Please wait a minute...
Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (3): 391-395    DOI: 10.31083/j.ceog.2020.03.5334
Original Research Previous articles | Next articles
Factors associated with hyperemesis gravidarum
G. Keren1, *(), G. Ayala1
1Nursing Department, Faculty of Social and Community Sciences, Ruppin Academic Center, Emeq-Hefer, 4025000, Israel
Download:  PDF(168KB)  ( 206 ) Full text   ( 14 )
Export:  BibTeX | EndNote (RIS)      

Introduction: Nausea and Vomiting of Pregnancy (NVP) is a common health condition during pregnancy, often referred to as ‘morning sickness’. The most severe degree is Hyperemesis Gravidarum (HG). The reasons for this phenomenon are still somewhat unclear. Methods: The sample included 201 fertility-age women, who had experienced at least one pregnancy. Data were gathered by a questionnaire that included sociodemographic questions and validated questionnaires: BSI, anxiety state and anxiety trait. Results: A relationship was found between existing gastrointestinal disorders and HG, and anxiety state and HG. Logistic regression significantly showed that previous gastrointestinal disorders predicted HG. Discussion: It seems that the emotional state and physical condition are related to HG, and that women with gastrointestinal diseases are more likely to suffer from HG.

Key words:  Hyperemesis Gravidarum (HG)      Nausea and Vomiting of Pregnancy (NVP)      Somatization      Anxiety     
Submitted:  11 August 2019      Accepted:  11 November 2019      Published:  15 June 2020     
*Corresponding Author(s):  GRINBERG KEREN     E-mail:

Cite this article: 

G. Keren, G. Ayala. Factors associated with hyperemesis gravidarum. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(3): 391-395.

