Adverse maternal and birth outcomes in women admitted to hospital for hyperemesis gravidarum: A population-based cohort study

Fiaschi, Linda; Nelson-Piercy, Catherine; Gibson, Jack E.; Szatkowski, Lisa; Tata, Laila J.

Abstract

Background: Evidence for risks of adverse maternal and birth outcomes in women with hyperemesis gravidarum (HG) is predominantly from small studies, unknown, or conflicting.

Methods: A population-based cohort study using secondary health care records (Hospital Episode Statistics covering all of England from 1997 to 2012) was used to calculate odds ratios (OR) with 99% confidence intervals (CI) for the association between HG hospital admission and adverse outcomes, adjusting for maternal and pregnancy confounders.

Results: Within 8 211 850 pregnancies ending in live births or stillbirths, women with HG had increased odds of anaemia (OR 1.28, 99% CI 1.23, 1.33), preeclampsia (OR 1.16, 99% CI 1.09, 1.22), eclampsia (OR 1.84, 99% CI 1.07, 3.18), venous thromboembolism antenatally (OR 1.94, 99% CI 1.57, 2.39 for deep vein thrombosis, and OR 2.54, 99% CI 1.89, 3.40 for pulmonary embolism) and post-partum. Odds of stillbirth (OR 0.77, 99% CI 0.66, 0.89) and post-term (OR 0.86, 99% CI 0.81, 0.92) delivery were decreased. Women were more likely to be induced (OR 1.20, 99% CI 1.16, 1.23), to deliver preterm (OR 1.11, 99% CI 1.05, 1.17), very preterm (OR 1.18, 99% CI 1.05, 1.32), or by caesarean section (OR 1.12, 99% CI 1.08, 1.16), to have low birthweight (OR 1.12, 99% CI 1.08, 1.17) or small for gestational age (OR 1.06, 99% CI 1.01, 1.11) babies and although absolute risks were small, their offspring were more likely to undergo resuscitation or neonatal intensive care.

Conclusion: HG may have important antenatal and postnatal consequences that should be considered in communications between health care professionals and women to best manage HG and prevent progression during pregnancy.

Citation

Fiaschi, L., Nelson-Piercy, C., Gibson, J. E., Szatkowski, L., & Tata, L. J. (in press). Adverse maternal and birth outcomes in women admitted to hospital for hyperemesis gravidarum: A population-based cohort study. Paediatric and Perinatal Epidemiology, 32(1), https://doi.org/10.1111/ppe.12416

• Journal Article Type: Article
• Acceptance Date: Sep 6, 2017
• Online Publication Date: Oct 6, 2017
• Deposit Date: Sep 20, 2017
• Publicly Available Date: Oct 7, 2018
• Journal: Paediatric and Perinatal Epidemiology
• Print ISSN: 0269-5022
• Electronic ISSN: 1365-3016
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 1
• DOI: https://doi.org/10.1111/ppe.12416
• Public URL: https://nottingham-repository.worktribe.com/output/886596
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/ppe.12416/abstract
• Additional Information: This is the peer reviewed version of the following article: Fiaschi, L., Nelson-Piercy, C., Gibson, J., Szatkowski, L. and Tata, L. J. (2017), Adverse Maternal and Birth Outcomes in Women Admitted to Hospital for Hyperemesis Gravidarum: a Population-Based Cohort Study. Paediatric and Perinatal Epidemiology. doi: 10.1111/ppe.12416, which has been published in final form at http://dx.doi.org/10.1111/ppe.12416. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Sep 20, 2017