Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Slone Epidemiology Center, Boston University, Boston, MA, USA.
Paediatr Perinat Epidemiol. 2021 Jan;35(1):57-64. doi: 10.1111/ppe.12705. Epub 2020 Jul 4.
Although nausea and vomiting of pregnancy (NVP) is common, the secular and demographic trends of NVP and its treatments are not well-studied.
To describe the prevalence and patterns of first-trimester NVP and selected treatments among controls in the National Birth Defects Prevention Study (NBDPS).
National Birth Defects Prevention Study is a population-based case-control study of birth defects in the United States (1997-2011). We collected self-reported data about NVP and use of commonly reported pharmacological and herbal/natural treatments (ondansetron, promethazine, pyridoxine, metoclopramide, doxylamine succinate, ginger, phosphorated carbohydrate solution, and prochlorperazine) from mothers of non-malformed control infants. We estimated the prevalence of NVP and selected treatments and examined secular and demographic trends (education, race/ethnicity, and maternal age) for such use, adjusting for study centre.
Among 10 540 mothers of controls, 7393 women (70.1%) reported first-trimester NVP, and 12.2% of those used one or more of the commonly reported treatments. Specific treatment use varied after adjustment for study centre (ondansetron: 3.4%; promethazine: 4.2%; pyridoxine: 3.2%; metoclopramide: 0.7%; doxylamine succinate: 1.7%; ginger: 1.0%; phosphorated carbohydrate solution: 0.4%; and prochlorperazine: 0.3%). Treatment use increased for each agent over the study period. Women with more years of education reported more NVP and treatment use. White (72%), Hispanic (71%), and other race (73%) women reported more NVP than Black women (67%); White women used selected NVP treatments most frequently, and Black women used them more than Hispanic women. Though women aged 25-34 years reported more NVP (72%) than younger (69%) or older (67%) women, the frequency of medication use was similar among women aged 25-34 and ≥35, and lower among women aged <25 years.
National Birth Defects Prevention Study controls reported NVP at frequencies similar to those previously reported. Of note, we observed an increase in use of selected treatments over time, and variations in NVP and treatments by study site and demographic factors.
尽管妊娠恶心和呕吐（NVP）很常见，但 NVP 及其治疗的季节性和人口统计学趋势尚未得到充分研究。
描述美国国家出生缺陷预防研究（NBDPS）中对照者中妊娠早期 NVP 及其选定治疗的流行率和模式。
NBDPS 是一项在美国进行的基于人群的出生缺陷病例对照研究（1997-2011 年）。我们收集了母亲自我报告的关于 NVP 和常用药物和草药/天然疗法（昂丹司琼、苯海拉明、吡哆醇、胃复安、琥珀酸多西拉敏、生姜、磷酸碳水化合物溶液和丙氯拉嗪）使用的数据。我们估计了 NVP 和选定治疗的流行率，并研究了这种使用的季节性和人口统计学趋势（教育程度、种族/民族和产妇年龄），并根据研究中心进行了调整。
在 10540 名对照者的母亲中，有 7393 名女性（70.1%）报告了妊娠早期 NVP，其中 12.2%的女性使用了一种或多种常用治疗方法。在调整研究中心后，特定治疗方法的使用有所不同（昂丹司琼：3.4%；苯海拉明：4.2%；吡哆醇：3.2%；胃复安：0.7%；琥珀酸多西拉敏：1.7%；生姜：1.0%；磷酸碳水化合物溶液：0.4%；丙氯拉嗪：0.3%）。在研究期间，每种药物的使用都有所增加。受教育程度较高的女性报告 NVP 和治疗方法的使用较多。白人（72%）、西班牙裔（71%）和其他种族（73%）女性报告的 NVP 多于黑人女性（67%）；白人女性最常使用选定的 NVP 治疗方法，而黑人女性比西班牙裔女性更常使用。尽管 25-34 岁的女性报告的 NVP （72%）多于年轻（69%）或年长（67%）的女性，但 25-34 岁和≥35 岁的女性使用药物的频率相似，而<25 岁的女性使用药物的频率较低。
国家出生缺陷预防研究的对照组报告的 NVP 频率与之前报道的相似。值得注意的是，我们观察到随着时间的推移，选定治疗方法的使用有所增加，并且 NVP 和治疗方法因研究地点和人口统计学因素而异。
