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Adverse Maternal and Birth Outcomes in Women Admitted to Hospital for Hyperemesis Gravidarum: a Population‐Based Cohort Study
Author(s) -
Fiaschi Linda,
NelsonPiercy Catherine,
Gibson Jack,
Szatkowski Lisa,
Tata Laila J.
Publication year - 2018
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12416
Subject(s) - medicine , obstetrics , odds ratio , hyperemesis gravidarum , caesarean section , pregnancy , population , confidence interval , small for gestational age , pulmonary embolism , eclampsia , gestational age , pediatrics , vomiting , environmental health , biology , genetics
Background Evidence for risks of adverse maternal and birth outcomes in women with hyperemesis gravidarum ( HG ) is predominantly from small studies, unknown, or conflicting. Methods A population‐based cohort study using secondary health care records (Hospital Episode Statistics covering all of England from 1997 to 2012) was used to calculate odds ratios ( OR ) with 99% confidence intervals ( CI ) for the association between HG hospital admission and adverse outcomes, adjusting for maternal and pregnancy confounders. Results Within 8 211 850 pregnancies ending in live births or stillbirths, women with HG had increased odds of anaemia ( OR 1.28, 99% CI 1.23, 1.33), preeclampsia ( OR 1.16, 99% CI 1.09, 1.22), eclampsia ( OR 1.84, 99% CI 1.07, 3.18), venous thromboembolism antenatally ( OR 1.94, 99% CI 1.57, 2.39 for deep vein thrombosis, and OR 2.54, 99% CI 1.89, 3.40 for pulmonary embolism) and post‐partum. Odds of stillbirth ( OR 0.77, 99% CI 0.66, 0.89) and post‐term ( OR 0.86, 99% CI 0.81, 0.92) delivery were decreased. Women were more likely to be induced ( OR 1.20, 99% CI 1.16, 1.23), to deliver preterm ( OR 1.11, 99% CI 1.05, 1.17), very preterm ( OR 1.18, 99% CI 1.05, 1.32), or by caesarean section ( OR 1.12, 99% CI 1.08, 1.16), to have low birthweight ( OR 1.12, 99% CI 1.08, 1.17) or small for gestational age ( OR 1.06, 99% CI 1.01, 1.11) babies and although absolute risks were small, their offspring were more likely to undergo resuscitation or neonatal intensive care. Conclusion HG may have important antenatal and postnatal consequences that should be considered in communications between health care professionals and women to best manage HG and prevent progression during pregnancy.