[Hyperemesis gravidarum and pregnancy outcomes].
OBJECTIVE
The aim of this study was to determine the impact of hyperemesis gravidarum (HG) on pregnancy.


METHODS
For this purpose, we conducted a retrospective cohort study between January 1st, 2006 and July 31st, 2009 in the level-3 maternity of the South Reunion teaching hospital, Saint-Pierre. Perinatal outcomes (gestational diabetes mellitus, hypertensive disorders of pregnancy, caesarean section, IUGR<10th percentile, low birth weight<2500 g, preterm birth<37 weeks, perinatal death) were compared among the women hospitalized for HG (exposed group) and a non-exposed group randomly selected from the South Reunion birth register. Finally, we also investigated the interactions between HG and maternal weight gain to assess whether HG might change perinatal outcomes according to weight gain.


RESULTS
During the study period, 215 women hospitalized for HG delivered (cumulative incidence rate of HG 14.1‰ among total deliveries), of which 197 were included in the exposed group. The low gestational weight gain (<7 kg), used as a criterion to define severe HG, was significantly more likely in the exposed group (30.5% versus 16.1%, P<0.0001). There was no significant association between HG and the various perinatal outcomes tested. The risk of delivering a low birth weight neonate was twofold (adjusted RR: 2.0, 95%CI: 1.0-3.1), that for a small-for-gestational age infant was more likely (adjusted RR: 1.7, 95% CI: 1.1-2.4), both only in case of severe HG.


CONCLUSIONS
Severe HG, defined for women with a gestational weight gain of less than 7 kg, is a poor prognostic factor for fetal growth.
Maternité Paule-de-Viguier, CHU de Toulouse, avenue de Grande-Bretagne, 31059 Toulouse, France.
A
A
Hastoy
Service de gynécologie-obstétrique, pôle femme-mère-enfant, groupe hospitalier Sud Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion.
P
P
Lien Tran
Service de gynécologie-obstétrique, pôle femme-mère-enfant, groupe hospitalier Sud Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion.
O
O
Lakestani
Service de gynécologie-obstétrique, pôle femme-mère-enfant, groupe hospitalier Sud Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion.
G
G
Barau
Service de gynécologie-obstétrique, pôle femme-mère-enfant, groupe hospitalier Sud Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion; Centre d'investigation clinique et épidémiologie, groupe hospitalier Sud Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion.
P
P
Gérardin
Service de gynécologie-obstétrique, pôle femme-mère-enfant, groupe hospitalier Sud Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion; UFR santé de la Réunion, centre d'étude périnatale de l'océan Indien (CEPOI), CHU de la Réunion, Saint Pierre, Réunion; UFR santé, université de la Réunion, Saint Denis, Réunion. Electronic address: malik.boukerrou@chu-reunion.fr.
M
M
Boukerrou
D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D007231:Infant, Newborn; D008787:Metoclopramide / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D017508:Reunion / Q000453:epidemiology; D055815:Young Adult
D000932:Antiemetics; D008787:Metoclopramide
Cohort study; Croissance fœtale; Fetal growth; Gestational weight gain; Hyperemesis gravidarum; Hyperémèse gravidique; Issues périnatales; Perinatal outcomes; Prise de poids gestationnelle; Étude de cohorte