[Hyperemesis gravidarum and pregnancy outcomes]

The aim of this study was to determine the impact of hyperemesis gravidarum (HG) on pregnancy.

For this purpose, we conducted a retrospective cohort study between January 1st, 2006 and July 31st, 2009 in the level-3 maternity of the South Reunion teaching hospital, Saint-Pierre. Perinatal outcomes (gestational diabetes mellitus, hypertensive disorders of pregnancy, caesarean section, IUGR<10th percentile, low birth weight<2500 g, preterm birth<37 weeks, perinatal death) were compared among the women hospitalized for HG (exposed group) and a non-exposed group randomly selected from the South Reunion birth register. Finally, we also investigated the interactions between HG and maternal weight gain to assess whether HG might change perinatal outcomes according to weight gain.

During the study period, 215 women hospitalized for HG delivered (cumulative incidence rate of HG 14.1‰ among total deliveries), of which 197 were included in the exposed group. The low gestational weight gain (<7 kg), used as a criterion to define severe HG, was significantly more likely in the exposed group (30.5% versus 16.1%, P<0.0001). There was no significant association between HG and the various perinatal outcomes tested. The risk of delivering a low birth weight neonate was twofold (adjusted RR: 2.0, 95%CI: 1.0-3.1), that for a small-for-gestational age infant was more likely (adjusted RR: 1.7, 95% CI: 1.1-2.4), both only in case of severe HG.

Severe HG, defined for women with a gestational weight gain of less than 7 kg, is a poor prognostic factor for fetal growth.