Pre-Pregnancy Risk Factors for Severe Hyperemesis Gravidarum: Korean Population Based Cohort Study

Hyperemesis gravidarum is known to be associated with poor perinatal outcomes. This study aimed to identify pre-pregnancy risk factors for hospital admission in women with hyperemesis gravidarum. We enrolled women who had delivered between 1 January 2013 and 31 December 2015, and had undergone a national health screening examination through the National Health Insurance Corporation 1-2 years before their first delivery. Multiple logistic regression analysis was performed to estimate the risk factors for hospital admission due to hyperemesis gravidarum. Of the 216,373 study participants with hyperemesis gravidarum, 2210 (1.02%) pregnant women were hospitalized. These women had lower waist circumference and were underweight based on body mass index compared to pregnant women who did not require hospitalization due to hyperemesis gravidarum. On multivariate analysis, primiparity, multiple pregnancies, female fetus, alcohol consumption, and pre-pregnancy underweight status were associated with an increased risk of hospitalization due to the condition. In this population-based cohort study, we found that hospitalization due to hyperemesis gravidarum was associated with pre-pregnancy lifestyle characteristics. Early recognition and management of these pre-pregnancy factors may help control the need for hospitalization in women with the condition in subsequent pregnancies.