Marjette H Koot1, Iris J Grooten2, Joris A M van der Post3, Joke M J Bais4, Carrie Ris-Stalpers5, Mariska M G Leeflang6, Henk A Bremer7, David P van der Ham8, Wieteke M Heidema9, Anjoke Huisjes10, Gunilla Kleiverda11, Simone M Kuppens12, Judith O E H van Laar13, Josje Langenveld14, Flip van der Made15, Mariëlle G van Pampus16, Dimitri Papatsonis17, Marie-José Pelinck18, Paula J Pernet19, Leonie van Rheenen-Flach16, Robbert J Rijnders20, Hubertina C J Scheepers21, Tatjana E Vogelvang22, Ben W Mol23, Tessa J Roseboom24, Rebecca C Painter3. 1. Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: m.h.koot@amsterdamumc.nl. 2. Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands. 3. Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 4. Department of Obstetrics and Gynaecology, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands. 5. Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Laboratory of Reproductive Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 6. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 7. Department of Obstetrics and Gynecology, Reinier de Graaf Hospital, Delft, the Netherlands. 8. Department of Obstetrics and Gynecology, Martini Hospital, Groningen, the Netherlands. 9. Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands. 10. Department of Obstetrics and Gynecology, Gelre Hospital, Apeldoorn, the Netherlands. 11. Department of Obstetrics and Gynecology, Flevo Hospital, Almere, the Netherlands. 12. Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, the Netherlands. 13. Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands. 14. Department of Obstetrics and Gynecology, Zuyderland Hospital, Heerlen, the Netherlands. 15. Department of Obstetrics and Gynecology, Franciscus Gasthuis, Rotterdam, the Netherlands. 16. Department of Obstetrics and Gynecology, OLVG, Amsterdam, the Netherlands. 17. Department of Obstetrics and Gynecology, Amphia Hospital, Breda, the Netherlands. 18. Department of Obstetrics and Gynecology, Scheper Hospital, Emmen, the Netherlands. 19. Department of Obstetrics and Gynecology, Spaarne Gasthuis, Haarlem, the Netherlands. 20. Department of Obstetrics and Gynecology, Jeroen Bosch Hospital, 's, Hertogenbosch, the Netherlands. 21. Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, the Netherlands. 22. Department of Obstetrics and Gynecology, Diakonessenhuis, Utrecht, the Netherlands. 23. Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia. 24. Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Abstract
OBJECTIVE: We aimed to identify determinants that predict hyperemesis gravidarum (HG) disease course and severity. STUDY DESIGN: For this study, we combined data of the Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER) randomized controlled trial (RCT) and its associated observational cohort with non-randomised patients. Between October 2013 and March 2016, in 19 hospitals in the Netherlands, women hospitalised for HG were approached for study participation. In total, 215 pregnant women provided consent for participation. We excluded women enrolled during a readmission (n = 24). Determinants were defined as patient characteristics and clinical features, available to clinicians at first hospital admission. Patient characteristics included i.e. age, ethnicity, socio-economic status, history of mental health disease and HG and gravidity. Clinical features included weight loss compared to pre-pregnancy weight and symptom severity measured with Pregnancy Unique Quantification of Emesis (PUQE-24) questionnaire and the Nausea and Vomiting in Pregnancy specific Quality of Life questionnaire (NVPQoL). Outcome measures were measures of HG disease severity present at 1 week after hospital admission, including weight change, PUQE-24 and NVPQoL scores. Total days of admission hospital admission and readmission were also considered outcome measures. RESULTS: We found that high PUQE-24 and NVPQoL scores at hospital admission were associated with those 1 week after hospital admission (difference (β) 0.36, 95 %CI 0.16 to 0.57 and 0.70,95 %CI 0.45-1.1). PUQE-24 and NVPQoL scores were not associated with other outcome measures. None of the patient characteristics were associated with any of the outcome measures. CONCLUSION: Our findings suggest that the PUQE-24 and NVPQoL questionnaires can identify women that maintain high symptom scores a week after admission, but that patient characteristics cannot be used as determinants of HG disease course and severity.
OBJECTIVE: We aimed to identify determinants that predict hyperemesis gravidarum (HG) disease course and severity. STUDY DESIGN: For this study, we combined data of the Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER) randomized controlled trial (RCT) and its associated observational cohort with non-randomised patients. Between October 2013 and March 2016, in 19 hospitals in the Netherlands, women hospitalised for HG were approached for study participation. In total, 215 pregnant women provided consent for participation. We excluded women enrolled during a readmission (n = 24). Determinants were defined as patient characteristics and clinical features, available to clinicians at first hospital admission. Patient characteristics included i.e. age, ethnicity, socio-economic status, history of mental health disease and HG and gravidity. Clinical features included weight loss compared to pre-pregnancy weight and symptom severity measured with Pregnancy Unique Quantification of Emesis (PUQE-24) questionnaire and the Nausea and Vomiting in Pregnancy specific Quality of Life questionnaire (NVPQoL). Outcome measures were measures of HG disease severity present at 1 week after hospital admission, including weight change, PUQE-24 and NVPQoL scores. Total days of admission hospital admission and readmission were also considered outcome measures. RESULTS: We found that high PUQE-24 and NVPQoL scores at hospital admission were associated with those 1 week after hospital admission (difference (β) 0.36, 95 %CI 0.16 to 0.57 and 0.70,95 %CI 0.45-1.1). PUQE-24 and NVPQoL scores were not associated with other outcome measures. None of the patient characteristics were associated with any of the outcome measures. CONCLUSION: Our findings suggest that the PUQE-24 and NVPQoL questionnaires can identify women that maintain high symptom scores a week after admission, but that patient characteristics cannot be used as determinants of HG disease course and severity.