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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.

Authors

LINDA FIASCHI LINDA.FIASCHI@NOTTINGHAM.AC.UK
Senior Research Fellow in Ehealth

Catherine Nelson-Piercy

Jack E. Gibson



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.

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