Use of antiemetics in early pregnancy 2012-2022: A cross-sectional study

Nausea and vomiting in pregnancy impact quality of life, yet many pregnant women feel dismissed by healthcare professionals, despite the safety of first-line antiemetic treatments for both mother and fetus. Therefore, this study aims to describe the prevalence of patient-reported antiemetic use in early pregnancy in Copenhagen, Denmark, the changes in use over two time periods, and the maternal characteristics of users and non-users.

We analysed patient-reported data on antiemetic use during early pregnancy and maternal characteristics from the Copenhagen Pregnancy Cohort (2012-2022). Descriptive statistics were applied to assess the prevalence, changes in use over two time periods and differences between users and non-users.

Among 40 856 pregnancies, 1.0% (n = 412) reported using antiemetics in early pregnancy. Metoclopramide was the most used, reported by 0.2% (n = 93). The number of pregnancies with patient-reported antiemetic use doubled from 0.7% in 2012-2017 to 1.4% in 2018-2022. Among users, 83.3% received monotherapy, and 74.1% used antiemetics daily. Compared with non-users, a significantly higher proportion of antiemetic users scored <50 on the World Health Organization Five Well-Being Index (66.6% vs. 20.5%, p < .001) and to a higher extent reported sick leave (68.0% vs. 14.1%, p < .001).

We found a low but rising prevalence of antiemetic use in early pregnancy, and the treatment often deviated from clinical guidelines. Antiemetic users differed from non-users on several maternal characteristics, with a higher proportion reporting somatic and psychiatric disorders, as well as poorer mental well-being, despite antiemetic treatment.