The Experts below are selected from a list of 2046 Experts worldwide ranked by ideXlab platform

Weesong Yeo - One of the best experts on this subject based on the ideXlab platform.

  • a meta analysis of the association between helicobacter pylori h pylori infection and Hyperemesis Gravidarum
    Helicobacter, 2018
    Co-Authors: Nandini Venkatanarayanan, Michelle Lee Zhi Qing De Deyn, Weesong Yeo
    Abstract:

    BACKGROUND Hyperemesis Gravidarum remains a common, distressing, and significant yet poorly understood disorder during pregnancy. The association between maternal Helicobacter pylori (H. pylori) infection and Hyperemesis Gravidarum has been increasingly recognized and investigated. This study thus aimed to provide an updated review and meta-analysis of the topic. METHODS Using the search terms (H. pyloriOR Helicobacter ORHelicobacter pyloriOR infection) AND (pregnancy OR emesis OR Hyperemesis Gravidarum OR nausea OR vomiting), a preliminary search on the PubMed, Ovid, Web of Science, Google Scholar, and WanFang database yielded 372 papers published in English between January 1st, 1960 and June 1st, 2017. RESULTS A total of 38 cross-sectional and case-control studies, with a total of 10 289 patients were eligible for review. Meta-analysis revealed a significant association between H. pylori infection and Hyperemesis Gravidarum during pregnancy, with a pooled odds ratio of 1.348 (95% CI: 1.156-1.539, P < .001). Subgroup analysis found that serologic and stool antigen tests were comparable methods of detecting H. pylori as they yielded similar odds ratios. LIMITATIONS Although the studies did not have high heterogeneity (I2  = 28%), publication bias was observed, and interstudy discrepancies in the diagnostic criteria adopted for Hyperemesis Gravidarum limit the reliability of findings. Also, 15 of the included studies were from the same country (Turkey), which could limit the generalizability of current findings. The prevalence of H. pylori infection varies throughout the world, and there may also be pathogenic differences as most strains of H. pylori in East Asia carry the cytotoxin-associated gene A gene. CONCLUSION H. pylori infection was associated with an increased likelihood of Hyperemesis Gravidarum during pregnancy. Given the high prevalence of H. pylori infections worldwide, detecting H. pylori infection and the eradication of maternal H. pylori infection could be part of maternal Hyperemesis Gravidarum management. Further confirmation with robust longitudinal studies and mechanistic investigations are needed.

Marlena S Fejzo - One of the best experts on this subject based on the ideXlab platform.

  • Nausea and vomiting of pregnancy and Hyperemesis Gravidarum
    Nature Reviews Disease Primers, 2019
    Co-Authors: Marlena S Fejzo, Tessa J Roseboom, Rebecca C Painter, Ase Vikanes, Jone Trovik, Iris J. Grooten, Kannan Sridharan, Patrick M. Mullin
    Abstract:

    Nausea and vomiting of pregnancy (NVP) is a common condition that affects as many as 70% of pregnant women. Although no consensus definition is available for Hyperemesis Gravidarum (HG), it is typically viewed as the severe form of NVP and has been reported to occur in 0.3–10.8% of pregnant women. HG can be associated with poor maternal, fetal and child outcomes. The majority of women with NVP can be managed with dietary and lifestyle changes, but more than one-third of patients experience clinically relevant symptoms that may require fluid and vitamin supplementation and/or antiemetic therapy such as, for example, combined doxylamine/pyridoxine, which is not teratogenic and may be effective in treating NVP. Ondansetron is commonly used to treat HG, but studies are urgently needed to determine whether it is safer and more effective than using first-line antiemetics. Thiamine (vitamin B1) should be introduced following protocols to prevent refeeding syndrome and Wernicke encephalopathy. Recent advances in the genetic study of NVP and HG suggest a placental component to the aetiology by implicating common variants in genes encoding placental proteins (namely GDF15 and IGFBP7 ) and hormone receptors (namely GFRAL and PGR ). New studies on aetiology, diagnosis, management and treatment are under way. In the next decade, progress in these areas may improve maternal quality of life and limit the adverse outcomes associated with HG. This Primer provides a comprehensive review of the current state of basic science and clinical knowledge on nausea and vomiting of pregnancy, and its extreme form Hyperemesis Gravidarum. Directions to focus on for future study are also discussed.

