title: Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and nausea) identifies patients with hyperemesis gravidarum and poor nutritional intake: a prospective cohort validation study.
abstract: OBJECTIVE
  The English questionnaire Pregnancy-Unique Quantification of Emesis and nausea (PUQE) identifies women with severe Hyperemesis Gravidarum. Our aim was to investigate whether scores from the translated Norwegian version; SUKK (SvangerskapsUtløst Kvalme Kvantifisering) was associated with severity of hyperemesis and nutritional intake.
  
  
  METHODS
  A prospective cohort validation study.
  
  
  METHODS
  Hospital cohort of Hyperemesis Gravidarum (HG) patients from western Norway and healthy pregnant women from Bergen, Norway.
  
  
  METHODS
  38 women hospitalized due to HG and 31 healthy pregnant controls attending routine antenatal check-up at health centers.
  
  
  METHODS
  Data were collected May 2013-January 2014. The study participants answered the Norwegian PUQE-questionnaire (scores ranging from 3 to 15) and registered prospectively 24-hours nutritional intake by a food list form.
  
  
  METHODS
  Differences of PUQE-scores, QOL-score and nutritional intake between hyperemesis patients and controls.
  
  
  RESULTS
  Hyperemesis patients had shorter gestational age compared to controls (median 9.7 weeks; 95% CI 8.6-10.6 versus 11.9; 95% CI 10.1-12.9, p=0.004), and larger weight-change from pre-pregnant weight (loss of median 3 kg; 95% CI 3-4 versus gain of 2 kg; 95% CI 0.5-2, p<0.001) otherwise groups were similar regarding pre-pregnant BMI, age, gravidity, and inclusion weight. Compared to controls, hyperemesis patients had significant higher PUQE-score (median 13; 95% CI 11-14 vs. 7; 95% CI 4-8), lower QOL (median score 3; 95% CI 2-4 vs. 6; 95% CI 4.5-8) and lower nutritional intake (energy intake median 990 kcal/24 hours; 95% CI 709-1233 vs. 1652; 95% CI 1558-1880 all p<0.001). PUQE-score was inversely correlated to nutritional intake (-0.5, p<0.001). At discharge PUQE-score had fallen to median 6 (95% CI 5-8) and QOL score risen to 7 (95% CI 6-8) in the HG group, (both p<0.001 compared to admission values).
  
  
  CONCLUSIONS
  PUQE-scoring has been validated as a robust indicator of severe hyperemesis gravidarum and insufficient nutritional intake in a Norwegian setting.
authors.affiliation: Dpt. Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Birkeland
authors.affiliation: Dpt. Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Guro
authors.initials: G
authors.lastname: Stokke
authors.affiliation: Dpt. Research and Development, Haukeland University Hospital, Bergen, Norway.
authors.forename: Randi J
authors.initials: RJ
authors.lastname: Tangvik
authors.affiliation: Dpt. Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Erik A
authors.initials: EA
authors.lastname: Torkildsen
authors.affiliation: Dpt. Obstetrics and Gynecology, Helse-Foerde, Foerde, Norway.
authors.forename: Jane
authors.initials: J
authors.lastname: Boateng
authors.affiliation: Dpt. Bergen, Volvat Medical Centre, Bergen, Norway.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Wollen
authors.affiliation: Dpt. Clinical Science, University of Bergen, Bergen, Norway; Dpt. Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Susanne
authors.initials: S
authors.lastname: Albrechtsen
authors.affiliation: Dpt. Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway; Dpt. Clinical Medicine, University of Bergen, Bergen, Norway.
authors.forename: Hans
authors.initials: H
authors.lastname: Flaatten
authors.affiliation: Dpt. Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Jone
authors.initials: J
authors.lastname: Trovik
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D004435:Eating; D005260:Female; D006760:Hospitalization; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D009325:Nausea / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D009664:Norway / Q000453:epidemiology; D009752:Nutritional Status; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
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