Nausea, vomiting and poor appetite during pregnancy and adverse birth outcomes in rural Nepal: an observational cohort study

BMC Pregnancy and Childbirth

James M Tielsch¹  Joanne Katz²  Amanda Regodón Wallin²  Helen Chu³  Luke C Mullany⁴  Subarna K Khatry⁵  Steven C LeClerq⁶  Janet A Englund⁷ 

[1] Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA;Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W5009, 21203-2105, Baltimore, MD, USA;Department of Medicine, University of Washington, Seattle, WA, USA;Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Nepal Nutrition Intervention Project, Sarlahi, Kathmandu, Nepal;Nepal Nutrition Intervention Project, Sarlahi, Kathmandu, Nepal;Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Seattle Children’s Research Institute, University of Washington, Seattle, WA, USA;

关键词: Nausea and vomiting in pregnancy;    adverse birth outcomes;    pregnancy;    birthweight;    low birth weight;    small for gestational age;    preterm birth;    Nepal;   

DOI  :  10.1186/s12884-020-03141-1

来源: Springer

【 摘 要 】

BackgroundNausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite during pregnancy on birth outcomes in rural Nepal.MethodsObservational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011 to 2013. Exposure was defined as nausea, vomiting or poor appetite at any point during pregnancy and by trimester; symptoms were recorded monthly throughout pregnancy. Adverse outcomes were low birth weight (LBW), preterm birth and small for gestational age (SGA). Adjusted relative risks (aRR) with 95% CIs are reported from Poisson regressions with robust variance.ResultsAmong 3,623 pregnant women, the cumulative incidence of nausea, vomiting or poor appetite was 49.5% (n = 1793) throughout pregnancy and 60.6% (n = 731) in the first trimester. Significantly higher aRRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower aRR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29).ConclusionsSymptoms of nausea, vomiting or poor appetite during pregnancy are associated with LBW, SGA and preterm birth in a setting with limited resources, especially beyond the first trimester.Trial registrationProspectively registered at ClinicalTrials.gov on Dec 17, 2009 (NCT01034254).

【 授权许可】

CC BY