The timing, duration, and severity of nausea and vomiting of pregnancy and adverse birth outcomes among controls without birth defects in the National Birth Defects Prevention Study

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2024-04-05 DOI:10.1002/bdr2.2334

Nina L. Schrager, Samantha E. Parker, Martha M. Werler, for the National Birth Defects Prevention Study

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引用次数: 0

Abstract

Background

Nausea and vomiting of pregnancy (NVP) occurs in approximately 70% of pregnant people, with varying severity and duration. Treatments include pharmacologic and herbal/natural medications. The associations between NVP and birth outcomes, including preterm birth, small for gestational age (SGA), and low birth weight are inconclusive.

Objective

To determine whether NVP and reported medications are associated with adverse birth outcomes.

Methods

We used data from the population-based, multisite National Birth Defects Prevention Study (1997–2011) to evaluate whether self-reported NVP according to timing, duration, and severity or its specific treatments were associated with preterm birth, SGA, and low birth weight among controls without birth defects. Odds ratios (aOR) and 95% confidence intervals (CI) were adjusted for sociodemographic, reproductive, and medical factors. For any NVP, duration, treatment use, and severity score analyses, the comparison group was participants with no reported NVP. For timing analyses, the comparison group was women with no reported NVP in the same trimester of pregnancy.

Results

Among 6018 participants, 4339 (72.1%) reported any NVP. Among those with NVP, moderate or severe symptoms were more common than mild symptoms. Any versus no NVP was not associated with any of the outcomes of interest. NVP in months 4–6 (aOR 1.21, 95% CI: 1.00, 1.47) and 7–9 (aOR 1.57, 95% CI: 1.22, 2.01) of pregnancy were associated with an increase in the risk of preterm birth. NVP lasting one trimester in duration was associated with decrease in risk of SGA (aOR: 0.74, 95% CI: 0.58, 0.95), and NVP present in every trimester of pregnancy had a 50% increase in risk of preterm birth (aOR: 1.50, 95% CI: 1.11, 2.05). For NVP in months 7–9 and preterm birth, ORs were elevated for moderate (aOR: 1.82, 95% CI: 1.26, 2.63), and severe (aOR: 1.53, 95% CI: 1.06, 2.19) symptoms. NVP was not significantly associated with low birth weight. Our analyses of medications were limited by small numbers, but none suggested increased risk of adverse outcomes associated with use of the medication.

Conclusion

Mild NVP and NVP limited to early pregnancy appear to have no effect or a small protective effect on birth outcomes. Long-lasting NVP, severe NVP, and NVP later in pregnancy may increase risk of preterm birth and SGA.

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全国出生缺陷预防研究中无出生缺陷对照组的妊娠恶心和呕吐的时间、持续时间和严重程度以及不良出生结果

背景约有 70% 的孕妇会出现妊娠恶心和呕吐（NVP），其严重程度和持续时间各不相同。治疗方法包括药物和草药/天然药物。NVP 与早产、胎龄小（SGA）和出生体重不足等出生结果之间的关系尚无定论。目的确定 NVP 和报告的药物是否与不良出生结局相关。方法我们利用基于人群的多地点全国出生缺陷预防研究（1997-2011 年）的数据，评估无出生缺陷对照组中，根据时间、持续时间和严重程度或其特定治疗方法自我报告的 NVP 是否与早产、SGA 和低出生体重相关。比值比 (aOR) 和 95% 置信区间 (CI) 已根据社会人口、生殖和医疗因素进行了调整。对于任何 NVP、持续时间、治疗使用和严重程度评分分析，对比组为未报告 NVP 的参与者。在时间分析中，对比组为在同一孕期未报告过 NVP 的妇女。结果在 6018 名参与者中，4339 人（72.1%）报告了任何 NVP。在有 NVP 的妇女中，中度或重度症状比轻度症状更常见。有无NVP与任何相关结果无关。妊娠 4-6 个月（aOR 1.21，95% CI：1.00，1.47）和 7-9 个月（aOR 1.57，95% CI：1.22，2.01）的 NVP 与早产风险的增加有关。持续三个月的 NVP 与 SGA 风险的降低有关（aOR：0.74，95% CI：0.58，0.95），而妊娠期每个三个月都有 NVP 会使早产风险增加 50%（aOR：1.50，95% CI：1.11，2.05）。对于第 7-9 个月的 NVP 和早产，中度症状（aOR：1.82，95% CI：1.26，2.63）和重度症状（aOR：1.53，95% CI：1.06，2.19）的 OR 值升高。NVP 与低出生体重无明显相关性。我们对药物的分析因数量较少而受到限制，但没有发现任何一种药物会增加不良后果的风险。结论轻度 NVP 和仅限于孕早期的 NVP 似乎对出生结果没有影响或有轻微的保护作用。长期 NVP、重度 NVP 和孕晚期 NVP 可能会增加早产和 SGA 的风险。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.