Interventions Initiated Before and After Pregnancy for Women who Experience Severe Nausea and Vomiting of Pregnancy: A Scoping Review

TL;DR

This study reviews interventions before and after pregnancy to help women with severe nausea and vomiting during pregnancy, finding limited but promising approaches.

Contribution

The study identifies and characterizes pre- and post-pregnancy interventions for severe NVP, highlighting a gap in current research and practice.

Findings

Pre-emptive counseling and antiemetic treatment reduced NVP severity and HG recurrence.

Post-pregnancy writing therapy aided recovery and emotional processing.

There is a lack of interventions initiated before and after pregnancy for severe NVP.

Abstract

Nausea and vomiting of pregnancy (NVP) affects up to 90% of women, while hyperemesis gravidarum (HG), a severe form of NVP, impacts quality of life, and ability to eat and drink normally, with reported recurrence rates up to 89% in subsequent pregnancies. Severe NVP has a profound impact on maternal physical and mental health, impairing daily functioning and quality of life, and is associated with anxiety and depression.

To conduct a scoping review to identify and characterise interventions initiated before and after pregnancy that aim to mitigate the impact and consequences of severe NVP on maternal health.

A comprehensive search was conducted across seven electronic databases and included grey literature without restrictions on language or date. Eligible studies were identified according to a prespecified criteria. All references were screened independently by two reviewers.

Three studies were included; two utilised pre-emptive counselling and antiemetic treatment beginning before pregnancy or in early pregnancy/upon recognition of pregnancy, while one focused on post-pregnancy writing therapy. Both pre-emptive interventions reported a reduction in NVP symptom severity and a lower recurrence rate of HG, while writing therapy was beneficial in aiding recovery from severe NVP and allowed women an opportunity to externalise and process the experience.

This study revealed a paucity of interventions initiated before and after pregnancy for women with severe NVP. The included studies showed some benefits of pre-emptive treatment and writing therapy.

Tailored pre-pregnancy and postpartum interventions for women with previous severe NVP are urgently needed to address the physical and mental health burden of the condition.

Despite the profound physical and mental health effects of HG and a reported recurrence rate of up to 89% in subsequent pregnancies, there is limited knowledge of effective interventions initiated before and after pregnancy. This study highlights the scarcity of such interventions, identifying two pre-emptive pharmacological and counselling interventions that reduced NVP symptom severity and lowered HG recurrence and one post-pregnancy writing therapy intervention that aided in recovery and provided an opportunity for women to externalise and process their experience.

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