  • Analysis of GDF15 and IGFBP7 in Hyperemesis Gravidarum Support Causality.
    Geburtshilfe und Frauenheilkunde, 2019
    Co-Authors: Marlena S Fejzo, Kimber Macgibbon, Peter A Fasching, Michael O Schneider, Judith Schwitulla, Matthias W Beckmann, Eva Schwenke, Patrick M. Mullin
    Abstract:

    Objective Hyperemesis Gravidarum, severe nausea and vomiting in pregnancy, occurs in up to 2% of pregnancies and leads to significant weight loss, dehydration, electrolyte imbalance, and ketonuria. It is associated with both maternal and fetal morbidity. Familial aggregation studies and twin studies suggest a genetic component. In a recent GWAS, we showed that placentation, appetite, and cachexia genes GDF15 and IGFBP7 are linked to Hyperemesis Gravidarum (HG). The purpose of this study is to determine whether GDF15 and IGFBP7 are upregulated in HG patients. Methods We compared serum levels of GDF15 and IGFBP7 at 12 and 24 weeks' gestation in women hospitalized for HG, and two control groups, women with nausea and vomiting of pregnancy (NVP), and women with no NVP. Results We show GDF15 and IGFBP7 serum levels are significantly increased in women with HG at 12 weeks' gestation. Serum levels of hCG are not significantly different between cases and controls. At 24 weeks gestation, when symptoms have largely resolved, there is no difference in GDF15 and IGFBP7 serum levels between cases and controls. Conclusion This study supports GDF15 and IGFBP7 in the pathogenesis of HG and may be useful for prediction and diagnosis. The GDF15-GFRAL brainstem-activated pathway was recently identified and therapies to treat conditions of abnormal appetite are under intense investigation. Based on our findings, HG should be included.

  • antihistamines and other prognostic factors for adverse outcome in Hyperemesis Gravidarum
    European Journal of Obstetrics & Gynecology and Reproductive Biology, 2013
    Co-Authors: Marlena S Fejzo, Aromalyn Magtira, Frederic Paik Schoenberg, Kimber Macgibbon, Patrick Mullin, Roberto Romero, Khalil Tabsh
    Abstract:

    A B S T R A C T Objective: The purpose of this study is to determine the frequency of adverse perinatal outcome in women with Hyperemesis Gravidarum and identify prognostic factors. Study design: This is a case–control study in which outcomes of first pregnancies were compared between 254 women with Hyperemesis Gravidarum treated with intravenous fluids and 308 controls. Prognostic factors were identified by comparing the clinical profile of patients with Hyperemesis Gravidarum with a normal and an adverse pregnancy outcome. Binary responses were analyzed using either a Chi-square or Fisher exact test and continuous responses were analyzed using a t-test. Results: Women with Hyperemesis Gravidarum have over a 4-fold increased risk of poor outcome including preterm birth and lower birth weight (p < 0.0001). Among maternal characteristics, only gestational hypertension had an influence on outcome (p < 0.0001). Treatment as an outpatient and/or by alternative medicine (acupuncture/acupressure/Bowen massage) was associated with a positive outcome (p < 0.0089). Poor outcomes were associated with early start of symptoms (p < 0.019), and treatment with methylprednisolone (p < 0.0217), promethazine (p < 0.0386), and other antihistamines [diphenhydramine (Benadryl), dimenhydrinate (Gravol), doxylamine (Unisom), hydroxyzine (Vistaril/Atarax), doxylamine and pyridoxine (Diclectin/Bendectin)] (p < 0.0151) independent of effectiveness. Among these medications, only the other antihistamines were prescribed independent of severity: they were effective in less than 20% of cases and were taken by almost 50% of patients with an adverse outcome. Conclusion: Poor outcomes are significantly greater in women with HG and are associated with gestational hypertension, early symptoms, and antihistamine use. Given these results, there is an urgent need to address the safety and effectiveness of medications containing antihistamines in women with severe nausea of pregnancy.

