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Licensed Unlicensed Requires Authentication Published by De Gruyter March 7, 2006

Is the nausea and vomiting of early pregnancy really feto-protective?

  • M. Margaret Weigel , Monica Reyes , Maria Elena Caiza , Nora Tello , Nancy P. Castro , Sara Cespedes , Sylvia Duchicela and Miriam Betancourt

Abstract

Background: Health care providers and popular press articles frequently advise women that nausea and vomiting of early pregnancy (NVP) portends a favorable fetal outcome.

Aim: To investigate the claim that NVP protects against adverse fetal outcomes and improves placental and fetal growth.

Methods: Data were collected on a prospective cohort of 849 Ecuadorian prenatal patients beginning in early gestation until postpartum. A questionnaire collected information on NVP and other maternal characteristics. Fetal outcomes and placental characteristics were examined using anthropometry and physical examination. Multivariate statistical methods controlled for potential confounders.

Results: Women with nausea only (AOR=0.45; 95% CI=0.22–0.94) or nausea with vomiting (AOR=0.66; 95% CI=0.46–0.99) had significantly decreased miscarriage risk although the strength of the protection appeared less than that reported for other populations. NVP was not associated with low birth weight, preterm delivery, congenital anomaly, or other outcomes excepting slightly increased mean infant thigh skinfold (P=0.024), mid-upper arm circumference (P=0.049), and placental weight (P=0.034).

Conclusions: The data did not support the common belief that NVP protects against multiple adverse outcomes. Placental weight was slightly increased in women with NVP but this difference was not reflected in higher birth weights or other types of fetal growth except of marginally increased limb fat.

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Corresponding author: Dr. M. Margaret Weigel, PhD University of Texas at El Paso Department of Health Promotion College of Health Sciences 1101 North Campbell Street El Paso, 79902-0581 Texas/USA Tel.: 1-(915)-747-8308 Fax: 1-(915)-747-7207

References

1 Attard CL, MA Kohli, S Coleman, C Bradley, M Hux, G Atanackovic, GW Torrance: The burden of illness of severe nausea and vomiting of pregnancy in the United States. Am J Obstet Gynecol185 (2002) S22010.1067/mob.2002.122605Search in Google Scholar

2 Behrman CA, ML Hediger, TO Scholl, CM Arkangel: Nausea and vomiting during teenage pregnancy: effects on birth weight. J Adolesc Health Care11 (1990) 418Search in Google Scholar

3 Boneva RS, CA Moore, L Botto, LY Wong, JD Erickson: Nausea during pregnancy and congenital heart defects: a population-based case-control study. Am J Epidemiol149 (1999) 717Search in Google Scholar

4 Boskovic R, N Rudic, B Danieliewska-Nikiel, Y Navioz, G Koren: Is lack of morning sickness teratogenic? A prospective controlled study. Birth Defects Res A Clin Mol Teratol70 (2004) 528Search in Google Scholar

5 Brandes JM: First-trimester nausea and vomiting as related to outcome of pregnancy. Obstet Gynecol30 (1967) 427Search in Google Scholar

6 Czeizel AE, A Sarkozi, DF Wyszynski: Protective effect of hyperemesis gravidarum for nonsyndromic oral clefts. Obstet Gynecol2003101(4) 73710.1097/00006250-200304000-00021Search in Google Scholar

7 Coad J, B Al-Rasai, J Morgan: Nutrient insult in early pregnancy. Proc Nutr Soc61 (2002) 51Search in Google Scholar

8 Chin RK: Antenatal complications and perinatal outcome in patients with nausea and vomiting complicated pregnancy. Eur J Obstet Gynecol Reprod Biol33 (1989) 21510.1016/0028-2243(89)90132-9Search in Google Scholar

9 Corey LA, K Berg, MH Solaas, WE Nance: The epidemiology of pregnancy complications and outcome in a Norwegian twin population. Obstet Gynecol80 (1992) 989Search in Google Scholar

10 Czeizel AE, E Puho: Association between severe nausea and vomiting in pregnancy and lower rate of preterm births. Paediatr Perinat Epidemiol18 (2004) 253Search in Google Scholar

11 Ferenz C, JD Rubin, CA Loffredo, CA Magee (eds): Epidemiology of congenital heart disease. Volume 4: perspectives in pediatric cardiology. Futura Publishing Company, New York 1983Search in Google Scholar

12 Gadsby R, AM Barnie-Adshead, C Jagger C: A prospective study of nausea and vomiting during pregnancy. Br J Gen Practice43 (1988) 245Search in Google Scholar

