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Psychological morbidity associated with hyperemesis gravidarum: a systematic review and meta‐analysis
Author(s) -
MitchellJones N,
Gallos I,
Farren J,
Tobias A,
Bottomley C,
Bourne T
Publication year - 2017
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14180
Subject(s) - meta analysis , anxiety , hyperemesis gravidarum , nausea , medicine , depression (economics) , strictly standardized mean difference , medline , clinical psychology , psychiatry , political science , law , economics , macroeconomics
Background Psychological illness occurring in association with hyperemesis gravidarum ( HG ) has been widely reported. Objective To determine if there is a higher incidence of psychological morbidity in women with HG compared with women without significant nausea and vomiting in pregnancy. Search strategy PubMed, MEDLINE , Embase and Psych INFO were searched up to September 2015. Selection criteria Articles referring to psychological morbidity in relation to HG . For meta‐analysis case–control studies using numerical scales to compare psychological symptoms. Data collection and analysis Articles were independently assessed for inclusion by two reviewers and methodology was appraised using the Newcastle Ottawa Scale. Comparison was made using the standard mean difference ( SMD ) in symptom scale scores. Main results In all, 59 articles were included in the systematic review, 12 of these were used in the meta‐analysis. Meta‐analysis of depression scale scores demonstrated a very large effect with statistically significantly higher depression scale scores in women with HG ( SMD 1.22; 95% CI 0.80–1.64; P ≤ 0.01) compared with controls. Meta‐analysis of anxiety scores demonstrated a large effect with statistically significantly higher anxiety disorder scale scores in women with HG ( SMD 0.86; 95% CI 0.53–1.19; P ≤ 0.01). In both analyses significant heterogeneity was identified (depression and HG I 2 = 94%, P ≤ 0.01; anxiety and HG I 2 = 84%, P = 0.02). Conclusions Our systematic review and meta‐analysis have shown a significantly increased frequency of depression and anxiety in women with HG . The findings should prompt service development for women with HG that includes provision of psychological care and support. Tweetable abstract Meta‐analysis demonstrates an increase in #PsychologicalMorbidity in women with #HyperemesisGravidarum