Variation in severity of NVP from pregnancy to pregnancy in the same woman
8a. VARIATION IN SEVERITY OF NVP FROM PREGNANCY TO PREGNANCY IN THE SAME WOMAN
1. Some women who have no symptoms of nausea and vomiting in one pregnancy shall be violently attacked with it in another. - Smellie, 1779. (From Ref 10).
2. Frequency and duration of NVP vary greatly in individuals, as well as in different pregnancies in the same individual. (1)
3. The multipara numbered 63 between them gave a history of 175 previous pregnancies.
The syndrome of NVP was not necessarily a constant feature of successive pregnancies in the same woman. (2)
4. A woman could be very sick in one pregnancy and yet have been less affected or even not affected at all in a previous or in a subsequent pregnancy. (41)
5. Of 55 women in this study, 18 had no NVP in the current pregnancy but 5 (27%) of these 18 women had distress with NVP in a previous pregnancy. (102)
8b. SYMPTOMS OF NVP CAN RECUR SIMILARLY FROM ONE PREGNANCY TO THE NEXT IN THE SAME WOMAN
1. Prior nausea on parity residuals were positively associated with nausea (P
2. A history of nausea during previous pregnancy was associated with an increased risk of NVP during current pregnancy. 825 women in study. (78)
3. The present study confirms the significant relationship between pregnancy nausea in the current pregnancy and the occurrence of pregnancy sickness in a previous pregnancy. 363 women in study (P=0.005). (53)
4. Women with nausea during a previous pregnancy were significantly more likely to report NVP during the index pregnancy P
5. Vomiting in one pregnancy is highly associated with vomiting in the subsequent pregnancy (P
6. For women with a normal first pregnancy, the risk of HG in the second pregnancy was very similar to the overall population risk in the first pregnancy. 0.7% developed HG in the second pregnancy 0.9% in the first. No convincing protective effect of a former normal pregnancy was observed. 547,238 singleton pregnancies registered with their first and second deliveries between 1967 and 1998. Norwegian women. (148)
8c. THERE IS A 50-66% CHANCE THAT SYMPTOMS OF NVP WILL BE SIMILAR IN SUCCEEDING PREGNANCIES IN THE SAME WOMAN
1. Of the 57 women who were multiparous and who had had over 100 hours of nausea, 36 (63%) stated they had similar symptoms in a previous pregnancy. Of 41 women who were multiparous and had no nausea in the current pregnancy, 24 (59%) stated they had no or only slight symptoms in a previous pregnancy. These figures suggest about 1/3 of women will have varying NVP in their pregnancies, whereas about 2/3 will have similar NVP in successive pregnancies. (50)
2. A third to half of multipara admitted to hospital with hyperemesis gravidarum in this series had been treated in hospital with this condition in previous pregnancies. Of the 106 treated in their second pregnancy, 50 had been treated in their first. There were 82 patients in their third pregnancy. 44 had been treated in both and 11 in one previous pregnancy (67%). (9)
3. The number of women who had very bad nausea or sickness in their first pregnancy (longer than 3/12 or very severe in the first 3/12) 99 out of 300 = 33%. The number of women who had similar severe symptoms in their second pregnancy 51 in 99 = 51%
(Barnie-Adshead, not published).
4. First pregnancy no vomiting in 314 patients but of these, 54% vomited in their second pregnancy. (18)
Total 818 women in 4 studies
8d. RECURRENCE RATE OF HYPERMEMESIS GRAVIDARUM IN SUCCEEDING PREGNANCIES 70%-80%
1. Multiparous hyperemetic subjects were more likely to have suffered from hyperemesis in a previous pregnancy than multiparious control subjects. 13/16 (81.2%) v 3/16 (18.8%). (113)
2. 10 out of 14 (71.4%) multipara with severe HG had a previous pregnancy affected by HG. (121)
3. The control group of 35 women who had severe nausea and vomiting in their previous pregnancy exhibited the expected 80% rate of recurrence of severe nausea and vomiting in a successive pregnancy. (122)
4. Of the 545 Women with at least 2 pregnancies 453 (83.1%) reported at least 1 recurrence of HG (808 Women from 23 Countries located the survey of Women with HG through an internet search regarding HG). (145)
5. Among women who had HG in their 1st pregnancy (n = 4796) 15.2% developed HG in their 2nd pregnancy. Women without HG in their 1st pregnancy 0.7% developed HG in 2nd pregnancy. A woman is 26 times more likely to have a recurrence of HG in 2nd pregnancy if she had HG in her 1st pregnancy than the woman who did not have HG in her 1st pregnancy. (148).
6. Among 504 informative women 331 reported more than one pregnancy and among these women 307 (96%) reported at least one recurrence, with 84% (1104 pregnancies out of 1309 pregnancies) reported to be HG pregnancies. (152).
7. 26.6% patients with hyperemesis gravidarum in their second or subsequent pregnancy admitted to hospital because of hyperemesis gave a history of admission in a previous pregnancy with a similar diagnosis. (10) Incidence of hyperemesis gravidarum in pregnancy is 0.14%-1.3% of births (RI 9a).
Pooled population in 6 studies 7038 women.
NVP can vary in severity from one pregnancy to the next in the same woman.
(1) (2) (10) (41) (102) Total: Five references
Symptoms of NVP can recur similarly from one pregnancy to the next in the same woman. (31) (53) (78) (80) (18) Total: Five References
There is a 50-66% chance that symptoms of NVP will be similar in succeeding pregnancies. (9) (50) (Barnie-Adshead, not published) (18)
Total: Four References
In seven recent references the recurrence rate of HG for succeeding pregnancies in the same woman is recorded between 70% and 80%. (113) (121) (122) (145) (148) (152) (10)
Total: Seven References
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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