  • change in paternity and recurrence of Hyperemesis Gravidarum
    Journal of Maternal-fetal & Neonatal Medicine, 2012
    Co-Authors: Marlena S Fejzo, Frederic Paik Schoenberg, Kimber Macgibbon, Roberto Romero, Murphy T Goodwin, Chunyu Ching, Patrick M. Mullin
    Abstract:

    Objective: To determine whether change in paternity changes recurrence risk of Hyperemesis Gravidarum (HG). Study design: Survey data on recurrence of HG was compared between cases who had a paternity change between pregnancies and cases who did not. Results: The percentage of HG pregnancies in women with the same partner for all pregnancies was not significantly different from the percentage of HG pregnancies in women who changed partners for at least one pregnancy (78% vs 71%, p > 0.05). Participants who did and did not change partners between their first and second pregnancies, were asked to rate their first and second pregnancy in regards to symptoms of HG. Neither the ratings nor the change in rating between pregnancies was significantly different between the two groups. Conclusion: Women reported HG in over 70% of their pregnancies regardless of a paternity change. Paternal genes expressed through the fetus do not have a significant effect on incidence or recurrence of HG. This study supports a stro...

  • recurrence risk of Hyperemesis Gravidarum
    Journal of Midwifery & Women's Health, 2011
    Co-Authors: Marlena S Fejzo, Kimber Macgibbon, Roberto Romero, Murphy T Goodwin, Patrick M. Mullin
    Abstract:

    Introduction: The purpose of this study is to describe the recurrence risk for Hyperemesis Gravidarum (HG). Methods: Women who registered on a Web site sponsored by the Hyperemesis Education and Research Foundation as having had one HG-complicated pregnancy were contacted to follow-up on a subsequent pregnancy. Participants completed an online survey. Results: One hundred women responded. Fifty-seven had become pregnant again, 2 were trying to conceive, 37 were not willing to get pregnant again because of HG, and 4 did not have a second pregnancy for other reasons. Among the 57 women who responded that they had become pregnant again, 81% reported having severe nausea and vomiting in their second pregnancy. Among the women reporting recurrent HG, 98% reported losing weight and taking prescribed medication for HG, 83% reported treatment with intravenous fluids, 20% reported treatment with total parenteral nutrition or nasogastric tube feeding, and 48% reported hospitalization for HG. Discussion: This study demonstrates both a high recurrence rate of HG and a large percentage of women who change reproductive plans because of their experiences with HG.

Patrick M. Mullin - One of the best experts on this subject based on the ideXlab platform.

  • effect of gabapentin on Hyperemesis Gravidarum a double blind randomized controlled trial
    American Journal of Obstetrics & Gynecology MFM, 2021
    Co-Authors: Thomas Guttuso, Patrick M. Mullin, Susan Messing, Rachel Shepherd, Chad Strittmatter, Sumona Saha, Loralei L Thornburg
    Abstract:

