Vestibular symptom burden in hyperemesis gravidarum: A scale-based comparison with migraine and motion sickness

Purpose Motion sickness (MS), visually induced motion sickness (VIMS), hyperemesis gravidarum (HG), and migraine share a spectrum of symptoms, including nausea, vomiting, dizziness, and heightened motion sensitivity. These commonalities suggest a potential shared neurophysiological basis involving vestibular and central nervous system mechanisms. This study aimed to evaluate the association between HG severity, MS susceptibility, VIMS susceptibility, and migraine-related symptom burden from a specialized vestibular perspective. Methods This cross-sectional study included 1010 women with a history of pregnancy. Data were collected via a comprehensive online questionnaire. The following assessment tools were utilized: Pregnancy-Unique Quantification of Emesis (PUQE-24), Motion Sickness Susceptibility Questionnaire (MSSQ), Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ), Migraine Disability Assessment Scale (MIDAS), and Headache Impact Test-6 (HIT-6). Nonparametric tests were used for group comparisons and correlations. Results Participants were categorized as mild (44.5%), moderate (46.8%), or severe (8.7%) based on PUQE-24 scores. MSSQ, VIMSSQ, and HIT-6 scores differed significantly across HG severity groups ( p < .05), whereas MIDAS scores did not ( p = .055). Participants with severe HG symptoms demonstrated higher motion sickness and visually induced motion sickness susceptibility, as well as greater headache impact, compared with those reporting mild symptoms. Conclusions Greater HG severity was accompanied by greater susceptibility to MS and VIMS, as well as a greater migraine-related symptom burden, although the observed associations were generally limited in magnitude. These findings suggest a possible role of vestibular sensitivity in pregnancy-related nausea and vomiting. However, further studies incorporating objective vestibular assessments are needed to clarify its clinical and physiological relevance.