General Obstetrics and Gynecology Obstetrics
Nausea and vomiting during pregnancy: A prospective study of its frequency, intensity, and patterns of change,☆☆

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Abstract

Objective: Our purpose was to provide a detailed description of patterns of nausea and vomiting of pregnancy. Study Design: A prospective study was performed with 160 women who provided daily recordings of frequency, duration, and severity of nausea and vomiting. Results: Seventy-four percent of women reported nausea lasting a mean of 34.6 days. “Morning sickness” occurred in only 1.8% of women, whereas 80% reported nausea lasting all day. Only 50% of women were relieved by 14 weeks’ gestation; 90% had relief by week 22. Data based on the McGill Nausea Questionnaire indicate that the nausea experienced by pregnant women is similar in character and intensity to the nausea experienced by patients undergoing cancer chemotherapy. Conclusions: Traditional teachings about nausea and vomiting of pregnancy are contradicted by our findings. Standardized tools for measuring the distribution, duration, and intensity of nausea are applicable to the study of nausea and vomiting of pregnancy and could be used in clinical trials to assess palliative measures. (Am J Obstet Gynecol 2000;182:931-7.)

Section snippets

Methods

These data were collected as part of an extensive prospective study of correlates of nausea and vomiting during pregnancy. All women seeking prenatal care at an outpatient clinic of a McGill University teaching hospital in Montreal, Quebec, Canada and examined by one of us (Erica Eason, SM, MDCM) were invited at the first visit to participate in a study of nausea and vomiting in pregnancy. In accordance with university and hospital policies for human experimentation, informed consent was

Results

Of 200 potential subjects during the 2-year period beginning in May 1990, a total of 195 initially agreed to take part in the study and 180 (92%) completed it. Twenty participants miscarried, leaving 160 subjects with live births who are the basis of this report. Three women from this clinic who were admitted to the hospital for hyperemesis gravidarum during the study period are not study subjects. Of the 15 women not completing the study, 70% reported nausea, which is not significantly

Comment

This prospective study of 160 women used daily self-recording of symptoms and the McGill Nausea Questionnaire, a previously validated tool (Melzack et al10), to provide detailed descriptive information on severity and timing of nausea and vomiting throughout the day and throughout the pregnancy.

In this study the prevalence of nausea (74%) and vomiting (37.5%) during pregnancy is comparable to that found in other studies. Gadsby et al,8 reporting prospectively on 363 women, noted an 80%

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Supported by the Natural Sciences and Engineering Research Council of Canada, grant No. A7891 (Ronald Melzack, PhD).

☆☆

Reprint requests: Renée Lacroix, PhD, Department of Psychology, McGill University, 1205 Dr Penfield Ave, Montreal, Quebec, Canada H3A lB1.

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