Pre-hospital healthcare for hyperemesis gravidarum: a cross-sectional analysis of baseline data from the SUKK-P study

Abstract Background Women suffering fromhyperemesis gravidarum need timely and appropriate treatment to alleviate symptoms and prevent complications to the mother and fetus. Aim The aim of this study was to identify and analyze treatment given prior to hospitalization to women included in the SUKK-P study. Methods This study presents cross-sectional analyses at enrollment in the prospective SUKK-P cohort study of hyperemesis gravidarum (HG) treatment. Women hospitalized for HG were included from 11 departments within Norway between February 2021 and December 2023. Self-reported symptom severity and its impact on daily life at inclusion, treatment and health care received prior to hospitalization were collected by survey and chart review. Results The majority (89%) of the 214 women included in SUKK-P had sought health care for nausea and vomiting during pregnancy (NVP)/HG prior to hospitalization. Although 88% had used one or more antiemetics prior to hospitalization, 42% were on sick leave for nausea prior to being offered antiemetic treatment. The median PUQE-score at hospitalization was 14 (interquartile range (IQR) 12–15) with a median wellbeing score of 2 (IQR 1–3). The participants reported severe impact on daily life in terms of reduced ability to perform household chores, care for children, and socialize. Nearly all (99%) were feeling low or depressed to some degree, and nine of ten reported that the nausea impacted the relationship with their partners. Half of the women reported having thoughts about terminating the pregnancy. One or more additional symptoms were reported by 97% with headache and hopelessness or feeling low as the most frequent, closely followed by difficulty sleeping, acid reflux, and constipation. Conclusions Women with hyperemesis gravidarum describe high level of distress, still there is a delay in being provided antiemetics as 42% reported provision of sick leave as first healthcare measure.