Nausea and vomiting of pregnancy: what about quality of life?

• Published in: BJOG : an international journal of obstetrics and gynaecology 2008-11, Vol.115 (12), p.1484-1493
• Main Authors: Lacasse, A, Rey, E, Ferreira, E, Morin, C, Bérard, A
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Determinants; Female; Gynecology. Andrology. Obstetrics; Health Status; Humans; Impact analysis; Life Style; Maternal Age; Medical sciences; Morning Sickness - psychology; Morning Sickness - therapy; Nausea; Obstetrics; Parity; Pregnancy; Pregnancy Trimester, First; Prospective Studies; Quality of Life; Quebec; Socioeconomic Factors; Vomiting; Young Adult
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/j.1471-0528.2008.01891.x

Objective  The objective of this study was to determine the impact of nausea and vomiting of pregnancy (NVP) and other determinants on generic and NVP‐specific health‐related quality of life (QOL) in the first trimester of pregnancy. Design  Prospective study. Setting  Centre Hospitalier Universitaire (CHU) Sainte‐Justine or René‐Laennec clinics, Montreal, Quebec, Canada. Population  Pregnant women attending the clinics for their prenatal care from 2004 to 2006. Women were eligible if they were ≥18 years of age and ≤16 weeks of gestation at the time of their first prenatal visit. Methods  After their first prenatal visit, women were asked to fill out a questionnaire covering maternal characteristics, presence and severity of NVP, and health‐related QOL. Main outcome measures  QOL was measured by the generic 12‐item Short Form Health Survey v.1 (SF‐12) and the NVP‐specific Quality of Life for Nausea and Vomiting during Pregnancy. Results  Of the 367 pregnant women included in the study, 78.5% of women reported NVP in the first trimester of pregnancy. Multivariable linear models showed that presence of NVP in the first trimester of pregnancy was significantly associated with a lower physical component summary scale (P < 0.0001) and mental component summary scale (P = 0.0066) of the SF‐12 scores. More severe NVP (moderate versus mild: P = 0.0002; severe versus mild: P = 0.0177 as measured by the validated modified Pregnancy‐Unique Quantification of Emesis and Nausea index), intensity of nausea symptoms reported on a visual analogue scale (P < 0.0001), and nonpharmacological methods used to ease NVP symptoms in the first trimester of pregnancy (P = 0.0059) were significantly associated with poorer NVP‐specific QOL among women suffering from NVP. Conclusion  These findings show that presence and severity of NVP have a negative impact on health‐related QOL, which emphasises the importance of an optimal management of NVP.