Abstract
Nausea and vomiting of pregnancy (NVP) is a common condition that affects up to 70% of pregnant women. Hyperemesis gravidarum (HG) is considered the serious form of NVP, which is reported in 0.3–10.8% of pregnant women. NVP has a relatively benign course, but HG can be linked with some poor maternal, fetal, and offspring outcomes. The exact causes of NVP and HG are unknown, but various factors have been hypothesized to be associated with pathogenesis. With the advance of precision medicine and molecular biology, some genetic factors such as growth/differentiation factor 15 (GDF15) have become therapeutic targets. In our review, we summarize the historical hypotheses of the pathogenesis of NVP and HG including hormonal factors, Helicobacter pylori, gastrointestinal dysmotility, placenta-related factors, psychosocial factors, and new factors identified by genetics. We also highlight some approaches to the management of NVP and HG, including pharmacological treatment, complementary treatment, and some supporting treatments. Looking to the future, progress in understanding NVP and HG may reduce the adverse outcomes and improve the maternal quality of life during pregnancy.
Highlights
Nausea and vomiting of pregnancy (NVP) is a common condition that affects up to 70% of pregnant women [1]
NVP and Hyperemesis gravidarum (HG) are common problems in pregnant women, studies focusing on pathogenesis are lacking
More clinical trials and other studies related to NVP and HG are raising awareness and support for pregnant women, which is critical for further efforts to address this challenge
Summary
Nausea and vomiting of pregnancy (NVP) is a common condition that affects up to 70% of pregnant women [1]. In two meta-analyses, H. pylori has been shown to be related to an increased risk of NVP and HG in pregnant women [42, 85], and may be associated with some adverse symptoms, including reduced birth weight, low maternal weight gain, and small for gestational age [86]. Van Thiel et al mentioned that resting lower esophageal sphincter pressure is low throughout gestation with a nadir in the third-trimester and returning to normal postpartum Many clinical diseases, such as NVP, may be related to gastric dysrhythmia, and slow wave gastric arrhythmias often occur in early pregnancy nausea, affecting 50–70% of pregnant women [95]. Owing to the lack of safety studies at doses >1,000 mg/d and because of its potential inhibitory effect on platelet function, ginger is not recommended for pregnant patients receiving anticoagulant therapy [188]
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