Recurrence Likely When Hyperemesis Occurs in the First Pregnancy
NEW YORK (Reuters Health) Dec 15 2005- Women with hyperemesis gravidarum in a first pregnancy have a high risk of experiencing the same problem in a subsequent pregnancy, according to Norwegian researchers.
Dr. Lill I. S. Trogstad, of Ulleval University Hospital, Oslo, and colleagues compared the risk of hyperemesis in second pregnancies in women with and without hyperemesis in their first pregnancy. They also examined whether the risk of hyperemesis changes with change in paternity or with the interval between deliveries.
The team used data from the population-based Medical Birth Registry of Norway, 1967 through 1998. The cohort study included 547,238 women with records of their first and second singleton delivery. Results of the study are published in the December issue of the British Journal of Obstetrics and Gynecology.
Overall, 4796 women (0.9%) had hyperemesis in the first pregnancy and 4404 (0.8%) had hyperemesis in the second pregnancy. Among those with and without hyperemesis in their first pregnancy, 15.2% and 0.7%, respectively, experienced hyperemesis in the second pregnancy (OR = 26.4).
For women with hyperemesis in the first pregnancy, the risk of recurrent hyperemesis was 10.9% among those with a change in paternity, compared with 16.0% in those without a change in paternity (adjusted OR = 0.60).
Increasing time interval between deliveries increased the risk of hyperemesis in the second pregnancy, but only in women with no previous hyperemesis.
"For clinical purposes, the high risk of recurrence demonstrated in the present study is important in pre-pregnancy counseling," Dr. Trogstad and colleagues explain. "Women with long intervals between pregnancies are at higher risk of hyperemesis as well as preeclampsia and other adverse pregnancy outcomes, and need more careful monitoring."
Br J Obstet Gynecol 2005;112:1641-1645.