    Background Hyperemesis Gravidarum is a disabling disease of nausea, vomiting, and undernutrition in early pregnancy for which there are no effective outpatient therapies. Poor weight gain in Hyperemesis Gravidarum is associated with several adverse fetal outcomes including preterm delivery, low birthweight, small for gestational age, low 5-minute Apgar scores, and neurodevelopmental delay. Gabapentin is most commonly used clinically for treating neuropathic pain but also substantially reduces chemotherapy-induced and postoperative nausea and vomiting. Pregnancy registry data have shown maternal first-trimester gabapentin monotherapy to be associated with a 1.2% rate of major congenital malformations among 659 infants, which compares favorably with the 1.6% to 2.2% major congenital malformation rate in the general population. Open-label gabapentin treatment in Hyperemesis Gravidarum was associated with reduced nausea and vomiting and improved oral nutrition. Objective This study aimed to determine whether gabapentin is more effective than standard-of-care therapy for treating Hyperemesis Gravidarum. Study Design A double-blind, randomized, multicenter trial was conducted among patients with medically refractory Hyperemesis Gravidarum requiring intravenous hydration. Patients were randomized (1:1) to either oral gabapentin (1800–2400 mg/d) or an active comparator of either oral ondansetron (24–32 mg/d) or oral metoclopramide (45–60 mg/d) for 7 days. Differences in Motherisk–pregnancy-unique quantification of nausea and emesis total scores between treatment groups averaged over days 5 to 7, using intention-to-treat principle employing a linear mixed-effects model adjusted for baseline Motherisk–pregnancy-unique quantification of nausea and emesis scores, which served as the primary endpoint. Secondary outcomes included Motherisk–pregnancy-unique quantification of nausea and emesis nausea and vomit and retch subscores, oral nutrition, global satisfaction of treatment, relief, desire to continue therapy, Nausea and Vomiting of Pregnancy Quality of Life, and Hyperemesis Gravidarum Pregnancy Termination Consideration. Adjustments for multiple comparisons were made employing the false discovery rate. Results A total of 31 patients with Hyperemesis Gravidarum were enrolled from October 2014 to May 2019. Among the 21 patients providing primary outcome data (12 assigned to gabapentin and 9 to the active comparator arm), 18 were enrolled as outpatients and all 21 were outpatients from days 5 to 7. The study groups’ baseline characteristics were well matched. Gabapentin treatment provided a 52% greater reduction in days 5 to 7 baseline adjusted Motherisk–pregnancy-unique quantification of nausea and emesis total scores than treatment with active comparator (95% confidence interval, 16–88; P=.01). Most secondary outcomes also favored gabapentin over active comparator treatment including 46% and 49% decreases in baseline adjusted Motherisk–pregnancy-unique quantification of nausea and emesis nausea (95% confidence interval, 19–72; P=.005) and vomit and retch subscores (95% confidence interval, 21–77; P=.005), respectively; a 96% increase in baseline adjusted oral nutrition scores (95% confidence interval, 27–165; P=.01); and a 254% difference in global satisfaction of treatment (95% confidence interval, 48–459; P=.03). Relief (P=.06) and desire to continue therapy (P=.06) both showed trends favoring gabapentin treatment but Nausea and Vomiting of Pregnancy Quality of Life (P=.68) and Hyperemesis Gravidarum Pregnancy Termination Consideration (P=.58) did not. Adverse events were roughly equivalent between the groups. There were no serious adverse events. Conclusion In this small trial, gabapentin was more effective than standard-of-care therapy for reducing nausea and vomiting and increasing oral nutrition and global satisfaction in outpatients with Hyperemesis Gravidarum. These data build on previous findings in other patient populations supporting gabapentin as a novel antinausea and antiemetic therapy and support further research on gabapentin for this challenging complication of pregnancy.

  • Nausea and vomiting of pregnancy and Hyperemesis Gravidarum
    Nature Reviews Disease Primers, 2019
    Co-Authors: Marlena S Fejzo, Tessa J Roseboom, Rebecca C Painter, Ase Vikanes, Jone Trovik, Iris J. Grooten, Kannan Sridharan, Patrick M. Mullin
    Abstract:

    Nausea and vomiting of pregnancy (NVP) is a common condition that affects as many as 70% of pregnant women. Although no consensus definition is available for Hyperemesis Gravidarum (HG), it is typically viewed as the severe form of NVP and has been reported to occur in 0.3–10.8% of pregnant women. HG can be associated with poor maternal, fetal and child outcomes. The majority of women with NVP can be managed with dietary and lifestyle changes, but more than one-third of patients experience clinically relevant symptoms that may require fluid and vitamin supplementation and/or antiemetic therapy such as, for example, combined doxylamine/pyridoxine, which is not teratogenic and may be effective in treating NVP. Ondansetron is commonly used to treat HG, but studies are urgently needed to determine whether it is safer and more effective than using first-line antiemetics. Thiamine (vitamin B1) should be introduced following protocols to prevent refeeding syndrome and Wernicke encephalopathy. Recent advances in the genetic study of NVP and HG suggest a placental component to the aetiology by implicating common variants in genes encoding placental proteins (namely GDF15 and IGFBP7 ) and hormone receptors (namely GFRAL and PGR ). New studies on aetiology, diagnosis, management and treatment are under way. In the next decade, progress in these areas may improve maternal quality of life and limit the adverse outcomes associated with HG. This Primer provides a comprehensive review of the current state of basic science and clinical knowledge on nausea and vomiting of pregnancy, and its extreme form Hyperemesis Gravidarum. Directions to focus on for future study are also discussed.

