Interventions for nausea and vomiting in early pregnancy

Area of Science:

• Obstetrics and Gynecology
• Evidence-Based Medicine
• Pharmacology

Background:

• Nausea, retching, and vomiting in early pregnancy (NVP) are common, significantly impacting women's physical, social, and psychological well-being.
• This review is an update of interventions for NVP, last published in 2014.

Purpose of the Study:

• To assess the effectiveness and safety of all interventions for nausea, vomiting, and retching in early pregnancy (up to 20 weeks' gestation).

Main Methods:

• Searched Cochrane Pregnancy and Childbirth Group's Trials Register, Cochrane Complementary Medicine Field's Trials Register, and reference lists.
• Included randomized controlled trials (RCTs) of interventions for NVP, excluding hyperemesis gravidarum and quasi-randomized or cross-over trials.
• Four reviewers independently assessed eligibility, risk of bias, and extracted data from included trials.

Main Results:

• Forty-one trials (5449 women) evaluated interventions like acupressure, ginger, and antiemetic drugs; no dietary or lifestyle interventions were studied.
• Limited evidence exists for acupressure, acupuncture, and ginger's effectiveness; pharmacological agents like vitamin B6 showed limited support.
• Data on maternal/fetal outcomes and psychological/social impacts were scarce; heterogeneity prevented pooling results, and methodological quality was mixed with unclear selection bias in many studies.

Conclusions:

• High prevalence of NVP necessitates clear guidance, but high-quality evidence supporting specific interventions is lacking.
• The absence of strong evidence does not equate to ineffectiveness but highlights insufficient robust data for any single intervention.
• Need for consistent, clearly justified outcomes and measurement approaches in future NVP research is emphasized.