Norwegian Research... British Journal of OBS

[Gracie]

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.

[Mom to Aidan & Daniel]

interesting! it struck me that changes in paternity may be significant!

what confused me was

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).

the 4404 women, are they the same women as the 4796 women, only in their second pg? i guess not, as only 15.2 had hg in their second pg???
i'm a bit confused

[aaronsmommy]

Yes, they are saying these are the same women. The risk of recurrence always seems quite low in studies compared to our personal experience.

Why? Severity of illness probably makes a big difference - would love a study on that.

[Irene]

I too have read this article and strongly disagree with their conclusion. The results are not a true representation of those inflicted with HG, only those diagnosed. Those diagnosed with Hg in their first pg went often undiagnosed in their second pg. Especially in the 60's and 70's, HG went largly undiagnosed in Norway. If you look at the nr of women diagnosed with Hg in the 60's and 70's and match this up to population, the rate is far lower then for the 90's. I will post an abstract of the article that deals with this as soon as I find it again!

Irene