  • Analysis of GDF15 and IGFBP7 in Hyperemesis Gravidarum Support Causality.
    Geburtshilfe und Frauenheilkunde, 2019
    Co-Authors: Marlena S Fejzo, Kimber Macgibbon, Peter A Fasching, Michael O Schneider, Judith Schwitulla, Matthias W Beckmann, Eva Schwenke, Patrick M. Mullin
    Abstract:

    Objective Hyperemesis Gravidarum, severe nausea and vomiting in pregnancy, occurs in up to 2% of pregnancies and leads to significant weight loss, dehydration, electrolyte imbalance, and ketonuria. It is associated with both maternal and fetal morbidity. Familial aggregation studies and twin studies suggest a genetic component. In a recent GWAS, we showed that placentation, appetite, and cachexia genes GDF15 and IGFBP7 are linked to Hyperemesis Gravidarum (HG). The purpose of this study is to determine whether GDF15 and IGFBP7 are upregulated in HG patients. Methods We compared serum levels of GDF15 and IGFBP7 at 12 and 24 weeks' gestation in women hospitalized for HG, and two control groups, women with nausea and vomiting of pregnancy (NVP), and women with no NVP. Results We show GDF15 and IGFBP7 serum levels are significantly increased in women with HG at 12 weeks' gestation. Serum levels of hCG are not significantly different between cases and controls. At 24 weeks gestation, when symptoms have largely resolved, there is no difference in GDF15 and IGFBP7 serum levels between cases and controls. Conclusion This study supports GDF15 and IGFBP7 in the pathogenesis of HG and may be useful for prediction and diagnosis. The GDF15-GFRAL brainstem-activated pathway was recently identified and therapies to treat conditions of abnormal appetite are under intense investigation. Based on our findings, HG should be included.

  • change in paternity and recurrence of Hyperemesis Gravidarum
    Journal of Maternal-fetal & Neonatal Medicine, 2012
    Co-Authors: Marlena S Fejzo, Frederic Paik Schoenberg, Kimber Macgibbon, Roberto Romero, Murphy T Goodwin, Chunyu Ching, Patrick M. Mullin
    Abstract:

    Objective: To determine whether change in paternity changes recurrence risk of Hyperemesis Gravidarum (HG). Study design: Survey data on recurrence of HG was compared between cases who had a paternity change between pregnancies and cases who did not. Results: The percentage of HG pregnancies in women with the same partner for all pregnancies was not significantly different from the percentage of HG pregnancies in women who changed partners for at least one pregnancy (78% vs 71%, p > 0.05). Participants who did and did not change partners between their first and second pregnancies, were asked to rate their first and second pregnancy in regards to symptoms of HG. Neither the ratings nor the change in rating between pregnancies was significantly different between the two groups. Conclusion: Women reported HG in over 70% of their pregnancies regardless of a paternity change. Paternal genes expressed through the fetus do not have a significant effect on incidence or recurrence of HG. This study supports a stro...

  • recurrence risk of Hyperemesis Gravidarum
    Journal of Midwifery & Women's Health, 2011
    Co-Authors: Marlena S Fejzo, Kimber Macgibbon, Roberto Romero, Murphy T Goodwin, Patrick M. Mullin
    Abstract:

    Introduction: The purpose of this study is to describe the recurrence risk for Hyperemesis Gravidarum (HG). Methods: Women who registered on a Web site sponsored by the Hyperemesis Education and Research Foundation as having had one HG-complicated pregnancy were contacted to follow-up on a subsequent pregnancy. Participants completed an online survey. Results: One hundred women responded. Fifty-seven had become pregnant again, 2 were trying to conceive, 37 were not willing to get pregnant again because of HG, and 4 did not have a second pregnancy for other reasons. Among the 57 women who responded that they had become pregnant again, 81% reported having severe nausea and vomiting in their second pregnancy. Among the women reporting recurrent HG, 98% reported losing weight and taking prescribed medication for HG, 83% reported treatment with intravenous fluids, 20% reported treatment with total parenteral nutrition or nasogastric tube feeding, and 48% reported hospitalization for HG. Discussion: This study demonstrates both a high recurrence rate of HG and a large percentage of women who change reproductive plans because of their experiences with HG.

Murphy T Goodwin - One of the best experts on this subject based on the ideXlab platform.

