Nutritional intakes and their association with symptom severity among women with Hyperemesis Gravidarum

Hyperemesis Gravidarum (HG) is characterised by severe nausea and vomiting in pregnancy. Despite the critical role of nutrition during pregnancy and risk of malnutrition in this cohort, few studies have reported dietary intakes of women with HG. The aim was to assess the nutritional intakes of women with HG compared with dietary recommendations and to explore the association between nutritional intakes and symptom severity. In this cross-sectional study, women with a diagnosis of HG attending a day assessment unit in a large maternity hospital in Dublin, Ireland, were invited (March 2021-January 2022) to participate. Nutritional intake was assessed using 24-h food and fluid diaries. Median intakes were compared with requirements using Wilcoxon signed-rank tests. The median (interquartile range) energy and fluid intake of the thirty-six women included was 1050 (481-1461) kcal and 1196 (778-2081) mL compared with estimated requirements of 2057 (1978-2332) kcal and 2300 mL (p < 0·001 for both). The median intakes of studied nutrients and fluid were significantly below estimated requirements. Spearman's correlations between nutritional intakes and symptom severity (24-h Pregnancy-Unique Quantification of Emesis and Nausea score) were calculated for twenty-nine participants. Several nutrient intakes, including energy, macronutrients, Na, potassium, Ca, Fe, iodine, vitamin D, thiamine and vitamin B₁₂, were significantly negatively correlated with nausea and/or vomiting scores. In conclusion, women with HG consume inadequate energy, fluid and essential nutrients, with poorer intake associated with more severe nausea and vomiting. These findings highlight the need for routine nutrition assessments and tailored interventions to improve nutritional status in women with HG.