Hyperemesis gravidarum and depression in pregnancy: is there an association?

The aim of this study was to evaluate the impact of hyperemesis gravidarum (HG) and sociodemographic parameters on depression during pregnancy.

Between September 2010 and September 2011, 200 consecutive women with HG were defined as the study group and 200 consecutive pregnant women without any signs and symptoms of HG, and matched for age, parity, and gestational age were defined as the control group. The Beck depression inventory-II (BDI-II) questionnaire and sociodemographic questionnaire evaluating educational level, occupation, economic status, and obstetric history were given to all participants for self-completion. The forms were collected within 6 h of hospital admission. Groups were compared according to the presence of depression and predictors of depression were analyzed by regression analysis.

Median BDI-II scores in study and control groups were 15 and 5, respectively. The difference was statistically significant (p < 0.001). In the HG group, 35.1% of patients had mild depression, 26.0% moderate, and 17.8% had severe depression, while only 5% of patients in the control group had mild depression and 95% had no depression. Multivariate analysis showed that HG, age and family relationship were related to depression during pregnancy. Moreover, depression risk was increased 76-fold in patients with HG (odds ratio = 76.000; 95% confidence interval: 36.840-156.788; p < 0.001).

Depression risk is increased in patients with HG, therefore not only medical therapy of HG, but also psychiatric evaluation should be considered for these patients.