Mode of conception in relation to nausea and vomiting of pregnancy: a nested matched cohort study in Sweden

Farnaz Bazargani,S I Iliadis,E Elenis

doi:10.1038/s41598-021-88575-z

Farnaz Bazargani, S I Iliadis + Show 1 more

Open Access

https://doi.org/10.1038/s41598-021-88575-z

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Abstract

Nausea and vomiting of pregnancy (NVP) is a common condition reported however inconclusively among pregnancies after assisted conception. The study objective was thus to explore whether NVP is associated to mode of conception or other in vitro fertilization (IVF)-related variables. This nested matched cohort study, originating from the BASIC-project, was conducted at the Uppsala University Hospital in Sweden between 2010 and 2016. IVF pregnancies (n = 210) and age and parity-matched women with spontaneous pregnancies (n = 420) comprised the study sample. The study outcome was self-reported NVP at gestational week 17. IVF treatment and pregnancy data were obtained after scrutinization of the medical records. NVP with or without medications was not associated with mode of conception (chi-square test, p = 0.889), even after adjusting for potential confounders. In a subgroup analysis among IVF pregnancies, NVP without medication was more frequently seen in the group who received cleavage stage embryos vs blastocysts (chi-square test, p = 0.019), exhibiting a marginally significant but strongly increased effect even after adjustment [crude RRR 3.82 (95% CI 1.23–11.92) and adjusted RRR 3.42 (95% CI 0.96–12.11)]. No difference in the rate of NVP with or without medication between women that underwent fresh and frozen/thawed embryo transfers as well as IVF or ICSI was observed. Conception through IVF is not associated with NVP. Transfer of a blastocyst may decrease the risk of developing NVP and further, large-scale prospective studies are required to validate this finding.

Highlights

Nausea and vomiting of pregnancy (NVP) is a common condition reported inconclusively among pregnancies after assisted conception
Hyperemesis gravidarum (HG) usually emerges in 0.3–3.6% of all pregnancies[1], whereas NVP may affect as much as 35–91% of pregnant w omen[1] and may have severe consequences on maternal and offspring well-being as well as the healthcare s ystem[2,3,4,5]
Some studies have examined the potential involvement of a Helicobacter pylori infection during pregnancy[6], while others focused on the role of elevated estrogens[7] and human chorionic gonadotropin levels in HG-affected p regnancies[8]; study findings still remain controversial

Summary

Introduction

Nausea and vomiting of pregnancy (NVP) is a common condition reported inconclusively among pregnancies after assisted conception. The study objective was to explore whether NVP is associated to mode of conception or other in vitro fertilization (IVF)-related variables. The studies concerning NVP and HG that include IVF populations are limited and with inconclusive findings One of these studies evaluated the prevalence of NVP in singleton and twin IVF pregnancies and demonstrated an increased NVP risk in the first trimester of pregnancy among twin but not singleton pregnancies[21]. Two other studies explored maternal characteristics among pregnant women with HG in order to estimate the incidence of the condition and identify related risk factors and reported increased risk for HG in ART conceived p regnancies[22,23]. The question of whether there is an association between IVF and NVP remains unanswered

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