Einarson Thomas R, Piwko Charles, Koren Gideon
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
J Popul Ther Clin Pharmacol. 2013;20(2):e163-70. Epub 2013 Jul 14.
Nausea and vomiting of pregnancy (NVP) is the most common medical condition during gestation, carrying tremendous health burden, especially for the severe form, hyperemesis gravidarum (HG). The rates of NVP in the USA have not been systematically calculated.
To estimate the rates of NVP and HG in the USA.
A meta-analysis was conducted of all peer-reviewed articles from the USA that provided rates of NVP in early or late pregnancy or HG. Medline, Embase and Cochrane databases were searched from inception through November 2012; reviews and articles were hand searched. Rates were combined across studies using a random effects model.
Forty-eight articles were identified; 15 were rejected and 33 were included for analysis. Twenty-three studies of 67,602 women provided rates of NVP which had a meta-analytic rate of 68.6% (CI95%:64.4%-72.8%). Three of them (N=5034) reported nausea without vomiting in 28.6% and two studies (N=136) produced a rate for NVP during late pregnancy of 24.0%. HG occurred in 1.2% of the 2.1 million women in 12 studies.
We have summarized rates of NVP and HG, which are similar to those found in other parts of the world. Almost 70% of women suffer some form of the syndrome; 1.2% have the severe form, most of whom were hospitalized because of the HG. Future research should address issues of cost and resource utilization.
妊娠恶心和呕吐（NVP）是孕期最常见的病症，带来巨大的健康负担，尤其是对于严重形式的妊娠剧吐（HG）。美国尚未系统计算过NVP的发生率。
估算美国NVP和HG的发生率。
对来自美国的所有经同行评审且提供早孕期或晚孕期NVP发生率或HG发生率的文章进行荟萃分析。检索了Medline、Embase和Cochrane数据库，检索时间从建库至2012年11月；对综述和文章进行了手工检索。使用随机效应模型对各研究的发生率进行合并。
共识别出48篇文章；15篇被排除，33篇纳入分析。对67602名女性进行的23项研究提供了NVP的发生率，荟萃分析得出的发生率为68.6%（95%CI：64.4%-72.8%）。其中三项研究（N=5034）报告恶心但无呕吐的发生率为28.6%，两项研究（N=136）得出晚孕期NVP的发生率为24.0%。在12项研究的210万名女性中，HG的发生率为1.2%。
我们总结了NVP和HG的发生率，与世界其他地区的发生率相似。近70%的女性患有某种形式的该综合征；1.2%患有严重形式，其中大多数因HG住院。未来的研究应解决成本和资源利用问题。
