Wills Loyola, Hsiao Han-Fang, Thomas Alicia, Kay-Smith Caitlin, Henry Amanda, Grzeskowiak Luke E
College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
SA Pharmacy, Flinders Medical Centre, SA Health, Adelaide, Australia.
PLoS One. 2025 Sep 3;20(9):e0329687. doi: 10.1371/journal.pone.0329687. eCollection 2025.
There is little data on contemporary patterns of antiemetic use or women's experiences when using such agents in the treatment of severe nausea and vomiting of pregnancy (NVP) or hyperemesis gravidarum (HG).
Online, national survey of Australian women who were currently or had previously experienced severe NVP or HG, distributed through the HG consumer group, Hyperemesis Australia between July and September 2020.
There were a total of 289 respondents with a mean age of 33 years, of which 38% were currently pregnant. More than 50% of respondents reported "major impacts" of the condition on areas such as social life, ability to undertake daily chores, ability to eat or drink, effects on work, taking care of pre-existing children and sleep. This resulted in 62% of respondents reporting 'often' or 'always' experiencing feelings of depression or anxiety as a result of their HG symptoms, with 54% reporting considering terminating their pregnancy, and 90% having considered having no more children. The most commonly used anti-emetic was ondansetron (91%), followed by pyridoxine (62%), doxylamine (62%), and metoclopramide (61%). Nearly all (95%) women who reported using ondansetron commenced it within the first trimester, with 55% reporting use as a first-line therapy. Most women reported one or more side effects to anti-emetics such as headache, constipation, sedation or impaired cognition, with 31% stopping metoclopramide because of side effects, compared with 14% for ondansetron and 10% for doxylamine. Ondansetron, doxylamine and corticosteroids had the greatest perceived effectiveness, with more than 50% rating them as "effective" or "very effective". Half (50%) reported use of acid suppressive therapy, with 51% reporting using complementary or alternative therapies in addition to conventional treatments.
The study findings demonstrate large variability in antiemetic use and outcomes, highlighting the need for individualised care and treatment approaches during pregnancy.
关于当代止吐药的使用模式，以及女性在使用此类药物治疗妊娠剧吐（NVP）或妊娠剧吐（HG）时的经历，相关数据较少。
2020年7月至9月期间，通过澳大利亚妊娠剧吐患者组织“Hyperemesis Australia”，对澳大利亚目前或曾经经历过严重NVP或HG的女性进行在线全国性调查。
共有289名受访者，平均年龄33岁，其中38%为目前怀孕。超过50%的受访者报告称，该病对社交生活、日常琐事处理能力、饮食能力、工作、照顾已有子女及睡眠等方面产生“重大影响 ”。这导致62%的受访者报告因HG症状 “经常” 或 “总是” 感到抑郁或焦虑，54%的受访者报告曾考虑终止妊娠，90%的受访者曾考虑不再生育。最常用的止吐药是昂丹司琼（91%），其次是维生素B6（62%）、多西拉敏（62%）和甲氧氯普胺（61%）。几乎所有（95%）报告使用昂丹司琼的女性在孕早期就开始使用，55%的人报告将其作为一线治疗药物。大多数女性报告称，止吐药有一个或多个副作用，如头痛、便秘、镇静或认知障碍，31%的人因副作用停用甲氧氯普胺，而昂丹司琼为14%，多西拉敏为10%。昂丹司琼、多西拉敏和皮质类固醇的疗效最受认可，超过50%的人将其评为 “有效” 或 “非常有效”。一半（50%）的人报告使用了抑酸疗法，51%的人报告除了传统治疗外还使用了补充或替代疗法。
研究结果表明，止吐药的使用和效果存在很大差异，突出了孕期个性化护理和治疗方法的必要性。