URL:     OR

Table 1  — Research population distribution by background and personality traits
Variable Mean SD SD error
Anxiety state 2.6208 0.35113 0.04424
Anxiety trait 2.4320 0.36493 0.03107
BSI 0.8290 0.63625 0.05416
BMI 27.0669 12.18856 1.03756
Age 32.75 0.936 0.080
Number of previous pregnancies 2.937 0.9482 0.1195
Number of previous births 1.88 1.070 0.091
Table 2  — Distribution of nausea and vomiting reports by weeks of pregnancy
Pregnancy timeline Frequency % Valid %
Up to 20 weeks 80 39.8 61.5
Beyond 20 weeks 50 24.9 38.5
Total responses 130 64.7 100
No response 71 35.3
Total responses + non-responses 201 100
[1] Segni H., Ayana D., Jarso H.: “Prevalence of hyperemesis gravidarum and associated factors among pregnant women at Jimma University Medical Center, South West Ethiopia, A Cross Sectional study”. EC Gynaecology, 2016, 3, 376-387.
[2] Berkowitch M., Choen R., Koren G., Shlomo M.: “Access to nausea and vomiting during pregnancy”. Harefua. 2015, 154, 720-721. (in Hebrew).
[3] Kramer J., Bowen A., Stewart N., Muhajarine N.: “Nausea and vomiting of pregnancy, prevalence, severity and relation to psychosocial health”. MCN Am J Matern Child Nurs., 2013, 38, 21-27.
doi: 10.1097/NMC.0b013e3182748489 pmid: 23232775
[4] Maltepe C., Koren G.: “The management of nausea and vomiting of pregnancy and hyperemesis gravidarum-a 2013 update”. J Popul Ther Clin Pharmacol., 2013, 20, 184-192.
[5] Mitchell-Jones N., Gallos I., Farren J., Tobias A., Bottomley C., Bourne T.: “Psychological morbidity associated with hyperemesis gravidarum, a systematic review and meta-analysis”. BJOG, 2017, 124, 20-30.
doi: 10.1111/1471-0528.14180 pmid: 27418035
[6] Mullin P.M., Ching C., Schoenberg F., MacGibbon K., Romero R., Goodwin T.M., Fejzo M.S.: “Risk factors, treatments, and outcomes associated with prolonged hyperemesis gravidarum”. J Matern Fetal Neonatal Med., 2012, 25, 632-636.
doi: 10.3109/14767058.2011.598588 pmid: 21916750
[7] Vikanes Å., Skjærven R., Grjibovski A.M., Gunnes N., Vangen S., Magnus P.: “Recurrence of hyperemesis gravidarum across generations, Population based cohort study”. BMJ, 2010, 340, 2050.
[8] Fiaschi L., Nelson-Piercy C., Tata L.J.: “Hospital admission for hyperemesis gravidarum, A nationwide study of occurrence, reoccurrence and risk factors among 8.2 million pregnancies”. Hum Reprod., 2016, 31, 1675-1684.
doi: 10.1093/humrep/dew128 pmid: 27251205
[9] Jarvis S., Nelson-Piercy C.: “Management of nausea and vomiting in pregnancy”. BMJ, 2011, 342, 3606.
[10] Dodds L., Fell D.B., Joseph K.S., Allen V.M., Butler B.: “Outcomes of pregnancies complicated by hyperemesis gravidarum”. Obstet Gynecol. 2006, 107, 285-292.
doi: 10.1097/ pmid: 16449113
[11] Kjeldgaard H.K., Eberhard-Gran M., Benth J.Š., Vikanes Å.V.: “Hyperemesis gravidarum and the risk of emotional distress during and after pregnancy”. Arch Women's Ment Health, 2017, 20, 747-756.
doi: 10.1007/s00737-017-0770-5
[12] Kleine I., Da Silva A., Ahmed W., Forya F., Whitten S.M., David A.L., James C.P.: “Hospital admission for hyperemesis gravidarum in women at increased risk of spontaneous preterm birth”. Birth, 2017, 44, 384-389.
doi: 10.1111/birt.12303 pmid: 28857251
[13] McCarthy F.P., Khashan A.S., North R.A., Moss-Morris R., Baker P.N., Dekker G.: “A prospective cohort study investigating associations between hyperemesis gravidarum and cognitive, behavioral and emotional well-being in pregnancy”. PLoS One, 2011, 6, 276-278.
[14] Thalava K., Manmatharaj E., Prabhakar R., Vaithialingam A.: “Human chorionic gonadotropin (HCG) levels in pre-eclampsia and hyperemesis”. Glob J Res Analy., 2018, 6.
[15] Shaban M.M., Kandil H.O., Elshafei A.H.: “Helicobacter pylori seropositivity in patients with hyperemesis gravidarum”. Am J Med Science, 2014, 347, 101-105.
doi: 10.1097/MAJ.0b013e31827bef91
[16] Hadar A.: “Nausea and vomiting during pregnancy”. The Medical., 2009, 8, 22-25.
[17] Peled Y., Melamed N., Hiersch L., Pardo J., Wiznitzer A., Yogev Y.: “The impact of total parenteral nutrition support on pregnancy outcome in women with hyperemesis gravidarum”. J Mater Fetal Neonat Med., 2014, 27, 1146-1150.
doi: 10.3109/14767058.2013.851187
[18] Kjeldgaard H.K., Eberhard-Gran M., Benth J.Š., Nordeng H., Vikanes Å.V.: “History of depression and risk of hyperemesis gravidarum, a population-based cohort study”. Arch Women's Ment Health, 2017, 20, 397-404.
doi: 10.1007/s00737-016-0713-6
[19] Tan P.C., Zaidi S.N., Azmi N., Omar S.Z., Khong S.Y.: “Depression, anxiety, stress and hyperemesis gravidarum, temporal and case controlled correlates”. PLoS One, 2014, 17, 9.
[20] Abramowitz A., Miller E.S., Wisner K.L.: “Treatment options for hyperemesis gravidarum”. Arch Women's Ment Health, 2017, 20, 363-372.
doi: 10.1007/s00737-016-0707-4
[21] Spielberger C.D., Gonzalez-Reigosa F., Martinez-Urrutia A., Natalicio L.F., Natalicio D.S.: “The state-trait anxiety inventory”. Int J Psychol., 1969, 5, 3-4.
[22] Teichman Y., Malineck F.: “Manual for the Hebrew state-trait anxiety inventory”. Tel Aviv, Israel, Tel Aviv University, 1978.
[23] Derogatis L., Melisaratos N.: “The brief symptom inventory, an introductory report”. Psychol Med., 1983, 13, 595-605.
pmid: 6622612
[24] Canetti L., Shalev A.Y., De-Nour A.K.: “Israeli adolescents' norms of the Brief Symptom Inventory (BSI)”. Isr J Psychiat Related Scien., 1994, 31, 13-18.
[25] Koot M.H., Grooten I.J., Sebert S., Koiranen M., Järvelin M.R., Kajantie E., Painter R.C., Roseboom T.J.: “Hyperemesis gravidarum and cardiometabolic risk factors in adolescents, a follow-up of the Northern Finland Birth Cohort 1986”. BJOG, 2017, 124, 1107-1114.
doi: 10.1111/1471-0528.14534 pmid: 28236378
[26] Tiran D., Chummun H.: “Complementary therapies to reduce physiological stress in pregnancy”. Complement Ther Nurs Midwifery, 2004, 10, 162-167.
doi: 10.1016/j.ctnm.2004.03.006
[27] Grooten I.J.: “Barriers and challenges in hyperemesis gravidarum research”. 2017, UvADARE.
[28] Hoirisch-Clapauch S., Brenner B., Nard A.E.: “Adverse obstetric and neonatal outcomes in women with mental disorders”. Thromb Res., 2015, 135, S60-S63.
doi: 10.1016/S0049-3848(15)50446-5 pmid: 25903540
[1] Y. Akdemir, M. Karadeniz. A psychological factor associated with pain during intrauterine device insertion: emotional reactivity[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(3): 335-340.
No Suggested Reading articles found!