± 0.3 weeks vs 39.7 ± 0.1 weeks), and a greater length of hospital stay (2.9 ± 0.5 days vs 1.8 ± 0.1 day), relative to infants from the control group. After undergoing multivariate analysis, HG was a significant predictor of decreased gestational age and increased hospital length of stay. Conclusions: Infants born of women who had HG are more likely to experience decreased gestational age and increased length of hospital stay. Efficacy of early and aggressive treatment of HG, including nutrition support, in minimizing these outcomes needs to be studied.

Journal of Parenteral and Enteral Nutrition, Vol. 29, No. 2, 93-96 (2005)
DOI: 10.1177/014860710502900293


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