Low weight gain reported among women with nausea and vomiting of pregnancy

In one of the largest studies of its kind, clinicians and researchers with Carolinas HealthCare System found that nearly 25% of women with nausea and vomiting of pregnancy (NVP) reported weight gain below recommended levels for their pre-pregnancy body mass index (PPBMI). Low weight gain was associated with increased rates of adverse maternal and neonatal outcomes. The results of the study illustrate the importance of managing NVP and providing nutritional counseling to encourage adequate weight gain during pregnancy. They also highlight the need for clinicians to better understand the differences between mild nausea and symptoms that can lead to poor health for expectant mothers and their infants.

“As clinicians, the real take-away from this research is that we have to pay attention to our patients, who may be at risk for and report symptoms of NVP”

The study was authored by Saju Joy, MD, MS, Maternal and Fetal Medicine Specialist at Carolinas HealthCare System, who practices at Carolinas Medical Center's Women's Institute. Titled "The Effect of Low Weight Gain on Pregnancy Outcomes in Women with Nausea and Vomiting of Pregnancy," the study was a collaboration between the Charlotte, NC-based research team and Alere Health. Results were presented at the American College of Obstetricians and Gynecologists' 60th Annual Clinical Meeting in San Diego on May 7, 2012.

The study sample comprised women pregnant for the first time with one baby in utero who enrolled in Alere's maternity risk screening and education program at less than 20 weeks' gestation. Maternal characteristics and pregnancy outcomes for those women who gained less than the recommended amount for their PPBMI were compared to those who achieved or exceeded weight gain recommendations. Not only did one-fourth of the women with NVP have poor weight gain during their pregnancies, but results of the study also showed that poor maternal weight gain was associated with an increased risk for adverse maternal and neonatal outcomes of 51%, even after controlling for maternal race, obesity and smoking.

"This study shows us there are real consequences for women with NVP whose symptoms inhibit the ability to eat a healthy diet and affect their overall quality of life," said Joy. "Health plans, obstetricians and others need to be aware of the potential consequences of NVP and take steps to help these women so that they will have healthier pregnancies and babies." Study authors stress that mild nausea or vomiting is expected during pregnancy, especially during the first trimester, and should not alarm women experiencing an overall healthy pregnancy.

"Women who experience occasional nausea during the first few months of pregnancy, but who continue to gain appropriate weight and lead a healthy life should not be alarmed by their symptoms," said Joy. "However, there comes a point where NVP affects the health of the mother, and potentially the infant, and it's important to educate women and physicians about treatment and care management options that can address those symptoms."

"As clinicians, the real take-away from this research is that we have to pay attention to our patients, who may be at risk for and report symptoms of NVP," continued Joy. "Managing NVP symptoms and monitoring maternal nutrition and weight gain lead to healthier outcomes for mothers and their babies, and this needs to be the top priority for any health plan or physician caring for expectant mothers."

"With more than 28 years' experience managing more than 750,000 high-risk pregnancies as part of services like our Nausea and Vomiting of Pregnancy Program, and with a nationwide network of OB nurse specialists available 24/7, we are experts in developing solutions that improve maternal health," stated Gregg Raybuck, President, Alere Health. "Through research and studies such as this one, we will continue to formulate strategies that help physicians and health plans ensure that mothers and their babies remain healthy while effectively managing costs."