Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.
OBJECTIVE
Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology.


METHODS
Prospective study.


METHODS
Antenatal counselling service for pregnant women.


METHODS
Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C).


METHODS
All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively.


METHODS
Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation.


RESULTS
Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002).


CONCLUSIONS
The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.
Department of Pediatrics, Hospital for Sick Children, Toronto, Ont.
S
S
Emelianova
P
P
Mazzotta
A
A
Einarson
G
G
Koren
D002170:Canada / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D009325:Nausea / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D011736:Pyridoxine / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use*; D014839:Vomiting / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*
D014815:Vitamins; D011736:Pyridoxine