Stillbirths and perinatal mortality in relation to nausea and vomiting of current pregnancy
36. STILLBIRTHS AND PERINATAL MORTALITY IN RELATION TO NAUSEA AND VOMITING OF CURRENT PREGNANCY
1. Hyperemesis patients did not have any increased risk of stillbirth or neonatal death. (10)
2. Women with hyperemesis (419) had a significantly reduced risk of stillbirth >20 weeks compared to 836 women who did not vomit. 6/419 = 1.43%, 25/836 = 3%. (22)
3. No excess of perinatal death rate in hyperemesis gravidarum. 3,068 women with hyperemesis gravidarum. (29)
4. No statistically significant association was observed between nausea and vomiting of pregnancy and perinatal mortality. 873 women in study, 69% had NVP. (44)
5. Pregnancy outcome between hyperemesis patients (193) and the general population (13,053 women in study) was similar for perinatal mortality. (61)
6. There was no statistical difference in perinatal mortality between women with hyperemesis gravidarum and the control group. Hyperemesis gravidarum 1.9%, 3/164.
Control 1.9%, 4/209. (64)
7. There were no stillbirths or neonatal deaths in 64 women with HG. (42)
8. The evidence from reanalysis and meta-analysis indicates that the decreased mortality risk associated with NVP was restricted to the first 20 weeks gestation, and was not detected during the last 20 weeks or in the neonatal period. (30)
9. No significant association of freedom from nausea with stillbirth. 7,767 pregnancies in study, 29%, i.e. 2,252 pregnancies had no nausea. (51)
10. An association between higher neonatal and perinatal mortality rates and the absence of nausea and vomiting during the first trimester is demonstrated. 7,027 women in study. (5)
1. No increased risk of stillbirth or perinatal mortality with NVP or HG.
(10) (29) (42) (44) (61) (64) (30) Seven References
Pooled population 2908 HG pregnancies 602 NVP pregnancies
2. Significant reduced risk of stillbirth in women with hyperemesis gravidarum.
(22) One Reference
3. No significant association of freedom from nausea and stillbirth. (51)
4. Higher neonatal and perinatal mortality rates and the absence of nausea and vomiting are demonstrated. (5) One Reference
Did you know?
Use an holistic approach to assessing women, including perinatal mental health support, and recognise that no one measure, including ketones, can reliably assess severity of HG
Please note this guideline is for moderate to severe NVP symptoms rather than HG
RCOG Green-top Guideline No. 69
The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum
BMJ Clinical Update 2018
Management of severe pregnancy sickness and hyperemesis gravidarum
The risk of a baby being born with a congenital abnormality - the difference between relative and absolute risk
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