Hastoy A, Lien Tran P, Lakestani O, Barau G, Gérardin P, Boukerrou M
Maternité Paule-de-Viguier, CHU de Toulouse, avenue de Grande-Bretagne, 31059 Toulouse, France.
Service de gynécologie-obstétrique, pôle femme-mère-enfant, groupe hospitalier Sud Réunion, CHU de la Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion.
J Gynecol Obstet Biol Reprod (Paris). 2015 Feb;44(2):154-63. doi: 10.1016/j.jgyn.2013.12.003. Epub 2014 Jan 17.
The aim of this study was to determine the impact of hyperemesis gravidarum (HG) on pregnancy.
For this purpose, we conducted a retrospective cohort study between January 1st, 2006 and July 31st, 2009 in the level-3 maternity of the South Reunion teaching hospital, Saint-Pierre. Perinatal outcomes (gestational diabetes mellitus, hypertensive disorders of pregnancy, caesarean section, IUGR<10th percentile, low birth weight<2500 g, preterm birth<37 weeks, perinatal death) were compared among the women hospitalized for HG (exposed group) and a non-exposed group randomly selected from the South Reunion birth register. Finally, we also investigated the interactions between HG and maternal weight gain to assess whether HG might change perinatal outcomes according to weight gain.
During the study period, 215 women hospitalized for HG delivered (cumulative incidence rate of HG 14.1‰ among total deliveries), of which 197 were included in the exposed group. The low gestational weight gain (<7 kg), used as a criterion to define severe HG, was significantly more likely in the exposed group (30.5% versus 16.1%, P<0.0001). There was no significant association between HG and the various perinatal outcomes tested. The risk of delivering a low birth weight neonate was twofold (adjusted RR: 2.0, 95%CI: 1.0-3.1), that for a small-for-gestational age infant was more likely (adjusted RR: 1.7, 95% CI: 1.1-2.4), both only in case of severe HG.
Severe HG, defined for women with a gestational weight gain of less than 7 kg, is a poor prognostic factor for fetal growth.
本研究旨在确定妊娠剧吐（HG）对妊娠的影响。
为此，我们于2006年1月1日至2009年7月31日在圣皮埃尔留尼汪岛南部教学医院的三级产科进行了一项回顾性队列研究。比较了因妊娠剧吐住院的女性（暴露组）和从留尼汪岛南部出生登记册中随机选取的非暴露组的围产期结局（妊娠期糖尿病、妊娠高血压疾病、剖宫产、小于胎龄儿<第10百分位数、低出生体重<2500 g、早产<37周、围产期死亡）。最后，我们还研究了妊娠剧吐与孕妇体重增加之间的相互作用，以评估妊娠剧吐是否会根据体重增加情况改变围产期结局。
在研究期间，215名因妊娠剧吐住院的女性分娩（妊娠剧吐在总分娩中的累积发病率为14.1‰），其中197名被纳入暴露组。以低孕期体重增加（<7 kg）作为定义严重妊娠剧吐的标准，暴露组中这种情况明显更常见（30.5%对16.1%，P<0.0001）。妊娠剧吐与所测试的各种围产期结局之间无显著关联。只有在严重妊娠剧吐的情况下，分娩低体重新生儿的风险增加两倍（调整后的相对危险度：2.0，95%置信区间：1.0 - 3.1），分娩小于胎龄儿的可能性更大（调整后的相对危险度：1.7，95%置信区间：1.1 - 2.4）。
对于孕期体重增加少于7 kg的女性定义的严重妊娠剧吐是胎儿生长的不良预后因素。
