First Olivia K, MacGibbon Kimber W, Cahill Catherine M, Cooper Ziva D, Gelberg Lillian, Cortessis Victoria K, Mullin Patrick M, Fejzo Marlena S
Hyperemesis Education and Research Foundation, Clackamas, OR, USA.
David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Geburtshilfe Frauenheilkd. 2022 May 6;82(5):517-527. doi: 10.1055/a-1749-5391. eCollection 2022 May.
There is limited research on effective treatment of Hyperemesis Gravidarum (HG), the most extreme version of nausea and vomiting during pregnancy (NVP). This paper examines current patterns of use and self-reported effectiveness of cannabis/cannabis-based products (CBP) to treat HG. The study employed a 21-question survey to gather information on demographics, antiemetic prescription use, and experience with cannabis/CBPs among individuals who experienced extreme nausea and vomiting or HG during their pregnancy. Age-adjusted unconditional logistic regression was used to compare odds of symptom relief and weight gain between respondents who used prescription antiemetics and those who used cannabis. Of the 550 survey respondents, 84% experienced weight loss during pregnancy; 96% reported using prescription antiemetics and 14% reported cannabis use for HG. Most respondents reported using cannabis/CBPs (71%) because their prescribed antiemetics were self-reported to be ineffective. More than half of cannabis/CBP users reported using products daily or multiple times per day (53%), primarily via smoke inhalation (59%), and mainly either delta-9-tetrahydrocannabinol (THC) only or THC dominant preparations (57%). Eighty-two percent of cannabis/CBP users reported symptom relief, compared to 60% of prescription antiemetic users. Among patients who reported weight loss during pregnancy, 56% of cannabis users reported gaining weight within two weeks of treatment, compared to 25% of prescription antiemetic users. Respondents reported using cannabis primarily because prescribed medications were self-reported to be ineffective. Although the survey approach has inherent limitations so results should be interpreted with caution, in this sample, cannabis was self-reported to be more effective than prescription medications in alleviating HG symptoms and enabling pregnancy weight gain. Therefore, depending on the safety profiles, randomized, double-blinded, placebo-controlled trials of cannabis compared to other antiemetics are warranted to determine whether cannabinoids may provide an effective alternative treatment for HG.
关于妊娠剧吐（HG）这一孕期最严重的恶心呕吐形式的有效治疗方法，相关研究有限。本文探讨了大麻/大麻制品（CBP）治疗HG的当前使用模式及自我报告的疗效。该研究采用了一项包含21个问题的调查问卷，以收集经历过孕期极度恶心呕吐或HG的人群的人口统计学信息、止吐处方药使用情况以及大麻/CBP使用经历。使用年龄调整后的无条件逻辑回归来比较使用处方药止吐的受访者与使用大麻的受访者之间症状缓解和体重增加的几率。在550名参与调查的受访者中，84%在孕期体重减轻；96%报告使用过处方药止吐，14%报告使用过大麻治疗HG。大多数受访者（71%）报告使用大麻/CBP是因为他们自我报告所开的止吐药无效。超过一半的大麻/CBP使用者报告每天或每天多次使用产品（53%），主要通过吸入烟雾（59%），且主要使用仅含δ-9-四氢大麻酚（THC）或THC为主的制剂（57%）。82%的大麻/CBP使用者报告症状缓解，而使用处方药止吐的使用者这一比例为60%。在报告孕期体重减轻的患者中，56%的大麻使用者报告在治疗两周内体重增加，而使用处方药止吐的使用者这一比例为25%。受访者报告使用大麻主要是因为自我报告所开药物无效。尽管调查方法存在固有局限性，所以对结果的解读应谨慎，但在这个样本中，自我报告显示大麻在缓解HG症状和促进孕期体重增加方面比处方药更有效。因此，根据安全性概况，有必要进行大麻与其他止吐药对比的随机、双盲、安慰剂对照试验，以确定大麻素是否可为HG提供有效的替代治疗方法。