  • change in paternity and recurrence of Hyperemesis Gravidarum
    Journal of Maternal-fetal & Neonatal Medicine, 2012
    Co-Authors: Marlena S Fejzo, Frederic Paik Schoenberg, Kimber Macgibbon, Roberto Romero, Murphy T Goodwin, Chunyu Ching, Patrick M. Mullin
    Abstract:

    Objective: To determine whether change in paternity changes recurrence risk of Hyperemesis Gravidarum (HG). Study design: Survey data on recurrence of HG was compared between cases who had a paternity change between pregnancies and cases who did not. Results: The percentage of HG pregnancies in women with the same partner for all pregnancies was not significantly different from the percentage of HG pregnancies in women who changed partners for at least one pregnancy (78% vs 71%, p > 0.05). Participants who did and did not change partners between their first and second pregnancies, were asked to rate their first and second pregnancy in regards to symptoms of HG. Neither the ratings nor the change in rating between pregnancies was significantly different between the two groups. Conclusion: Women reported HG in over 70% of their pregnancies regardless of a paternity change. Paternal genes expressed through the fetus do not have a significant effect on incidence or recurrence of HG. This study supports a stro...

  • recurrence risk of Hyperemesis Gravidarum
    Journal of Midwifery & Women's Health, 2011
    Co-Authors: Marlena S Fejzo, Kimber Macgibbon, Roberto Romero, Murphy T Goodwin, Patrick M. Mullin
    Abstract:

    Introduction: The purpose of this study is to describe the recurrence risk for Hyperemesis Gravidarum (HG). Methods: Women who registered on a Web site sponsored by the Hyperemesis Education and Research Foundation as having had one HG-complicated pregnancy were contacted to follow-up on a subsequent pregnancy. Participants completed an online survey. Results: One hundred women responded. Fifty-seven had become pregnant again, 2 were trying to conceive, 37 were not willing to get pregnant again because of HG, and 4 did not have a second pregnancy for other reasons. Among the 57 women who responded that they had become pregnant again, 81% reported having severe nausea and vomiting in their second pregnancy. Among the women reporting recurrent HG, 98% reported losing weight and taking prescribed medication for HG, 83% reported treatment with intravenous fluids, 20% reported treatment with total parenteral nutrition or nasogastric tube feeding, and 48% reported hospitalization for HG. Discussion: This study demonstrates both a high recurrence rate of HG and a large percentage of women who change reproductive plans because of their experiences with HG.

  • patients with a history of Hyperemesis Gravidarum have similar symptoms during egg stimulation and develop ovarian hyperstimulation syndrome case series
    Fertility and Sterility, 2010
    Co-Authors: Marlena S Fejzo, Roberto Romero, Murphy T Goodwin
    Abstract:

    Objective To investigate the symptoms and outcomes of ovarian stimulation in patients with a history of Hyperemesis Gravidarum. Design Retrospective case series. Setting Research laboratory of a university hospital. Patient(s) Participants in an ongoing study on Hyperemesis Gravidarum that reported ovarian stimulation for gestational surrogacy. Intervention(s) Review of medical records. Main Outcome Measure(s) Pregnancy history, symptoms, estradiol level and mature oocyte number in cases, and nausea and vomiting level reported in surrogate. Result(s) Three cases in their early thirties with a history of Hyperemesis Gravidarum presented with severe nausea and vomiting during ovarian stimulation and ovarian hyperstimulation syndrome. Gestational carriers reported normal nausea and vomiting of pregnancy. Conclusion(s) This series provides lessons for in vitro fertilization for cases with a history of Hyperemesis Gravidarum and their gestational carriers as well as insight into the cause of Hyperemesis Gravidarum and its potential role in fertility. A link between Hyperemesis Gravidarum and an evolutionary advantage of increased fertility suggests a novel theory to explain the selection for nausea and vomiting in pregnancy.

  • psychological factors and Hyperemesis Gravidarum
    Journal of women's health and gender-based medicine, 2001
    Co-Authors: Steven W Simpson, Murphy T Goodwin, Sean B Robins, Albert Rizzo, Ryan A Howes, Deborah K Buckwalter, Galen J Buckwalter
    Abstract:

    Hyperemesis Gravidarum (HG) is a condition of severe, intractable nausea and vomiting during pregnancy. It has long been held that HG is a psychosomatic illness reflective of a long-term psychological trait, that is, conversion disorder. We investigated this possibility by conducting a two-phase study: (1) a comparison of women with (n = 9) and without (n = 10) HG during pregnancy and (2) a comparison of nonpregnant women who did (n = 10) and did not (n = 12) have HG during their most recent pregnancies. The pattern of findings differed between experiments 1 and 2. During pregnancy, women with HG scored significantly higher on three scales associated with conversion disorder (all p values <0.01) than did women without HG. There were no significant differences between HG subjects and controls after pregnancy. We find no support for the theory that HG is a psychosomatic condition. Rather, it appears to be a complex interaction of biological, psychological, and sociocultural factors.

