Abstract
Hyperemesis gravidarum (HG) is a condition characterized by severe, intractable nausea and vomiting in early pregnancy. It affects about 0.3–2% of all pregnancies and is thought that HG is a multifactorial disease resulting from the combination of various unrelated conditions such as genetic, hormonal and psychiatric. Although there are studies investigating the relationship between anxiety, depression and HG; however, none have sufficiently clarified this link. The aim of this prospective case–control study was to investigate the possible relationship between depression and HG and compare the prevalence of depression disorders in pregnant women with and without HG.A prospective case–control study was performed at our tertiary referral centre between December 2013 and July 2014. The study group consisted of 78 pregnant women with HG and the control group consisted of 82 healthy pregnant women who never had experienced any nausea and vomiting. No study participants had any pre-pregnancy history of any psychiatric disorder including depression. Structured Clinical Interview for Diagnostic (SCID-I) and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) was used to evaluate symptoms of depression. Beck Depression Inventory (BDI) was administered to patients during the psychiatric interview and was evaluated by the same psychiatrist.The mean BDI scores in HG study and healthy control groups were 18.97 ± 9.85 and 6.36 ± 5.61, respectively (p < 0.001). Among the 78 women in the HG study population, 42 (53.9%) of patients had moderate or severe depression disorder. Only 6.1% of patients in the control group had moderate or severe depression.In conclusion, the findings of this study indicated that psychological distress associated with HG was a direct consequence rather than a cause of HG. Therefore, patients with HG during pregnancy should be evaluated with respect to mood disorders as much as their medical conditions.
Highlights
The majority of pregnant women experience varying degrees of severity from mild to severe symptoms of nausea and vomiting during pregnancy (NVP) known as morning sickness
A total of 198 patients who admitted to our obstetric department for hospitalization due to Hyperemesis gravidarum (HG) and routine antenatal care were evaluated for eligibility
Depression disorder is common in patients with HG
Summary
The majority of pregnant women experience varying degrees of severity from mild to severe symptoms of nausea and vomiting during pregnancy (NVP) known as morning sickness. Hyperemesis gravidarum (HG) is an extreme form of morning sickness during early pregnancy. Some other pathologic factors, such as gastrointestinal dysfunction, hepatic abnormalities, lipid alterations, overactivation of sympathetic nervous system and infection, in addition to endocrine factors of hyperemesis gravidarum may play a role in etiology and pathophysiology of this medical condition (Verberg et al 2005, Koch 2002, Ustün et al 2004, Lee et al 2005, Niemeijer et al 2014). Along with all of these physiological changes, psychosomatic factors may play a role in this complex and multifactorial condition
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