13 Gibson RS: Principles of Nutritional Assessment Oxford Press, New York 1990Search in Google Scholar

14 Hook EB: Changes in tobacco smoking and ingestion of alcohol and caffeinated beverages during early pregnancy: are these consequences, in part, of feto-protective mechanisms diminishing maternal exposure to embryotoxins? In: Birth Defects. Editors: S. Kelly, Academic Press, New York 1976Search in Google Scholar

15 Huxley RR: Nausea and vomiting in early pregnancy: its role in placental development. Obstet Gynecol95 (2000) 77910.1016/S0029-7844(99)00662-6Search in Google Scholar

16 Jarnfelt-Samsioe A, G Samsioe, GM Velinder: Nausea and vomiting in pregnancy – a contribution to its epidemiology. Gynecol Obstet Invest16 (1983) 221Search in Google Scholar

17 Jong-Im L, L Jeong-A, L Hyeon-Sook: Morning sickness reduces dietary diversity, nutrient intakes, and infant outcome of pregnant women. Nutrition Research24 (2004) 531Search in Google Scholar

18 Kallen B, G Lundberg, A Aberg: Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy. Acta Obstet Gynecol Scand82 (2003) 916Search in Google Scholar

19 Klebanoff MA, PA Koslowe, R Kaslow, GG Rhoads: Epidemiology of vomiting in early pregnancy. Obstet Gynecol66 (1985) 612Search in Google Scholar

20 Klebanoff MA, JL Mills: Is vomiting during pregnancy teratogenic? Br Med J15 (1986) 724Search in Google Scholar

21 Kricker A, J Elliott, J Forrest, J McCredie: Congenital limb deficiency: maternal factors in pregnancy. Aust N Z J Obstet Gynaecol26 (1986) 272Search in Google Scholar

22 Kullander S, B Kallen: A prospective study of drugs and pregnancy. II. Anti-emetic drugs. Acta Obstet Gynecol Scand55 (1976) 105Search in Google Scholar

23 Langston C, C Kaplan, T Macpherson, E Manci, K Peevy, B Clark, C Murtagh, S Cox, G Glen: Practice guideline for examination of the placenta: developed by the Placental Pathology Practice Guideline Development Task Force of the College of American Pathologists. Arch Pathol Lab Med121 (1997) 449Search in Google Scholar

24 Mazotta P, C Maltepe, Y Navioz, LA Magee, G Koren: Attitudes, management and consequences of nausea and vomiting of pregnancy in the United States and Canada. Int J Gynecol Obstet70 (2000) 359Search in Google Scholar

25 Ministerio de Salud Publica: Manual de Atencion Materno-Infantil, Ministerio de Salud Publica, Quito 1992Search in Google Scholar

26 Pike IL: The nutritional consequences of pregnancy sickness. Human Nature11 (2000) 20710.1007/s12110-000-1011-5Search in Google Scholar PubMed

27 Profet M: The evolution of pregnancy sickness as a protection to the embryo against Pleistocene teratogens. Evol Theory8 (1988) 177Search in Google Scholar

28 Smith C, C Crowther, J Beilby, J Dandeaux: The impact of nausea and vomiting on women: a burden of early pregnancy. Austral J Obstet Gynecol40 (2000) 397Search in Google Scholar

29 Tayie FAK, A Lartey, E Aisbey-Berko: Effects of pregnancy sickness on infant birth-weight and maternal weight-gain among Ghanian women. Ecol Food Nut40 (2001) 143Search in Google Scholar

30 Tierson FD, CL Olsen, EB Hook: Nausea and vomiting of pregnancy and association with pregnancy outcome. Am J Obstet Gynecol155 (1986) 1017Search in Google Scholar

31 Vasconez F, F Sempertegui, C Naranjo, L Estrella, V Espin, A Arias: Crecimiento Intrauterino en Quito, CONACYT/Universidad Central del Ecuador, Quito 1984Search in Google Scholar

32 Weigel MM, RM Weigel: The association of reproductive history, demographic factors, and alcohol and tobacco consumption with the risk for developing nausea and vomiting in early pregnancy. Am J Epidemiol127 (1987) 562Search in Google Scholar

33 Weigel MM, RM Weigel: An epidemiologic study of the association between the nausea and vomiting of pregnancy and pregnancy outcome. Br J Obstet Gynecol96 (1989) 1304Search in Google Scholar

34 Weigel RM, MM Weigel: Evaluating the association between early pregnancy nausea and vomiting with miscarriage and perinatal mortality: a meta-analytic review. Br J Obstet Gynecol96 (1989) 1312Search in Google Scholar

35 Weigel MM, ME Caiza, J Lascano, G Barreno, L Mosquera: The nausea and vomiting of early pregnancy in a high-altitude Andean population. Int J Gynecol Obstet69 (2000) 9Search in Google Scholar

Published Online: 2006-03-07
Published in Print: 2006-04-01

©2005 by Walter de Gruyter Berlin New York

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