  • transient hyperthyroidism and Hyperemesis Gravidarum clinical aspects
    American Journal of Obstetrics and Gynecology, 1992
    Co-Authors: Murphy T Goodwin, Martin Montoro, Jorge H Mestman
    Abstract:

    OBJECTIVES: Our objectives were to describe the presentation and course of Hyperemesis Gravidarum with respect to thyroid function and to test the hypothesis that patients with biochemical hyperthyroidism differ in clinical presentation from euthyroid Hyperemesis patients. STUDY DESIGN: Sixty-seven patients seen at Los Angeles County Women's Hospital over a 10-month period with Hyperemesis Gravidarum were studied prospectively with respect to thyroid function. RESULTS: Forty-four patients (66%) had biochemical hyperthyroidism (increased free thyroxine index [ n = 39] or suppressed thyroid-stimulating hormone [ n = 40]) that was self-limited, resolving by 18 weeks' gestation. Hyperthyroid patients were more likely than euthyroid patients to have abnormal electrolyte levels (23/39 [59%] vs 6/28 [21%] and increased liver enzyme levels (23/59 [59%] vs 5/28 [18%], p CONCLUSIONS: Hyperthyroidism is a common, self-limited finding in Hyperemesis. The cause of the hyperthyroidism may be linked to the cause of Hyperemesis itself.

Ase Vikanes - One of the best experts on this subject based on the ideXlab platform.

  • Nausea and vomiting of pregnancy and Hyperemesis Gravidarum
    Nature Reviews Disease Primers, 2019
    Co-Authors: Marlena S Fejzo, Tessa J Roseboom, Rebecca C Painter, Ase Vikanes, Jone Trovik, Iris J. Grooten, Kannan Sridharan, Patrick M. Mullin
    Abstract:

    Nausea and vomiting of pregnancy (NVP) is a common condition that affects as many as 70% of pregnant women. Although no consensus definition is available for Hyperemesis Gravidarum (HG), it is typically viewed as the severe form of NVP and has been reported to occur in 0.3–10.8% of pregnant women. HG can be associated with poor maternal, fetal and child outcomes. The majority of women with NVP can be managed with dietary and lifestyle changes, but more than one-third of patients experience clinically relevant symptoms that may require fluid and vitamin supplementation and/or antiemetic therapy such as, for example, combined doxylamine/pyridoxine, which is not teratogenic and may be effective in treating NVP. Ondansetron is commonly used to treat HG, but studies are urgently needed to determine whether it is safer and more effective than using first-line antiemetics. Thiamine (vitamin B1) should be introduced following protocols to prevent refeeding syndrome and Wernicke encephalopathy. Recent advances in the genetic study of NVP and HG suggest a placental component to the aetiology by implicating common variants in genes encoding placental proteins (namely GDF15 and IGFBP7 ) and hormone receptors (namely GFRAL and PGR ). New studies on aetiology, diagnosis, management and treatment are under way. In the next decade, progress in these areas may improve maternal quality of life and limit the adverse outcomes associated with HG. This Primer provides a comprehensive review of the current state of basic science and clinical knowledge on nausea and vomiting of pregnancy, and its extreme form Hyperemesis Gravidarum. Directions to focus on for future study are also discussed.

