Dysmenorrhea as a Risk Factor for Hyperemesis Gravidarum

Abstract

Background: The aims of the study were to assess the association of dysmenorrhea and hyperemesis gravidarum (HG) and to determine other factors that may influence its onset and severity. Methods: This is a prospective case-control IRB approved study of 344 consecutive singleton pregnant women with and without hyperemesis gravidarum in pregnancy from February 2011 to April 2012. The association between HG and dysmenorrhea in adolescent and adult was examined using Pearson’s Chi-square with Yates correlation, Student’s t -test and Mann-Whitney U test. Bivariate analysis and odd ratios (ORs) were calculated to evaluate the strength of their association, and multivariate logistic regression analysis while correcting for confounders. P-value of 0.05 was considered statistically significant. Results: A total of 344 consecutive singleton pregnant women were recruited. Significant association was found between HG and adolescent dysmenorrhea: 77.8% versus 43.4% of controls (P < 0.0001, OR: 4.6, 95% CI: 2.3 - 8.9). Also, there was a significant association between HG and adult dysmenorrhea: 76.4% versus 38.1% controls (P < 0.0001, OR: 5.3, 95% CI: 2.7 - 10.2). The association of severe adolescent and adult dysmenorrhea with HG was stronger (P < 0.0001, OR: 8.8, 95% CI: 3.9 - 19.9 and P < 0.0001, OR: 12.2, 95% CI: 5.0 - 29.7 respectively). There was a modest association with moderate dysmenorrhea (P = 0.004, OR: 3.1, 95% CI: 1.4 - 6.9) which was not sustained but no associations were found between HG and all mild dysmenorrhea of both adolescent and adult. Conclusion: This study found an association between adolescent and adult dysmenorrhea and HG. These associations were stronger with severe dysmenorrhea. J Clin Gynecol Obstet. 2015;4(4):283-289 doi: http://dx.doi.org/10.14740/jcgo356w