The Impact of Hyperemesis Gravidarum on Fetal Development and Birth Outcomes: A Systematic Review and Meta-Analysis

Abstract

Background: Hyperemesis gravidarum (HG) is a condition characterized by severe nausea and vomiting experienced during pregnancy, with an incidence rate estimated to affect between 0.3% and 2% of pregnant individuals. As HG results in prolonged periods of maternal starvation and multiple nutritional deficiencies, it can potentially disrupt the delicate balance of nutrients and metabolic processes required for optimal fetal growth and development. This systematic review aims to analyze the impact of HG on fetal development and birth outcomes. Methods: The following databases were searched from January 2000 to March 2024: PubMed, Web of Science, Science Direct, Medline (Ovid), and Embase (Ovid). The search focused on HG and its pathogenesis, treatment, fetal development, and pregnancy-related adverse outcomes. Results: 6 out of 907 studies were included which focused on HG with fetal development and birth outcomes. All 6 studies were cohort studies and the quality was high. Meta-analysis revealed that HG is associated with an increased risk of preterm birth (odds ratio (OR): 1.2; 95% confidence interval (95% CI): 1.17–1.23) and small for gestational age (SGA) (OR: 1.30; 95% CI: 1.22–1.40). Conclusions: A limited number of studies have investigated the effects of HG on fetal development and birth outcomes. The present systematic review indicated an increased risk of preterm birth and SGA associated with HG; however, high heterogeneity among the limited included studies should be noted.