  • history of depression and risk of Hyperemesis Gravidarum a population based cohort study
    Archives of Womens Mental Health, 2017
    Co-Authors: Helena Kames Kjeldgaard, Malin Eberhardgran, Jurate Saltyte Benth, Hedvig Nordeng, Ase Vikanes
    Abstract:

    Hyperemesis Gravidarum (HG) is a pregnancy condition characterised by debilitating nausea and vomiting. HG has been associated with depression during pregnancy but the direction of the association remains unclear. The aim of this study was to assess whether previous depression is associated with HG. This is a population-based pregnancy cohort study using data from The Norwegian Mother and Child Cohort Study. The study reviewed 731 pregnancies with HG and 81,055 pregnancies without. Logistic regression analyses were performed to examine the association between a lifetime history of depression and Hyperemesis Gravidarum. Odds ratios were adjusted for symptoms of current depression, maternal age, parity, body mass index, smoking, sex of the child, education and pelvic girdle pain. A lifetime history of depression was associated with higher odds for Hyperemesis Gravidarum (aOR = 1.49, 95% CI (1.23; 1.79)). Two thirds of women with Hyperemesis Gravidarum had neither a history of depression nor symptoms of current depression, and 1.2% of women with a history of depression developed HG. A lifetime history of depression increased the risk of HG. However, given the fact that only 1.2% of women with a history of depression developed HG and that the majority of women with HG had no symptoms of depression, depression does not seem to be a main driver in the aetiology of HG.

  • maternal body composition smoking and Hyperemesis Gravidarum
    Annals of Epidemiology, 2010
    Co-Authors: Ase Vikanes, A M Grjibovski, Nina Gunnes, Siri Vangen, Sven Ove Samuelsen, Per Magnus
    Abstract:

    PURPOSE: To study associations between maternal prepregnant body mass index (BMI), smoking, and Hyperemesis Gravidarum (Hyperemesis). METHODS: The sample consisted of 33,467 primiparous women from the Norwegian Mother and Child Cohort Study (1999-2008). Data on Hyperemesis, BMI, education, maternal age, eating disorders, maternal and paternal smoking habits were obtained from questionnaires. All associations were studied by logistic regression. RESULTS: Altogether, 353 (1.1%) women had Hyperemesis. Among non-smokers, both underweight and obese women were more likely to develop Hyperemesis than normal-weighted women: odds ratio (OR), 2.36; 95% confidence interval (95% CI), 1.43-3.88 and OR, 1.48; 95% CI, 1.00-2.20, respectively. No associations were found among smokers. Women who smoked daily (OR, 0.44; 95% CI, 0.32-0.60) or occasionally (OR, 0.64; 95% CI, 0.44-0.93) had lower risk of Hyperemesis than non-smokers. No effect of partner's smoking habits was observed. CONCLUSIONS: Both underweight and obesity were associated with Hyperemesis, but only among non-smokers. Maternal prepregnant smoking reduced the risk of Hyperemesis, whereas partner's smoking habits had no effect.

  • recurrence of Hyperemesis Gravidarum across generations population based cohort study
    BMJ, 2010
    Co-Authors: Ase Vikanes, Rolv Skjaerven, A M Grjibovski, Nina Gunnes, Siri Vangen, Per Magnus
    Abstract:

    Objective To estimate the risk of Hyperemesis Gravidarum (Hyperemesis) according to whether the daughters and sons under study were born after pregnancies complicated by Hyperemesis. Design Population based cohort study. Setting Registry data from Norway. Participants Linked generational data from the medical birth registry of Norway (1967-2006): 544 087 units of mother and childbearing daughter and 399 777 units of mother and child producing son. Main outcome measure Hyperemesis in daughters in mother and childbearing daughter units and Hyperemesis in female partners of sons in mother and child producing son units. Results Daughters who were born after a pregnancy complicated by Hyperemesis had a 3% risk of having Hyperemesis in their own pregnancy, while women who were born after an unaffected pregnancy had a risk of 1.1% (unadjusted odds ratio 2.9, 95% confidence interval 2.4 to 3.6). Female partners of sons who were born after pregnancies complicated by Hyperemesis had a risk of 1.2% (1.0, 0.7 to 1.6). Daughters born after a pregnancy not complicated by Hyperemesis had an increased risk of the condition if the mother had Hyperemesis in a previous or subsequent pregnancy (3.2 (1.6 to 6.4) if Hyperemesis had occurred in one of the mother’s previous pregnancies and 3.7 (1.5 to 9.1) if it had occurred in a later pregnancy). Adjustment for maternal age at childbirth, period of birth, and parity did not change the estimates. Restrictions to firstborns did not influence the results. Conclusions Hyperemesis Gravidarum is more strongly influenced by the maternal genotype than the fetal genotype, though environmental influences along the maternal line cannot be excluded as contributing factors.